Anyone use oral appliance with CPAP ?

[dcg494]

Hi everybody, has anyone tried using both cpap and a MAD device ? do you think using both helps, and do you think it would lower the cpap pressure required ?

I already have an oral appliance, but I cannot use it alone because the advancement I need is too much for my jaw to handle.

Also, CPAP alone just doesn't cut it for me. Because of aerophagia, I cannot get the pressure up to the therapeutic pressure I need.

I think using an oral appliance + cpap would lower my pressure requirement and lower the advancement required of the oral appliance. What do you all think ? Anyone have experience in this ?

[D.H.]

This is a question for the sleep specialists.

There just isn't a very large sample of patients using both at this time. Certainly, it's reasonable that some might need both.

I also wonder if some might need to use the Inspire implant in conjunction with CPAP and/or an oral device.

[ChicagoGranny]

Hi everybody, has anyone tried using both cpap and a MAD device ? do you think using both helps, and do you think it would lower the cpap pressure required ?

1. Yes, there are forum members who use both.

2. It might help to decrease the pressure needs. You would have to try it to know.

There are a lot of people who use foam cervical collars with their CPAP therapy. For many people, the collars decrease pressure needs and help prevent jaw drop. Pressure needs are lower because the collar holds the neck in the best position for airway patency. I've been using one every night for about eight years.

It's cheap to try one - https://www.walmart.com/search/?query=d ... l%20collar

[grayghost4]

I use a boil and bite snore stopper set with my lower jaw forward slightly and a 4 in. cervical collar, along with my Cpap machine.

I had all the problems that you list, and I also had a MAD made for me several years ago with the same results you had. I find that the cheep boil and bite works better than the MAD because it helps to seal the mouth closed, also much more comfortable, I use an Amara View full face mask.

[jnk...]

I used an oral appliance alone from the time I was diagnosed OSA until I got my autobilevel machine. Then when I started autobilevel, I had trouble keeping my mouth closed during autobilevel. So I used both oral appliance and autobilevel for a few years until I eventually learned to sleep with my mouth closed. Then I used autobilevel alone until I transitioned myself to APAP with 3cm EPR.

The oral appliance did not lower my pressure needs when I used it. But I have a small nasopharynx, so I may not be the norm. I believe that for some with an anatomy that differs from mine, pressure needs may be reduced with use of an oral appliance that advances the mandible.

You may not know until you try it.

[dcg494]

I use a boil and bite snore stopper set with my lower jaw forward slightly and a 4 in. cervical collar, along with my Cpap machine.

I had all the problems that you list, and I also had a MAD made for me several years ago with the same results you had. I find that the cheep boil and bite works better than the MAD because it helps to seal the mouth closed, also much more comfortable, I use an Amara View full face mask.

Thanks Grayghost, which boil and bite do you use ? I tried a couple before but found them to be very bulky.

I'll try a cervical collar too sometime, but it takes me a week at least of bad sleep to get used to new sleep introductions, so I'd need a slow week at work to try that out.

I transitioned to a nasal mask about a month ago, and find my MAD doesn't leave me enough tongue space to keep the seal. I tape as well and use chinstrap, but using the MAD my cheeks keep blowing up with air which wakes me up.

Which MAD appliances do people recommend here ?

I'm thinking about getting the new dreamtap which has more tongue space than my current and other devices : http://tapintosleep.com/2016/10/18/dreamtap-features/

[blacknebula]

I have a custom made oral device from my dentist that I wear concurrently with my CPAP. It is actually for clenching which was showing up as jaw bone deformation on my dental x-rays, but does bring my jaw forward a slight amount. It is quite small - full coverage along the back bottom teeth and a just small strip along the bottom of the front teeth to connect them so it does not interfere my tongue position and ability to keep my mouth closed/sealed. I use a nasal mask as well. It may help lower my CPAP pressure a bit, but I can't really tell for sure unless I stopped wearing it for a while and checked the pressures. My pressures are quite low; my machine is set from 7-12 and my average is 8-9.

[dcg494]

I have a custom made oral device from my dentist that I wear concurrently with my CPAP. It is actually for clenching which was showing up as jaw bone deformation on my dental x-rays, but does bring my jaw forward a slight amount. It is quite small - full coverage along the back bottom teeth and a just small strip along the bottom of the front teeth to connect them so it does not interfere my tongue position and ability to keep my mouth closed/sealed. I use a nasal mask as well. It may help lower my CPAP pressure a bit, but I can't really tell for sure unless I stopped wearing it for a while and checked the pressures. My pressures are quite low; my machine is set from 7-12 and my average is 8-9.

Oh interesting, do you know what the model of oral device is that you use blacknebula ? I'm looking for something low profile like that.

Also, sounds like we're similar in terms of pressure needs. My pressure is at 7.5, which is really my max before aerophagia, but maybe I'll try more of a range like what you're doing.

[blacknebula]

I have a custom made oral device from my dentist that I wear concurrently with my CPAP. It is actually for clenching which was showing up as jaw bone deformation on my dental x-rays, but does bring my jaw forward a slight amount. It is quite small - full coverage along the back bottom teeth and a just small strip along the bottom of the front teeth to connect them so it does not interfere my tongue position and ability to keep my mouth closed/sealed. I use a nasal mask as well. It may help lower my CPAP pressure a bit, but I can't really tell for sure unless I stopped wearing it for a while and checked the pressures. My pressures are quite low; my machine is set from 7-12 and my average is 8-9.

Oh interesting, do you know what the model of oral device is that you use blacknebula ? I'm looking for something low profile like that.

Also, sounds like we're similar in terms of pressure needs. My pressure is at 7.5, which is really my max before aerophagia, but maybe I'll try more of a range like what you're doing.

There isn't a model number. They took an imprint of my teeth and then made it up. Here's a picture of it if that helps.

[grayghost4]

the one I use is like this one ... very cheap to try

https://www.ebay.com/itm/Silicone-Mouth ... Sw-mdbgQ8y