Provent a New Option for Sleep Apnea
By RISHI SHARMA , M.D.
It may look like she's strapping herself in for a trip to space, but Carol Lennon is actually getting ready to go to sleep.
The cumbersome mask that pumps air through Lennon's nostrils to keep her airways open at night, called a Continuous Positive Airway Pressure, or CPAP machine, is so uncomfortable, she'd rather wake up gasping for breath.
"I just refuse to use it," said Lennon, who lives just outside Cleveland.
Lennon, 53, has sleep apnea, a disorder that causes her breathing to repeatedly stop and start throughout the night. Not only does sleep apnea leave Lennon feeling tired, it's linked to an increased risk of heart disease, depression and death.
It also makes her snore.
"According to my boyfriend it was getting worse and worse," said Lennon.
"This is the one device that seems to rival CPAP," said Dr. Joe Golish, Professor of Pulmonary and Sleep Medicine at The MetroHealth System in Cleveland.
Provent is a small patch that fits over the nose with two small plugs in each nostril. During inhalation, a valve opens, allowing air to flow in freely. During exhalation, the valve closes. Air is directed out through two small channels, increasing the pressure in the airway and helping to keep it open.
Provent is a welcome rival to CPAP, which has long been the gold standard for treating sleep apnea. More than half of patients who try using CPAP stop using it.
"I knew I wouldn't wear it," said Lennon, calling the loud, cumbersome mask "obstructive" and "unattractive."
But Provent has its drawbacks, too. At $2 per night, it's expensive, not covered by insurance, and it only works in about half the people who try it.
"The main complaint has been the inability to tolerate having the plugs in their nose," said Dr. Nanci Yuan, medical director of the pediatric sleep center at Stanford University. "They complain of feeling like they are suffocating as they are unable to generate enough air pressure or movement."
Yuan added that patients with nasal congestion have found Provent to be useful.
"It may be effective, more so in patients with snoring alone and those with mild-moderate sleep apnea," said Dr. Donald Greenblatt, director of the University of Rochester Sleep Disorders Center. "It also may be useful for travel in patients using CPAP at home."
Provent did work for Lennon.
"I don't snore anymore, I'm sleeping better and I feel good," she said. "I'm not waking up all the time and tossing and turning."
Dr. Rishi Sharma is chief medical resident at Henry Ford Hospital in Detroit.