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Episode 88 - Heather McAdoo - Combining CPAP, Oral Appliance Therapy and Myofunctional Therapy


Hey everyone, it’s Emma Cooksey here and I'm your host.

So today I am interviewing Heather.

And I was really interested to talk to Heather because she was using a new company called Empire or sleep for diagnosis and treatment of her sleep apnea.


So what they do is quite different from the traditional, you know, medical saying, where you wait a really long time.

And You know, see the doctor for 10 minutes if you're lucky and it seems like they're trying to address a lot of the problems in traditional Healthcare, so Heather describes talking to her, doctor doctor show prefer like an hour for their first intake call, which is kind of unheard of, right?


So it's a good interview, just to kind of learn a bit about some of the new services for people with sleep apnea popping up.

The other thing that I think is really helpful to take away This episode is the fact that oftentimes sleep apnea patients are put on CPAP.


And then nothing happens for like, a year, like they go back after a year and often times, if they're even still using their machine, the doctor will just look at the data from their CPAP machine.

You know, if the data from the CPAP looks fine that'll be that whereas what was happening with Heather and her doctor through A asleep was they were actually tracking her data using a wearable ring so that you were using asleep image ring to look at whether she was having oxygen desaturation even with the CPAP.


So that let them figure out, you know, whether adding other therapies to what she was doing would help her.

So Heather explains a lot about yourself, in the end, the episode She is, newly retired, and she lives in Colorado.


Without further Ado, here's my conversation with Heather McAdoo.

So, listen, Heather.

Thanks for joining me.

We've got so much to talk about, and but the main reason I wanted to talk to you was about you using this Empower home sleep testing thing.


But you wanted before we get into that, do you want to just set the scene for everybody about?

Who you are, where you live, what you do, like, all of that.

And then we can talk a bit about the sleep apnea, part of it.

Okay, my name is Heather.

I live in Boulder, County Colorado, and I am retired fully retired now for a year, and so nice.


Yeah, my journey with all this CPAP breathing issue started in 2019 with my dental hygienist, who's really been?

Me along through this whole thing.

She encouraged me to go to vivos to get a sleep test in 2019.


So I did and I got the mouth device that they give you in the beginning, we had an expansion Appliance or did you have one that held your jaw forward?

It's got an upper and lower thing on it.


Is it connected together?

No, no, no.

So you had a DNA, upper and lower doing Mention that, you know, more about this than I do.

Yes, that's what I had.

It did nothing for me.


And then I got very frustrated and hot.


How long was that what you were going through that process a year?

And what did you sleep?

Studies say, did it say it?

Did they tell you like, what your age I was or how severe sleep apnea was we?

We only did a sleep test in the very beginning when I started with them and and my numbers less than 90 for the breathing was pretty bad.


Listen, 90%.

Oh, so there's oxygen desaturation.




And I didn't realize how bad that was.

Yeah, what it.


It really meant.

So dropping below. 90 below 80 sometimes goodness.




So How did to you, did they tell you about an H?

I like the number of times she stopped breathing an hour, or they didn't really say that nothing.

Okay, yes, that's with the different dentist provider there because then I go back to my hygienist again.


And she says, I want you to go back to be bows.

They have a new provider there.

I think you like her.

So, I went back and met with Dr. Smiley and she's very holistic in her approach.


Yeah, for my personal belief system.


So, you know, I told her the issues I was having and we did another sleep test.

And when I went back to get the results, she came out.

And just stood there, she said, oh my God.

Your hypoxia is horrible.


You need to talk to Dr. Chopra well, okay.

So, so was the task that you did with Dr. .Smiley

That would be Empower at home thing.

Or was that a different?

It's a different one.




So her office got me in touch with Dr. Chopra okay.

Empower SLI, and so we had our first meeting and the first thing that blew me away is he spent over an hour with me on the phone, or when detail, and how often you get an hour on the phone with the doctor, no often ever.


So so was this and so they Empower thing was that covered by your insurance or you were paying out of pocket or hi to that.

I paid.

I paid out of pocket for that.


And then so her point and me getting the Dr. Chopra was to get a CPAP machine.


Got it.

So he and I talked at length and he got me set up for the CPAP and I started with the nose, whatever loose yeah.

Yep, I did not like that at all.


I felt like there was a hurricane going through my head and I thought this is not going to work for me, and I've been avoiding CPAP because I get very claustrophobic.

And I thought the map, the big thing is not going to work for me.

Yeah, I did great with it.


It was a very smooth transition and I said, oh my God, I really like this.

Oh good, yeah.

So did you find that?

You felt better.

We didn't talk a lot about how you were feeling during the day, but I'm assuming that if you're Austin was dropping like that that you were feeling really tired.


And oh, yeah, great.


Oh yes.


I just kind of assumed.



And so was that immediately better when you started CPAP or hide?

It hide of that way.

It's hard to remember my mind with time these days, it's slowly did start getting better.


The one, the one thing I was really Concerned about when I started with him was I was having horrible brain fog issues.

That was one of the thing and I also have Lyme disease which contributes to that.


So, we hired, as the brain fog show up in your life, like I definitely deal with that too.


And so for me it's things like, like, if I don't write things down, I it's not happening.


I do things were all, like, leave groceries in the car.

Car and just kind of forget and all of that.

So is that the kind of thing that was happening with you?


It was like that but you know, when I was diagnosed with Lyme in 2013, I know that that, you know that place is all in this.

I knew nothing about sleep issues back in those days.


So what I was saying to Dr. Chopra is I, I was still working at the time.


I said, I'm in the kitchen and I say to myself, oh, you need to go to your computer and pull this file up and do blah, blah blah.

So we're talking ten, fifteen steps into my office.

Yeah and I just stand there and go.

Oh no idea why you're there.


Exactly exactly and it was bad.

And then the joke I had with him is when I get together with my next-door neighbor words, wouldn't come to me and I would just do my hands around and she would finish the sentence for me.


So, you know, she knew where I was trying to go, but it was to the point where it was really scary.

Scaring me.

Yeah so the I think the main thing that got me excited was that my brain fog was so unbelievably improved I still have issues but you know it could be age-related but it is so much better but Fang


And so Dr. Show Pratt is he a board-certified sleep specialist.

So he okay, got it, got it.

And so yeah.

So you said and with the Empire thing you said, you talked on the phone for an hour, we did a zoom meeting got it.


And then after that what tell take me through a little bit of the home testing element of that.

Like, how did that happen?

Like, does it just arrived at your door?

Or like is there a nap?

Well, he He got this set up with the CPAP.


And that, that was very easy, done.

His people are really his staff are great, getting me what I needed and then I'm looking over at the for that.

So, you did.

So I think we said you did another sleep study with him.

So after after I got the sleep after I got the same path.


Okay, we started doing testing again, okay, so I have my notes here so I Already working with him in October, 20, 21.

And so, he was looking app, a sleep study, you'd already done with the dentist to heal.


Well, he looked at that.

And then he also sent me the ring and we did, we did three more nights so he could look at that.

So that he would have, he could justify me getting the CPAP machine, got it.

So there was a ring.

The arrived at your yard or Or, and you just put it on?


Does it work with an app on your phone or us?


Yeah, it's the same app that I was using with Dr. Smiley and it's very easy to use.

The only thing you have to be careful about is, if you get up, you know, in the middle of the night to go to the kitchen to feed your cat or something, you have to carry your phone with you.


So it doesn't connect.

And so do, you know, was it sleep image?

Do you know what kind of ring it was?

Does it have a little thing on the top?

I think it was sleep image.



It just so, it felt fairly comfortable to sleep in, right?

Like, it doesn't have an easy Source on your, on your finger.



And so, along with doing those tests I told you this online on an email.

Yeah, I had ordered, you know, Rings myself to test, and the results were really frightening.


So I kept sending my spreadsheets to Dr .Choake We're going something's wrong here.

This isn't right.

This is while you're were using CPAP.



And then my acupuncturist said to me, are you sure that the Sleep ring is accurate?


Have you tested it during the day?


See what else was another ring?

You had ordered online.



Yes, because I am obsessed with data spreadsheets.

So anything I can get to get more data together.


For me, it's helpful.


So we found out that that ring was useless and after many calls with dr.

Chopra after many spreadsheets that I said, I'm going look at this.

Look at this.

This is how, you know, I should be dead based on what the ring said.



So he then, in March of this year, this is when I was working with the other ring.

We did a, we did a bunch of test where I would test it without the CPAP and the numbers still were not looking great.


So he said, we need to try something else.

Even with the CPAP, the numbers were not looking great.


Okay, we're still concerning.


So yeah, back in March, I would be below 90 for over an hour.


And so they're looking at oxygen desaturation is not getting better.

And so what about how you were feeling?

Like you felt a little bit better.

You said, but it still wasn't the brain fog was better, but I still wasn't like perky or anything.


Yeah, so he sent me back to Dr. Smiley to order the myofunctional advancement device where it has a popular advancement.



Keeping your lower jaw forward and bringing your tongue and soft tissue forward, right?


I know exactly what you're talking about, right?


So when I went to meet with her to get fitted for the device, my hygienist also said, I think you need to do myofunctional therapy.

I think you have a tongue tie so when I went back to


Dr. Smiley she said, oh my God.


Do have a tongue tie.

I'm working with some really great people for myofunctional therapy.

Let me get you in touch with them.

Okay, so yeah, so I worked wins.

I know.

It was my God.



Well, she's really good because she also wanted me to start craniosacral therapy.

Yeah, which I did and she referred me to a woman here in town.

So, I've been doing the cranial sacral therapy.

So, I started the myofunctional and eight.



And that's when I learned about the breathing and putting tape on your mouth at night, the James, Nestor and the oxygen Advantage, which was all new to me.


And I taught was April of this year.


Yeah, so I got really angry.

I said this information has been available for so long.

Why don't we know why this It just I know I'm not going to get into my personal opinions on that.


So the the myofunctional was great and I was excited to, you know, read the oxygen advantage and afters fault.

And what was your nasal breathing like before that were you nice breathing before that or yes?


Wait timeout reader.

Okay, thanks I'm a traitor and it's the same time that I I started taping my mouth.

My acupuncturist did too, because she and I were talking about my journey with all this, and she said, oh my God, you know, I can sleep all night now.



So it's so you could breathe through your nose.

You just weren't because she were, your worm is breathing, and nobody had told you my, everything's not good thing, right?



So That was fun because I've learned so much from the woman that I've worked with the bio functional and she is makes it fun.


It's challenging, really jonesing.

Yeah, especially to begin with.

I remember starting my emotional therapy and just being, like, that's not possible.

I remember thinking like, how do people even get their tongue on the roof of their mouth?

Like just seems like craziness to me but yeah, you probably have enough and then these things, you know, you realize that you can do them well and it's fine.


Because I would, you know, do something and she would give me my assignments and I go, oh God.

That's really hard.

And then our next meeting.


Oh, that's easy.

Give me more challenges.

Yeah, you know, we got to be a joke.

I mean, the improvements in my mental health on top of everything else was so great.



And then what?

Yeah, we didn't talk before about mental health.

I know that you talked about brain fog but Right.

I mean, I virtually haven't talked to anybody who was sleep apnea, that isn't dealing with some sort of mental health impact, whether that's anxiety depression or, you know, just people who their mood, you know, is a problem because they're so tired, all the time.


So, was that a problem for you before you started this whole journey?


But I didn't make the connection until I was in your podcast.

And I went, oh, I did.

No, the two were related.

Yes, it just you've just opened my world up his so many world.


I'm so pleased.


Oh God.

But it and then I thought this makes so much sense.


And I think that especially, so for me, I had craniosacral therapy to and I also had a tongue tie released and yeah, we could well go on to the two girls I think.


And and then I was working with My Father, Charles therapist as well.

And I think that the thing about that, which it can't be overstated, so it's not just about how you're sleeping.

So Learning To Breathe properly, using your nose, has a tremendous impact on your, you know, anxiety levels and how you feel in your body and like resting your tongue on the roof of your mouth, even for the vagus nerve and I'm totally not an expert in it.


But I just know that it feels completely different are able to rest.

Like with your tongue in the correct position, you feel your you know your body feels much more relaxed than if your mouth breathing all the time and why haven't we known about this?


Whatever I know.

So tell me about you said about the tongue tie and you're working with the myofunctional therapist and then did you have a tongue tie release or yeah?

Amy and I might myofunctional therapist and I you know, we're talking about the tongue tie.


And she wanted me to get through a certain number of meetings with her.

And then I kind of had to get cleared by them that it was okay for me to get the surgery, which is the perfect way to do it because people who do a tongue tie release especially as an adult with the wrong tongue posture and not with, you know, having built up all of the muscles in your tongue.


If you have a tongue tie release done with none of that, Operation work.

Your tongue doesn't know what to do with it.

Sell, that was why I did I did the my emotional therapy up until the point.

The, my emotional therapist said, okay, we have enough strength and tone and you know what you're doing.


And then I had the time to release and was able to, you know, like then carry on and do exercises to keep that, you know, K supposed to be, right?

So I had the therapy done on a say a Wednesday afternoon.



And then that the five o'clock that afternoon.

I got a video, These are the exercises, you need to start doing today and I thought I just have this surgery this hurts.

I know I mean, I was like, are you kidding me?



But it, you know, it hurt for about a month and and then after that it was like gosh I can do so many more things now.

Yeah, I remember I was kind of annoying but Many people were talking about, I think I talked to a lot of people who were talking about tying ties, like tongue-tie releases in children and I had a big old tongue tie.


So like my release was, I mean, it was surgery, you know?

Wait, you really.

I think that going into it.

I thought well, you know, it's not going to be that bad.

And you know, after a couple of days it will be completely fine.



It was a recovery like it was a couple of weeks of really like having to do all those exercises and just not being very happy.


It's not comfortable.

No, it's not comfortable.

No, but worth it.


Oh, absolutely.

But I appreciated the fact that, you know, that day I had to keep up with my exercises and, you know, she did, I had the laser surgery does.


Which I It was so gross and Mao's weird.


It smells nasty.

Yeah, so when I scheduled the appointment I said, do I need to have somebody drive me home or will I be?


She said no, you'll be okay.

And I was, but it's I mean it messes up your system.



And so did you feel like I'm just always interested in other people's experience because I definitely felt like, I mean, I don't just have been living with this.

This tongue-tie since birth but I definitely on the way home felt this feeling of like, you know, a lot of tension seemed to be kind of like, gone from my face.


Did you have a similar experience?

That's why do you say that?

Because I remember exactly where I was on the road coming home going, oh my God, touching your face.

And yeah, this feels so different.


And then, you know, I was doing the cranial sacral at the same I mean, the woman I'm working with said, your face looks different, you know, with the work she was doing and I mean, my tongue tie I've had since birth and I'm in my 60s.


So, you're way ahead of me.


Guess, I'm in my forties, but, you know, some days.

I feel like I'm in the sixties.

It depends.

Sweet young thing.

Oh, I love that.

I'm gonna go tell my husband, so you got through that.



Releasing you carried on with the myofunctional therapy and then what was?

So what was happening?

So I'm trying to figure out for the listeners.

The experience of working with the m power system.


Like, is there an ongoing app or nose just work with that one doctor on Zoom.

What I had talked to dr.

Chopra and I said, now that I've had the surgery, I want to do more tests.

So I went to the vivos office and got the ring, because I wanted to collect data on how?



My numbers were with the CPAP.

No mouth.

Device know bout, no mouth device, no CPAP with nothing.

Just keep my mouth to look at the numbers there to compare them.

So, we did that and we did a bunch in August, And we did a bunch the August 24th through the 30th, okay?


They pathology nothing CPAP and mouse device and just the amount of ice.

And what did it say?

Well, he when he looked at the results from my CPAP machine admit, I have the bedrest machine.

They were really driving with what was showing up with the ring results.


That and he said some things me too.

I hear ya.

So then they, They sent me and you have a podcast on this.

The watch Pat, one?

Yes, II, mean, I love that.


It's so easy.

And so before you've been doing the Sleep image ring, but then he said, let's try the watch that one.


And so I did that October 16th.

So for people at home, the watch Pat, is it goes Ranger risk.


There's something on your finger, and then you have a sensor on your Chest but you sleep in your own home and it was sent to your house and you don't want to go anywhere, do a home, it is it is so easy and you liked it.

So then what did that show?

I mean, I was like perfect lesson and minute below 90, that was it and that was with the mandibular advancement device, or would the same time with and mandibular, the CPAP and taking my mouth all together.



Yeah, so he was, you know, we were both through the moon with that.


And then the thing, I mean, I love the watch pad.

I wish you.

You could get more tests more than one night with it.


Yeah, it's my insurance, only covers the one test, so that's why I've emailed you, you know.

Do you know, of a good ring?

I could get on my own.

Just continue to collect the data.


But I'm going to see, Dr. Miley on the 30th of this month to, you know, see how the mouth device is doing.


And I want to do some more testing with just the ring and see what the results look like.

And then so be.

It sounds like so in terms of how you're feeling though, so now the combination of the mandibular advancement device, the CPAP and taping your mind, it seems like like as far as the date is concerned, it seems like you've kind of cracked it.


How are you feeling day-to-day?

I most days.

I feel really good.


Yeah, the, the brain fog is really good, but I, you know, I got a background in health statistics and I just like, to keep collecting data.


So, I mean, Dr. Chopra just laughs when I go here's the new spreadsheet.


It just makes it easier.


Well for sure.

So I guess I, I guess I don't really so that.

So some of the Some of these options where you have telemedicine and home testing and telemedicine follow-up.


It's like a sort of flat rate and you don't charge insurance and so Jack date.

They charge Insurance either charging.

Yeah, I pay for the initial consultation with him.


And then after that, my insurance is covered everything.



All right.

Good to know.

That's great.


And so, how do you feel about the using doctor?

She Oprah and the be able to do the telemedicine like Zoom call rather than having to actually go to an office.


I love it.

Yeah, I love it.

I mean, it's, you know, it's like talking to you right now, any questions that I have is always there to answer for me, I can send him, you know, emails or text messages, and answers my question.

And so all the testing you've done, you've never had to go to a lab to do an, you know, a sleep study.


A Sleep Clinic.


And how do you feel about that?

I feel very good about that because it one point when I was still having problems, you know, with the air, he said I may send you to, you know, it's hydrating.



And I thought I do not want to do that.

I have half you do that.

So then when we got my results, you know, the last results in October, he said that's off the table, you're going to be fine.

That's tremendous.

It makes me.

So So happy either.


Well, me too, but I mean, I love working with Dr. Chopra his, you know, the people he works with, get back to me, answer any of my questions and I can schedule my appointments online with him.

And yeah, I've all my questions lined up and he, you know, he always make sure do you understand everything that I'm telling you, which is amazing which you think would be really basic, but among, It's really not.



So so I guess what I'm trying to understand is like, what is the interface like?

So do you go online on your computer?

Or is it an app that you make the like your appointments and that kind of thing on it?

Some it's an email address.


You gives me a line to their offices, okay?

And then I just click on that and you know find its time where I can meet with him and perfect.

It can't be any easier, it's going to be any easier.

Well, I'm glad you figured out all.


I the only thing and I'm wondering just because have you discovered Oscar?



What is it?

Okay, there's a free software program called Oscar 0 SC AR, I'm taking over.


I mean, you're just gonna love me.

There was free you go on.

I want to say I mean, like, honestly just Google Oscar CPAP data.

And it will come up and it's called like the website is called sleep.


Like I remember what the website is.

Anyway, it comes up and it says, do you want to download this free software or whatever and you choose whether you're on like a PC or a Max or lineups or whatever you download it you take the EM don't ever have it here and the SD card at the side of your seat.


That machine?

You said you had two resonant.


So they're in this site.

Is that there says 10?


Okay, so in the, on the left hand side, you're going to look and it's got a little blue thing where it says SD card.


Yeah, and you're going to open it and you're going to take out the blue SD card, you're gonna get one of these, let me show you what it looks like.

You're going to find something.

That's got an SUV door.

Some computers actually already have them in them, but mine didn't.



So it's an SD card reader and it's like that they're not expensive and it's got a USB on one end.

You put your blue SD card from your res.

Meds are size 10 in here.

You shove it in your USB for you open, Oscar and it goes, do you want to download your data?


And you say yes, and it literally takes all the data from because you think that you You're seeing all the data but that's not all the data.

No, I know, right?

So you're just seeing like the little app that does the smiley face and all that?


No, no, so take this and download the data into that Oscar program and it lets you look at the total breakdown, how many of your apneas or obstructive?

How many of them are Central?

How long, like everything, like all about the pressure.


If you have it set to a path, it'll You like, this is when the pressure ramped up and down, it tells you, if you have huge leaks, like, don't pay attention to the, you know, the green smiley face like Oscar will tell you like, this is where you had a large leak.


And then whether you had it like a small leak all night, or whether you have like one big leak.

It's totally amazing for like troubleshooting.

Like so for a lot of people there, like why do I need that?

And I'm like you don't really but I'm kind of I'm not.


Not super tacky.

I feel like you're more tacky than me, but I am really curious like why, why is it doing that?

Like, why am I sleeping much better?

This night than that night and you know, just fine tuning like this.

Matt, this mask actually leaks less than the other mask and just different things.


Like I just like to kind of, like, try stuff out.

Like if I sleep only on my left side, is it better and like really the different nights and what your age I was and all that.

I Like someone who got you, one of these for Christmas.

And yeah, I love that because, as I said, I love data.


Yeah, I love data Oscar a sure thing.

So if you ever have you ever discovered Jason sasame he's got like, okay, so so his comedy is not to everyone's taste, I interviewed him on my podcast, we had a really good discussion and he's asleep tack.


But he also So has sleep apnea himself and use a CPAP and he has a YouTube channel called the lanky Lefty 27.

That's the one I was going to listen to today on.

Okay, so I love him and I think he's hilarious but it just kind of depends.


Like some people are like that guy.

So goofy.

And I'm just like, I know but I'm okay with that.

Like yeah, make it funny?

Yeah, it's make funniest, right?

So he is a tote like he's much more.

An expert on Oscar than I am.


If you want, like, ideas on how to use the data and like, how to manipulate it and stuff, his YouTube videos are always worse than people because he knows a lot more than I do.

That sounds good, because I was joking with Dr. Chopra last time because, you know, I look at the test results and I go, I only know the look at certain parts of it.


Yeah, he said, you need to do a class on this.

I know, so we all know.

Well, the other The issue that Dr. Chopra and I have to deal with with me is the altitude here because I'm almost in a while.


And he thought he thought that had, you know, a big impact on it and I said it might.


But I also used to live in New Mexico for five years and I wasn't having the problems there.

So for my to be altitude is figuring into that oxygen draw?



Yeah, he wants me to plan a trip at some point to sea level and take a test to see if it would be really interesting.


And so listen.

Heather, thank you so much for all your time.


I really appreciate it and it's been an absolute pleasure talking to you.

Thank you so much.

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