Thornton's tap-cpap combination work for anyone?

[Sheri755]

Hi. Anyone heard of results of this combination therapy and if so, did it work and was it as comfortable as reported?

The TAP alone is not working, so my hubby may neeed to go a step further. He's already had surgery and the sleep study.

Thanks!![/b]

[RipVW]

I'd never heard of this before, wondering if anyone else on the forum has:
From: http://www.sleepreviewmag.com/issues/ar ... -07_13.asp
Sleep Review spoke with Keith Thornton, DDS, founder and CEO of Airway Management Inc (AMI), Dallas, about using mandibular advancement devices (MADs) in combination with CPAP to manage snoring and sleep apnea.
SR: Most oral appliances that treat snoring and OSA are mandibular advancement devices. How do they work?
Thornton: They work by protruding the mandible to a position that opens the airway and then maintains that position over time. This is very similar to thrusting the mandible forward during CPR or anesthesia.

SR: How is the Thornton Adjustable Positioner (TAP) different than the other MADs?
Thornton: The TAP is the only MAD that is infinitely adjustable and that can move the patient’s mandible into a passively stretched position. This is the reason that the published treatment results are significantly better than those of other MADs and why it is the only one that can treat severe OSA consistently.

SR: What other unique features does it have?
Thornton: The TAP is the only appliance that can be adjusted vertically, laterally, and protrusively after construction; can be adjusted by the patient while in the mouth; has an attachment for CPAP; and can be titrated in the sleep lab.

SR: How does the combination TAP-CPAP work?
Thornton: Again, this is similar to CPR. If the jaw is placed in the proper position, then ventilation can occur at lower pressures. I have written a report about a patient that we treated by this means in the January 2002 issue of Sleep Review where we lowered the pressure from 16 to 7 cm of water. By holding the jaw closed, we can also prevent mouth leakage. The attachment to the TAP prevents movement of the mask and improves comfort and leakage.

SR: Compliance is an issue for CPAP users. Are TAP users compliant? If so, how does the TAP address the need for increased compliance?
Thornton: In virtually all compliance and preference studies, oral appliances are significantly ahead of CPAP. This is particularly true since the TAP can treat snoring without the intrusiveness of the sound of the CPAP. Therefore, the bed partner is a big factor in compliance. We are also offering a monitor for those who want to measure compliance.

SR: What are sleep apnea patients saying after using the TAP?
Thornton: They are thrilled. Most of my patients either have failed CPAP or want something that they can wear when they can’t wear CPAP or don’t want to take it on a trip. Once they get on the TAP, they usually stop wearing the CPAP. If the TAP doesn’t manage their sleep apnea, then we add the mask combination, which they prefer greatly over the regular mask.

[sombu]

Sounds interesting. It seems to me that a combination approach could lower the pressure needed to reduce OSA and thereby provide a more comfortable sleep. I wonder though about resulting TMJ. I like the idea of having a non-powered backup during travel or camping etc. I checked out their website. I didn't see the device that would connect TAP to the CPAP that he mentioned. Here is the link if you interested

http://www.amisleep.com/

Michael

[Velbor]

I have been using a different oral appliance, the Klearway, as my primary OSA therapy, for 9 years. PSG shows that it works very effectively. Due to dental issues, I now take a "break" from the appliance every third or fourth night and use CPAP. The appliance is thus used 5 nights weekly, and CPAP 2 nights weekly.

I have tried, for fun, using both together, and I can't make it work. With the appliance in place, I seem to have much less control over my cheek muscles, which then balloon out when I use CPAP. This is not at all a problem when I use CPAP alone, without the appliance. Experimenting, I find it barely tolerable to use both together with a minimal, non-therapeutic CPAP pressure of 4cm. Anything higher and I puff out uncontrollably.

There is another recent poster on this forum who has described his success using both the Klearway and CPAP together, but I believe that he also uses a special oral "dam" to make this possible.

Perhaps there are intrinsic differences between the TAP and the Klearway that make the simultaneous use of TAP and CPAP possible. From my experience, I find it interesting, but hard to imagine.

[GeneS]

I have been using a snorban dental device with cpap for 5 years or more. I couldnt get used to it at first but after a second try I could wear it. It seems logical for me since I had the mandular advancement surgery a number of years ago. I also had several UUUP surgerys. The MA surgery advanced my jaw and tongue but my chinstrap pushed it back. The dental device helps hold my jaw and tongue in position leaving my airway more open. I still need cpap but I feel better the next day when I wear the dental device with cpap so I wear it every night. I also tape and wear a chin strap. I am getting good results with this combination. I have been on cpap almost from the beginning in the early 80's so I have learned to tolerate about anything that helps me get a good nights sleep.
GeneS

[GeneS]

Correction
I think it was called a glossias advance and hyoid suspension. I do not know how to spell it.
GeneS