Is a CPAP the only way to get a nightly AHI?

[zonker]

"We can't even get a damn mask without a prescription."

You've been at this a lot longer than I have, but I sourced all the peripherals and thought I figured out that all you need a prescription for is the CPAP itself. Otherwise, I'd have thought that ebay and Amazon would have clamped down on their sale.

they get past it by selling the mask in parts. that is, strap separate from mask.

[ChicagoGranny]

"It's not that the tongue is too large."

In my case, I think that's all there is to it.

The Mallampati score is high when the jaw is underdeveloped.

One of my former sleep docs claimed to quite accurately diagnose OSA before the patient opened his mouth. She looked for underdeveloped jaws.

Look at the teeth. Can you find an OSA patient who has 32 straight, uncrowded teeth without having orthodontic treatment? He would be a rare patient. (Enlarged tonsils or adenoids aside.)

If a person doesn't have 32 straight, uncrowded teeth, his jaw didn't develop properly to allow the teeth to fit. If a survey were taken of the forum members, very few would have more than 28 teeth. Wisdom teeth were extracted or failed to move into place because the jaw was underdeveloped.

The tongue might be said to be too large, but the problem is underdeveloped jaws.

The checklist some doctors use:

 Crowded teeth
 Deep overbite
 Narrow dental arches
 Recessive lower jaw

[ChicagoGranny]

It seems like most people have to deal with the opposite problem- doctors who insist they just learn to sleep in a different position so their insurance won't have to pay out for a machine that could change their health and their lives. I know they told my son-in-law to sew a tennis ball in the back of his pajama top so he wouldn't sleep on his back. Well, to me that just seems unbelievably cheap. Changing your sleep position is not so easy for many people. And once we're asleep we tend to default to that position our bodies find most comfortable.

Maybe his AHI was 5.0 or less and the doctor knew insurance would not pay for CPAP?

[ChicagoGranny]

Small Jaws, Small Airway
... if you look at obstructive sleep apnea as being a craniofacial problem, everyone will have various degrees of jaw underdevelopment. If you have impacted molars, or had to have your wisdom teeth taken out, then your breathing passageways are compromised.

https://doctorstevenpark.com/sleep-apne ... al-problem

[el33]

"doctors who insist they just learn to sleep in a different position so their insurance won't have to pay out for a machine"

"Maybe his AHI was 5.0 or less and the doctor knew insurance would not pay for CPAP?"

Oh-oh, I'm glad I read that.

I had a sleep test giving me an AHI in the mid 30s laying flat, and I thought I was going to tell my Dr. a thing or two, by sleeping on an incline for a couple of weeks at the minimum APAP setting, and showing that it's only 2-3, when I do this.

He was insisting I use it, and that none of these silly "consumer-level" OTC products like the mat I mentioned were worth anything.

Unfortunately, I'm also starting to get backaches, as some others who've written about this have discovered.

I was hoping in the end to just get it approved to use on an experimental, as-needed basis, but now it's looking as if I'll have incentivized him to admit I was right, and take it away from me again. I guess I don't always know when to stop talking.

Can you be prescribed an APAP without the insurance paying for it, or does insurance now get to dictate to the Dr. what's medically necessary? This would be fine with me, if I could just be allowed to buy what I want. I don't feel like being monitored, anyway.

[el33]

"Look at the teeth. Can you find an OSA patient who has 32 straight, uncrowded teeth without having orthodontic treatment? He would be a rare patient."

That would be me also.

Never had braces, and I think my wisdom teeth only came out when I was much older and developed cavities. Or I think a couple did, and then the dentist pointed out that the other two were useless or something, having no opposing teeth.

I don't know the other indicators very well, but the study I referenced seemed just as emphatic about large tongues alone being one. The experts love talking past each other and leaving the contradictions for us to sort out, and not just in this area.

"once we're asleep we tend to default to that position our bodies find most comfortable."

I tried the tennis balls also. I ended up trying to sleep right on top of them. I have to be on my back, at least most of the time. I haven't tried thumbtacks yet.

[chunkyfrog]

I'm glad I had cpap while I was recovering from surgery.
I was forced to sleep exclusively on my back for several months,
even though my OSA would have been worse in that position.
When injury or surgery comes into the equation, "positional therapy"
goes straight out the window. (quotes added because the concept is a joke)

[Ollie4ISU]

"It's not that the tongue is too large."

In my case, I think that's all there is to it.

The Mallampati score is high when the jaw is underdeveloped.

One of my former sleep docs claimed to quite accurately diagnose OSA before the patient opened his mouth. She looked for underdeveloped jaws.

Look at the teeth. Can you find an OSA patient who has 32 straight, uncrowded teeth without having orthodontic treatment? He would be a rare patient. (Enlarged tonsils or adenoids aside.)

If a person doesn't have 32 straight, uncrowded teeth, his jaw didn't develop properly to allow the teeth to fit. If a survey were taken of the forum members, very few would have more than 28 teeth. Wisdom teeth were extracted or failed to move into place because the jaw was underdeveloped.

The tongue might be said to be too large, but the problem is underdeveloped jaws.

The checklist some doctors use:

 Crowded teeth
 Deep overbite
 Narrow dental arches
 Recessive lower jaw

Fascinating.... I had braces for years, had eight permanent teeth removed to make room for the 24 I have left (which are basically perfect. Thanks Dr. Langwith). Until I read these posts, it never even occurred to me the correlation.

[ChicagoGranny]

Fascinating.... I had braces for years, had eight permanent teeth removed to make room for the 24 I have left (which are basically perfect. Thanks Dr. Langwith). Until I read these posts, it never even occurred to me the correlation.

Extraction orthodontics. It's fallen out of favor. A few years ago, someone on here was drumming up a class action lawsuit against dental schools that teach it. Not for the money, but to raise awareness.

Thank Dr. Langwith for OSA.

[ChicagoGranny]

"Look at the teeth. Can you find an OSA patient who has 32 straight, uncrowded teeth without having orthodontic treatment? He would be a rare patient."

That would be me also.

Never had braces, and I think my wisdom teeth only came out when I was much older and developed cavities. Or I think a couple did, and then the dentist pointed out that the other two were useless or something, having no opposing teeth.

Oh, so it's not you. You only have 28 teeth.

[Ollie4ISU]

Fascinating.... I had braces for years, had eight permanent teeth removed to make room for the 24 I have left (which are basically perfect. Thanks Dr. Langwith). Until I read these posts, it never even occurred to me the correlation.

Extraction orthodontics. It's fallen out of favor. A few years ago, someone on here was drumming up a class action lawsuit against dental schools that teach it. Not for the money, but to raise awareness.

Thank Dr. Langwith for OSA.

I had teeth impacted into my sinus cavity. One was 180 degrees backwards. They were layering one behind the other, that was even prior to my wisdom teeth coming in. I guess the fact that the teeth I have are perfectly straight and healthy is going to have to be enough for me. My mouth was a wreck.

[ChicagoGranny]

I guess the fact that the teeth I have are perfectly straight and healthy is going to have to be enough for me.

0 CPAP = not enough

+1 CPAP = enough

[ILoveFlowers]

Maybe his AHI was 5.0 or less and the doctor knew insurance would not pay for CPAP?

I don't know what his AHI was, I just know he snores like a freight train and is always tired.