Success with dental appliance after CPAP failed!

zzzaoem · Post by **zzzaoem** » Sat May 05, 2007 3:26 pm

I was never able to sleep using CPAP. After a few months of failed efforts, my doctor referred me to a dentist for an adjustable dental appliance (TAP). It took me a little while to get used to, but it works! I just did an overnight sleep study and my apnea has disappeared!

The dental appliance is really small (like a brace) easy to travel with and much less of an intrusion into your and your partner's regular sleeping routine. I know that this will not work for everyone, but for those who cannot get used to CPAP, it is worth a try (see here for more info: http://www.amisleep.com/).

roster · Post by **roster** » Sat May 05, 2007 4:52 pm

When the lower jaw is pulled forward during the night, it may make the jaw muscles sore and temporarily change the bite. The Exercise Bite Tab is a simple means to help the patient’s bite quickly return to normal.

The Exercise Bite Tab is made of one flexible blue plastic (polyurethane) sheet. The patient places one tab between both sides of the front teeth on each side of the mouth. The patient then pulls his/her lower jaw back and squeezes as if to put the back teeth together. This process is repeated until the patient’s jaw is back in normal bite position and he/she reaches maximum jaw comfort.

Great for you! How long have you been wearing it? How was the soreness? Is the process above (from their website) necessary for you?

zzzaoem · Post by **zzzaoem** » Sun May 06, 2007 3:04 pm

It's necessary, but really takes only about 30 seconds or so and is not a big deal. Again, I know this will not work for everyone but people who have difficulties with CPAP should certainly try. Really, the discomfort from the device is minimal after a few weeks.

zzzaoem · Post by **zzzaoem** » Sun May 06, 2007 3:05 pm

ps. I have been wearing it for about 5 months.

rested gal · Post by **rested gal** » Sun May 06, 2007 3:26 pm

That's good to hear, zzzaoem. The TAP Titanium also worked wonders for one of the regular posters here, nicknamed snork1. He also was able to get off cpap by using just the TAP dental appliance.

I'm glad you mentioned you had a followup full PSG while using the TAP to be sure it really was taking care of OSA for you. Very good!

blarg · Post by **blarg** » Sun May 06, 2007 4:21 pm

Congrats on getting your OSA under control! It's a complex equation for anyone and specifically congrats on sticking with it even when you had trouble with CPAP.

sleepyhead63 · Post by **sleepyhead63** » Sun May 06, 2007 4:23 pm

How would one know ahead of time if it would work or do you just have to give it a shot?

zzzaoem · Post by **zzzaoem** » Mon May 07, 2007 8:04 am

I can't give you a good scientific answer to how one would know whether TAP may work for you, except that my dentist (dr Mintz, Rockville Md, who I would recommend) was optimistic from the start reviewing my case. One condition is that you need to have a relatively healthy set of teeth. My OSA was moderate (AHI in the 25-30 range) and I don't think they recommend it for severe cases. I am also a case where the cause of OSA was not immediately obvious in that I am young (35) and not overweight. My problem was probably caused by the relative position of my tongue in my mouth.

I also think it is easier to get used to after failing with CPAP as the first couple of nights with the device can be rough (so you need to be reminded that there are no easy alternatives). Now, though, I am happy as a clam.

snork1 · Post by **snork1** » Mon May 07, 2007 9:17 pm

I think I am coming up on 6 months or so of success with a dental device. (TAP Titanium in my case). I had really tried EVERY trick in the book with CPAP for a few years before going the dental route (TWO machines and maybe 10 or so masks...etc)

a dental device is definitely NOT for everyone.....but then the 50% compliance rate for CPAP says there is no SINGLE solution that works for everyone. If your tongue/jaw position isn't a major involvement in your apnea....ferget about it.

My latest interesting observation of a trend.....Not sure how to explain it. But I GAINED weight on CPAP, in addition to major aerophagia problems. I am finally losing weight at a slow but very steady rate since getting on the dental device. I have lost a solid 10 pounds since starting on the dental device and I am not all that overweight to begin with. Maybe one of several signs that its really working.

CPAP saved my life, but still didn't let me sleep well and caused all sorts of neck problems for me. I DO have to perform my jaw exercises DAILY to keep my jaw loose and (mostly) in line....which seems like a small price to pay.

Now I sleep and dream and wake up feeling great. My energy is good and I am not snoring or gasping. My sleep doc wants to bring me in for another sleep test, but I just changed med coverage and a new test will cost me MUCH money, so I am not seeing the point. They also REQUIRE that I sleep on my back during the test, which I don't do on CPAP or without and can't sleep that way and just don't feel the results are representative.

check out the talkaboutsleep.com, dental sleep medicine forum if you are curious and want to see some honest details that includes the good, the bad and the ugly....and just like for CPAP...everyone trying to work through and improve this whole apnea treatment thing which is really in its infancy.

sidebar: someone mentioned the Hylands "Restful Legs" remedy (NOT their anti spasm remedy) for RLS. I added that to the mix and REALLY sleep like a flippin' ROCK these days. No side effects or daytime grogginess that I was getting from the Gabapentin.

Its almost scarey how well its all coming together for me right now, sleepwise. I just enjoy every night of freedom and deep sleep, because you never know when the wheels MIGHT come off the train.

akcpapguy · Post by **akcpapguy** » Mon May 07, 2007 9:34 pm

Glad to hear the TAP is working fo you.

In the Military using a TAP device to control your OSA is the only surefire way to avoid a Medical Board and possible discharge. We have criteria for deciding which patients qualify for using a TAP device. We have ENT and Dentists who were trained by the people who make the device on certain things to look for when determining which patients might be successful in using a TAP. The Dentist is also trained in making the impressions that are used in making the TAP. Sleep Medicine is a big thing in the Military and Walter Reed has plans for a 14 bed lab to be finished around 2009.

Glad to hear that you also had a followup sleep study to determine if the TAP adjustment is treating your OSA, a followup study was also mandatory for any of our patients who took the TAP route.

Always good to see alternate treatments working for atleast some of the hosehead population.

Darin

cpapernewbie · Post by **cpapernewbie** » Mon May 07, 2007 9:53 pm

very interesting

One important info is missing though: what is the cost of TAP?

snork1 · Post by **snork1** » Mon May 07, 2007 10:03 pm

cpapernewbie wrote:very interesting

One important info is missing though: what is the cost of TAP?

TAP (or similar) is NOT a cheap "experiment"!
You really should go through a certified sleep dentist with TMJ specialty also and the prices vary WIDELY for the "installed price". And you really have to ASK what is included in the price and make sure its ALL laid out.

I got quotes for up to $3000, but I got mine from a certified sleep dentist for about $1700 including fitting, hardware and followup appointments. The dentist battled HARD for me with my insurance company and managed to get the insurance to pay for $800 of it as a medical device. But I did have to pay up front and then got a refund of $800.

Worth every penny, IF it works. My dentist acknowledged it doesn't work for everyone and will give a PARTIAL refund if it doesn't work out.

The Somnogard AP (non-prescription) could be a good $170 investment to experiment with it and then you would have a backup if the TAP breaks too, or while waiting the LONG wait to get the TAP. (or similar)

cpapernewbie · Post by **cpapernewbie** » Mon May 07, 2007 10:31 pm

snork1

thanks very much

Reason I ask for the price is that I have no insurance, was hoping to getAP for less than $100.

Am really shocked with price sticker of TAP, eEven more than CPAP!

However it will be easier - no masks testing and ease of travel, no need to depend on electricity, no card reader needed and Software required,

How do we know that TAP is still effective and when you really need CPAP later on? Annual sleep study? That will be very costly

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, Travel

snork1 · Post by **snork1** » Mon May 07, 2007 10:49 pm

$100? Heck thats about the cost of a tank of gas these days! Definitely less than a heated hose accessory for CPAP, or even a single of the many masks you will need to try, even with good internet deals.

A friend of mine is "employment challenged" and has no insurance. He took the gamble and picked up a Somnoguard AP for $170 from nosnorezone.com
And its been working for him. The SG AP is a bit bulky and he has it cranked out to its maximum, but it works. He could also not afford CPAP, although he used it in the past.

Good luck! I have seen a few threads on the forum for those on restricted budgets. You might do some searching and see what they suggest?

[quote="cpapernewbie"]snork1

thanks very much

Reason I ask for the price is that I have no insurance, was hoping to getAP for less than $100.

Am really shocked with price sticker of TAP, eEven more than CPAP!

However it will be easier - no masks testing and ease of travel, no need to depend on electricity, no card reader needed and Software required,

How do we know that TAP is still effective and when you really need CPAP later on? Annual sleep study? That will be very costly

zzzaoem · Post by **zzzaoem** » Tue May 08, 2007 6:02 pm

I got mine for a total of $1300 (including dentist services, which includes various follow-ups). I was unsuccesful in my insurance request but probably could have been successful with a partial had I been more careful to get the right referrals. Yes, it's expensive but worth it for me.

Success with dental appliance after CPAP failed!

Success with dental appliance after CPAP failed!

TAPped out