Mouthpiece for centrals???

[Chapalauser]

My sleep doc is suggesting a $2000 mouthpiece.My AHI is 15with 95% centrals and 5% hypopneas. I occaisonly get an obstructive.Am currently using an aircurve 10 vauto. My understanding is that a mouthpiece is used for obstructives and has no impact on centrals. I have been reducing pressure to lessen centrals but I believe the best way I am going to get close to 0 AHI is to switch to an asv. My sleep study 9 months ago showed an AHI of 64 so I have come a long way.
Would appreciate feedback.

[ChicagoGranny]

My AHI is 15with 95% centrals and 5% hypopneas.

Is that while using your machine, or was it during the sleep study without machine?

[LSAT]

viewtopic/t175302/WTS-Barely-used-Aircu ... 4ec423cbc5

[Chapalauser]

My AHI is 15with 95% centrals and 5% hypopneas.

Is that while using your machine, or was it during the sleep study without machine?

Ahi 15 is current using my machine.

[kteague]

Not the authority here by any means, just thinking this through. Do you have centrals even without CPAP treatment or did they emerge with treatment? If your centrals are pressure induced or exacerbated, being able to use a lower pressure due to use of a dental device in addition to CPAP could theoretically possibly result in fewer centrals. And also if your centrals are pressure induced, one would have to wonder if a dental device would lower one's obstructive AHI enough to make it an acceptable option instead of using CPAP, and thereby resolve the centrals.

If your centrals are secondary to a medication or neurologic in origin, all that is of no relevance to your situation.

IF your centrals have been reported on the machine only, I would want to know if the data appears to show they are true centrals or maybe just misreadings due to semi awake breathing.

That's a whole lot of ifs and maybes.

[zonker]

My sleep doc is suggesting a $2000 mouthpiece.My AHI is 15with 95% centrals and 5% hypopneas. I occaisonly get an obstructive.Am currently using an aircurve 10 vauto. My understanding is that a mouthpiece is used for obstructives and has no impact on centrals. I have been reducing pressure to lessen centrals but I believe the best way I am going to get close to 0 AHI is to switch to an asv. My sleep study 9 months ago showed an AHI of 64 so I have come a long way.
Would appreciate feedback.

any chance of posting some sleepyhead charts for the good folk here to comment upon?

[ChicagoGranny]

Ahi 15 is current using my machine.

OK, next question.

My sleep study 9 months ago showed an AHI of 64 so I have come a long way.

What was the breakdown of that 64 AHI? How many each of obstructive apneas, central apneas and hypopneas?

If you don't have a copy of your sleep study summary, get one. It's your legal right.

[TahoeGal]

I have had 2 different sleep drs. I have had to remind each of them once (and not as a new pt) that I have central apnea, not obstructive! Perhaps your dr. forgot you were a centrals patient. One of the drs (who I no longer see) absolutely insisted that I have a new sleep study because I had gained 30# in a year. That dr couldn't seem to get it that weight wouldn't make a difference. I was not having any trouble with my xpap therapy, and I had a sleep study 1.5 years prior. I really think they wanted the $$- they had an in-house sleep lab...

2K for a positioner is extremely expensive. The price should be $400-800. Seriously. I live in a resort town full of rich folks and they're around $600.

Good luck. Also, don't jump into a positioner if you have any TMJ issues.

[ChicagoGranny]

2K for a positioner is extremely expensive. The price should be $400-800. Seriously. I live in a resort town full of rich folks and they're around $600.

What are you calling a "positioner"?

Typically, doctors will prescribe a custom-made Mandibular Advancement Device (MAD). These run $1500+. It's not uncommon to see them at $2000.

If he truly has central sleep apnea, any oral appliance is likely to be worthless for treat the condition.

[TahoeGal]

2K for a positioner is extremely expensive. The price should be $400-800. Seriously. I live in a resort town full of rich folks and they're around $600.

What are you calling a "positioner"?

Typically, doctors will prescribe a custom-made Mandibular Advancement Device (MAD). These run $1500+. It's not uncommon to see them at $2000.

If he truly has central sleep apnea, any oral appliance is likely to be worthless for treat the condition.

Yes, a MAD. From a dentist, lab made. Maybe the price is super high at a sleep specialist? The lab cost is about $200. Impressions and time aren't much.

[palerider]

Yes, a MAD. From a dentist, lab made. Maybe the price is super high at a sleep specialist? The lab cost is about $200. Impressions and time aren't much.

I don't know where you're getting those discount rates, all the ones I've heard about people getting from their dentists were in the multiple thousands of dollars.

[ChicagoGranny]

Maybe the price is super high at a sleep specialist? The lab cost is about $200. Impressions and time aren't much.

No. Taking costs at a few points of the process will not achieve a good estimate of the price to the consumer. What the MAD supplier is willing to do the work for is a different thing.

From the American Sleep Apnea Association:

The average cost for a sleep apnea mouth guard is estimated at $1800 – $2000. This includes the actual mouthpiece, dentist visits, adjustments, follow ups and modifications to the dental device. Most health insurance companies and Medicare cover sleep apnea oral appliances.

https://www.sleepassociation.org/sleep- ... eep-apnea/

2K for a positioner is extremely expensive. The price should be $400-800. Seriously. I live in a resort town full of rich folks and they're around $600.

If your dentist is providing MADs for $600 in a town with high real estate values, he must be riding a mule in from back o' beyond and practicing in a tent.

You may be thinking about a tooth guard which is not adjustable and does not advance the lower jaw.