Why didn't my Pillar cure my snoring?

[RickRed]

Happy Thanksgiving

I've always thought snoring was a function of a weak and vibrating pallet. So when I went for the Pillar procedure I wasn't looking for a cure for apnea, as much as I was looking for a procedure that would cure my snoring. I'm a light sleeper and my own snoring would wake me many times per night. Nothing about that changed after my pillar.
Why doesn't the pillar cure snoring?

It took a pillar and the dental appliance to stop me from snoring. At that point I went for a sleep study and found the pillar and dental appliance combo treated my apnea successfully.

My ENT assures me my pallet does not vibrate.

Yet one year post pillar, when I try to take a short nap without the dental appliance, I can hardly get to sleep because hear myself snoring. Now, if my pallet isn't vibrating, what the heck is making all that noise??


Rick

[sleep talker]

I saw your post and will take a stab at the question. Snoring comes from tissue flopping around. Interesting that the dental appliance stops your snoring. The dental appliance works on the tongue base and holds that slightly forward out of the airway. That would be a partial explanation. Yet, I believe you're seeking the answer why wide awake and during the day, you don't have the same snoring noise when you're breathing normally? It is obviously an interuption of the signals between the brain and the nerve endings in the muscle/tissue in the airway are occuring. Perhaps this is the answer you seek? Why does your brain relax the tissue in your throat?

[Guest]

Still snoring? even after pillar? even after dental a device? why that is impossible.

haven't you read the pillar studies? that cannot happen, give it 90 more days, some patients it can take longer for the snake-oil to completely soak in.

[Sleepy Stoboy]

<drummer plays rimshot for mysterious "guest">

Guest, that is TOO funny! Wow! Hold on, let me collect myself first.

I'm telling ya, you gots to go on the road with that whole "snake oil" bit. I mean, I get what you're saying, it's like you're saying, hey, people don't still sell snake oil, cuz like that's what used to happen in the olden days, but wait, there's this pillar implant thing, and that's just like snake oil, cuz some really stupid people are getting fooled, and it might as well come off a wagon cart! Whoa, the truth can sure be funny!

You see, if it weren't for your warnings, hundreds, if not thousands of people will now be saved.

But most of all, I love that you do it in a light and breezy way, that allows all of us just to sit and laugh and laugh, and then realize how stupid we're being. It's just really cool that you take time out of your day job as both a rocket scientist and stand up comedian to give us your fresh perspectives.

As you step back into your cloak of anonymity, just know that just like some super hero, even though we can't see you or know your secret identity, we're all indebted to you.

[RickRed]

Dear Guest,

You responded to my post by saying

[Less Sleepy]

I'm not totally convinced that "guest" has OSA or is a CPAP user.

RickRed, I AM a CPAP user, and I support your efforts in finding alternatives. I think I represent the majority of CPAP users. Don't paint us all with the brush of one ignorant jerk.

[RickRed]

My comment wasn't meant to paint everyone with one brush, but I have experienced this kind of reaction MORE than ONCE and from different people so, I just started a new thread asking why this kind of reaction is present on this side of the forum, because it is there by a VERY SMALL MINORITY of people.
Rick

[Guest]

Rick,
If your combination of pillar and tap has worked for you then what are the issues that you still have? You are really active and want to volunteer and advocate pillar+tap, that is great!! Thanks.

[RickRed]

Guest,

[Less Sleepy]

RickRed, I kind of wonder if the dental device would have solved your problem without the pillars. I do wish the medical community would do some major longitudinal studies to evaluate which are the best approaches for which patients, so we wouldn't have to go through procedures that aren't likely to be helpful. Personally, I think UPPP needs to be moved to the category of experimental procedures until some serious, objective, longitudinal studies are complete, and comparison is made with palatal pillar implants.

Guest, would you mind staying out of this discussion unless you have something useful to contribute.

[Billinseattle]

Yes, Less Sleepy.

I agree !

I'm very skeptical that anything that works on the palate (UPPP or pillar) really addresses the major cause of OSA in most people...tongue base obstruction. I suppose it does indirectly, by strutting or nipping away at the the palate creating milimeters of airway. But, I think the dental device...or (in my case) a jaw and tongue advancement really addresses the problem by creating a centimeter (or more) of airway space.

I think Rick's snoring without the appliance demonstrates this principle.

It seems to go along with my thought that a UPPP or pillar alone won't work for moderate or severe OSA...which seems to involve untreated base of the tongue obstructions.

Just my opinion...no data involved.

Bill

[dizzy]

From the Restore webpage:
"The Pillar® Procedure
An effective, first-line treatment for
sleep apnea and snoring"

Hey Rick, do you think maybe you can get some of your money back?

Because if it doesn't help you with snoring, wasn't that one of their very first claims of this procedure? and we know it clearly doesn't cure OSA so what good is it having the procedure done?

I agree with Less Sleepy's suggestion, it was most likely the Dental Device that offered you any relief at all, your continued snoring proves it.

Like I said before OSA is your tongue falling into the back of your throat, stiffening or even removing some of your soft palate isn't going to prevent that from happening. That is why the UPPP, the LAUP and other palatal treatments often fail. If you have an obstruction those procedures can sometimes help. The MMA procedure pulls your tongue forward where it is attached.

The TAP dental device works by moving the jaw down and forward, then there is only so much you can actually move the jaw, that is why for so many years it was used by only those with mild OSA. But the Dental profession has always been straight forward with patients on the expectations of the device. Even with the void of studies, long term use of the device will prove weather it works or not.

Maybe you should look into the MMA procedure? But I'd look for a new ENT, not the one that has been giving you the poor advice so far, or has that just been Stoboy? What does he have to say about your snoring? I can't wait to read that response.

Since you guys are the self-proclaimed "advocates" for the Dental Forum, maybe you should be suggesting to folks over there that they FIRST try the Dental Device and save their money on the less proven procedures.

That would seem to me to be much better advice then preying on people trying to make a go with cpap.

P.S. Guest (that was way too funny don't care what anyone says).

[Sleepy Stoboy]

Dizzy, you've been consistent in your disdain for the pillar implants from the start, so your position isn't new.

Dental devices have been proven to lower RDIs to zero in many cases, in several studies side by side with CPAP. So no one will disagree that going straight to a dental device could resolve the apnea.

But you're wrong to continue to insinuate that having the pillar implants isn't a constructive part of a treatment plan. In my case, my apnea index was CUT IN HALF by the pillar implants, from 36 to 18. Why shouldn't I be thrilled that a 45 minute outpatient surgery cut my apnea in half?

As for the elimination of snoring, I guess you'd have to convince me that snoring is only related to the palatal segment of the airway. Are you saying that the only thing that leads to snoring is a weak palate? How about the rest of the airway? Dr. Dizzy, can you weigh in here? Even Restore's sight claims that 80% of bed partners report success with snoring. I don't remember seeing them claim 100%. You cherry pick what you want from the site to prove your point, which again doesn't lead itself to an intelligent, balanced discussion. But thanks for thinking of me in your post.

This guest is disruptive and counterproductive to a healthy discussion on alternative treatments. The fact that you would encourage them says a lot about your desire to see this treatment option ridiculed.

[RickRed]

Dizzy,
I don't understand you. I've read your posts when others need help. You are informative and helpful. Then the topic of Pillars and alternative treatments come up and you come on board in an attack and sarcastic mode and encourage others to do the same.

Help me understand why you seem so angry at those of us who are off CPAP and found alternative treatments.
Rick

[Less Sleepy]

I'm a little dismayed and disappointed, Dizzy. I usually have a lot of respect for what you have to say.

As I said in another thread, nobody has room to be dogmatic about any of this. There isn't enough science out there to support anybody's position. I, for one, am glad there are some people out there willing to take a different road, whether to be an explorer or for reasons of desperation because they can't adjust to xPAP. Even using AutoPAP is still considered "out there" by a lot of sleep specialists - mine included. Just like dental devices, AutoPAP works well for many people, but not for everyone (didn't work at all for me). I'm still glad there are people trying it. That is how progress is made.

We need to find a way to put pressure on the "system" to do some basic, objective research - first into determining which procedures work and how well. Also to determine why some people still continue to be sleepy even though they appear to be adequately treated with xPAP.