Considering a dental device for apnea. Appreciate feedback.

[Dale92]

Hi Jak3099

I have used an oral appliance since 2006 about 6 months after getting diagnosed with sleep apnea. I had an initial pressure of 18 which I was unable to find a way to keep my mask sealed. I approached my dentist about doing an oral appliance and he referred me to another dentist who specialized in this area. This dentist made my oral appliance an I was retested and ended up still needing cpap but at a lower pressure of 11. I have tried going with out my cpap and only using the oral appliance and the apneas still wake me up. Without cpap I wake up feeling like someone has a pillow over my face suffocating me. I have not heard of anyone having long-term success with only an oral appliance.

I really do not like sleeping with my cpap mask. I am waiting for the day when medical science comes up with something to replace cpap. I had my hopes up a few years ago when I heard they were doing studies with a pace maker type implant in the neck that was to be stimulated and cause the throat muscles to tense up to something resembling the wake state thereby keeping the airway open while sleeping. It was tested in a few people but only relieved snoring, it didn't help with apnea at all. I think I did hear somewhere they are revisiting something like this again in clinical trials now.

Dale

[SleepingUgly]

Check out the oral appliance section of apneasupport.org. There is a sleep dentist that posts there. Most people that come around here have not tried a dental device, are biased against them, or still need CPAP even with an oral device. That is not because no one succeeds with a MAD (Mandibular Advancement Device), but because this is a CPAP use site.

I am very slowly trying to titrate myself on a TAP3 Elite. Moving gradually forward.

[jamiswolf]

Jak,
On this forum, you'll find lots of us self-titrate. I can't even imagine trying to breathe at 4 cm. I'm with Julie and the others that feel your cpap has never been truly therapuetic and I'd focus on that.
J

[Jak3099]

I agree that I should focus on optimizing the CPAP. I've used it the past few nights and have not had snoring/headaches, but I keep waking up from the tube touching my face or the exhaust. I'm using the hose buddy.

I can't find the thread on self-titration. Does anyone have a link or tips on that, as well as hose management? Thanks so much!

[zoocrewphoto]

I agree that I should focus on optimizing the CPAP. I've used it the past few nights and have not had snoring/headaches, but I keep waking up from the tube touching my face or the exhaust. I'm using the hose buddy.

I can't find the thread on self-titration. Does anyone have a link or tips on that, as well as hose management? Thanks so much!

You might put some cloth around the hose so that it doesn't bother you.

As for self titrating, it is basically reviewing the data and adjusting to correct for problems you find in the data. It is mentioned a lot in various threads, but it is personal, so it depends on what is happening with you. There are reasons to raise the pressure such as obstructive events and reasons to lower it such as swallowing air and central apneas.

Do you have the software yet? Do you have any graphs you can post? Most people need a pressure of at least 6 to feel comfortable. You mentioned that your doctor lowered it to 4 (not sure if that was straight pressure or 4-16). Have you used it set for 6-16? Or something similar. If so, post a night of graphs for that showing the events, the pressure, leak. Most people seem to do better with a tighter range of pressure. And you may need a higher minimum to prevent more events without waiting for the machine to go up. If you have having issues with higher pressure, you may need the top end lowered a bit. But it is hard to guess without seeing data. If you can post some graphs, you will get a lot of advice in what to try.

[Jak3099]

Thanks for the advice Zoocrew! My doctor had me set the pressure to 4-16, because at 10-16 cmH2O, I was swallowing a lot of air. I use Sleepyhead software. I'll set my machine to 6-16 cmH2O tonight, and post up my results tomorrow. I didn't know that pressure should be lowered to decrease central apneas!

I also just ordered the cozyhose boss from pur sleep, and I'm going to try using a piece of velcro to attach the small hose attached to the nasal pillow mask to the top of the headgear in addition to using my hose hanger with proper amount of slack. Hopefully this will help.

[RogerSC]

I retitrated myself on my autoset, starting with a range of 8-18 (my original lab pressure was 14)
After observing my 95% pressures, my AHI, and centrals, I gradually adjusted my range to 9-13.
My pressures are usually in the low 11's.

Yeah, my sleep doctor originally said 4-10...I changed it to 6-10 and turned off the ramp because I didn't feel that I was getting enough air at 4. When I got around to looking at my sleep data, I saw that the pressure was basically going up to 10 and staying there all night. So I slowly moved it up until I ended up with 10-14 for some time, which worked better for me. Leaks were a little more difficult, though. Lately, I've settled on 11-13, doesn't hang up at 13 for very long, and then doesn't drop all the way to 10 (which it wasn't doing much when I was using 10-14). My current range seems to be working well, a lot of my nights have an AHI less than 1 now, and haven't seen 2 in quite a while. And I feel fine, although the whole cpap thing seems to keep me from sleeping the 8 hours that I used to get.

This is a process, finding your appropriate pressure range. And it can change as well, so it's good to keep watching your data to see what's going on.

[Gearhead]

See my previous note in the thread below for a description of my previous (negative) experience using a dental appliance. The dental appliance made my AHI much worse. I am a happy CPAP user now.


Gearhead


link:
viewtopic.php?f=1&t=89476&p=822017&hili ... ad#p822017