For patients with obstructive sleep apnea, CPAP is the gold standard treatment. The only problem is a lot of patients don’t like it. At Chicago ENT, we have recently begun to work with a newer device called Provent Nasal EPAP. “That’s it?” you might ask when you see what it looks like; a disposable sticker placed over each nostril prior to going to sleep. That’s it! But look a little closer…
Unlike CPAP which provides continuous positive airway pressure to keep the airway open during inspiration and expiration, Provent provides EPAP – positive airway pressure during expiration only.
How? Each sticker contains a central valve that stays open during inspiration allowing unobstructed airflow. The valve then closes during expiration leaving only a small hole to breathe out through. This expiratory resistance increases airway caliber towards the critical end-expiratory period in particular. Imagine trying to blow out a birthday candle on the other side of the room while breathing out through a drinking straw… same idea.
Why is the end-expiratory period critical? Because you’re just about to take another breath in! Without the externally provided positive pressure from CPAP or EPAP during this period, the upper airway is left prone to collapse as a result of negative pressure in the chest. Now imagine bending the drinking straw in the middle and trying to breathe in through it.
Like any new device, Provent takes some getting used to, but a number of studies conducted to date have shown excellent results for patients with mild right through to very severe sleep apnea.
If you’re not a fan of CPAP, there’s a lot more to be gained than to be lost by trying Provent. In fact, Dr Friedman and the team at Chicago ENT are so convinced of its potential, they’re about to start a study of their own.