NEWLY diagnosed OSA decisions: CPAP vs Oral device

[SleepyFireman702]

Ok so I am new to this, haven't even started treatment yet just in the decision making stage trying to decide between CPAP or an oral device.
My diagnosis is moderate OSA with an AHI of 16.6
My concerns regarding CPAP are noise and portability first, then comfort a close second.
I am a firefighter and live in a fire station for approximately 40% of each month. My station is 175 miles from where I live so either I would need two devices, one portable (if there is such a thing) and one set at home by my bed. Noise in the station would be a big concern because there are typically 2 to 3 crew members sleeping in my same dorm. Ease of use, getting it on and off when a call comes in is another big concern.
Suggestions and input
If anyone has used both CPAP and an oral device (not necessarily concurrently) and can weigh in on benefits for or against either, with my particular circumstances in mind, I would greatly appreciate hearing from you.
Thanks

[ChicagoGranny]

This is a CPAP forum. Buy two CPAP machines. Forget the oral appliance. CPAP is the gold standard. Oral appliances are for losers who can't educate themselves and learn to use CPAP properly.

What noise are you talking about? CPAP machines don't make any noise.

All CPAP machines are portable.

Do you have a locker at your workplace where you can safely store a CPAP when you are away? If not, CPAPs are pretty easy to travel with.

My diagnosis is moderate OSA with an AHI of 16.6

How old are you? Why did you have a sleep study in the first place?

[lindalam89]

I don't have much experience but I've tried both oral device and apap. MAD (mandible advancement devices), really hurt your jaw and there will be major drooling, but a great PRO is the portability and quietness. The Cpap is incredibly noisy to me, especially if you have nasal problems as the machine engine ramps up everytime you put in the effort to breathe. But cpap is the gold standard, does not hurt your jaw and no drooling.

Try a oral device study first, that will tell you if you are eligible for a MAD. For me, my respiratory events were only reduced by half, and so I was still out of normal range. People with normal anatomy also appear to not reap any benefits with MAD, or just very moderately. If you have a recessed jaw, it might be an effective option for you. Ask your doctor if you can do another study to test the efficacy of a oral device.

[Midnight Strangler]

CPAP is the gold standard.

+1

SleepyFireman702

It would be best to start your CPAP usage when you are at home and have the time to adjust a bit to it and do any necessary tweaking. The first nights are difficult for some people.

[Goofproof]

I only use the Gold Treatment Standard, XPAP, I'll leave the rest, the Lead Standard, appliances and surgery. While it may not be the answer for all, it's the best so far in results. The hardest part of XPAP treatment success it the mental component, you must accept it before it will work. Jim

[ChicagoGranny]

The Cpap is incredibly noisy to me, especially if you have nasal problems as the machine engine ramps up everytime you put in the effort to breathe.

You just joined here yesterday. Are you a new user of CPAP?

If your machine is "incredibly noisy", you are not managing everything properly. There could be a variety of problems. You could even have the wrong machine setting for the type hose you are using. If you want help with the noise, start a new thread titled, "Incredibly Noisy CPAP".

A properly operating CPAP system is not noisy.

[BlackSpinner]

Be aware that the cost of the oral device is often MORE then a cpap machine.

We did have a member who was in exactly the same situation as you and had no problems with using (and leaving) his cpap machine at the station. A fan makes more noise then a cpap machine. An air conditioner make A LOT MORE noise then a cpap machine (so does snoring).

Get your home cpap machine through a DME with your insurance. Then look for Second Wind dot com and buy the other one online for 1/4 of the price the DME quotes you.

[Midnight Strangler]

The Cpap is incredibly noisy to me, especially if you have nasal problems as the machine engine ramps up everytime you put in the effort to breathe.

I found this in your first thread from yesterday,

Unfortunately I need absolute silence to sleep. I've been awaken by noises through my ear plugs which sound like they could be 10 decibels or lower noise. It's ridiculous

You REALLY should not be on here scaring the newly diagnosed that CPAPs are noisy. Now, should you?

They are not noisy.

[SteveGold]

I think I can help here.

I got an oral device last year as a last resort before giving up completely. My first two years on CPAP were hell on earth and I was prepared to try anything.

I never got it to work for me on its own, but it did make CPAP more effective when I used the two together. But there were drawbacks: I couldn't close my mouth, which led to mouth breathing, and trained me to keep my mouth open even when I didn't use the device. It always caused discomfort and shifted my teeth a bit.

Used the thing a total of 17 times before putting it away. Cost me $1,000 out of pocket (insurance doesn't cover them). I figured out much later that my intolerance to CPAP could be addressed with a BiLevel, but hindsight is 20/20.

As it happens, my diagnosed AHI was 16 events/hour. That's low enough for oral devices to be a plausible alternative to CPAP, but it just didn't work.

CPAP or one of its variations is the way to go.

Regarding using a CPAP in a dorm room, I've had people ask me, "Is it on?" That's how quiet these things run. It's very unlikely it would disturb the people around you, even in close quarters.

[chunkyfrog]

My cpap is way quieter than my snoring.
Your colleagues will thank you for bringing a machine to work.
Your employer may even provide a machine for you in the firefighters' dorm;
---ESPECIALLY IF YOU DRIVE. (Thank you for your service)
It does not hurt to ask.

[Sheffey]

NEWLY diagnosed OSA decisions: CPAP vs Oral device

I've been using CPAP with great success every minute of every night for about 12 years.

Somewhere along the way, I had a dentist make a custom fitted MAD (mandibular advancement device) for about $1600. I went back to him twice for adjustments at no additional cost.

What a horrible piece of metal and plastic to cram into the mouth. Very uncomfortable. Could not entirely close my lips, so constant dry mouth.

Even at an extreme setting, it was not preventing apneas.

It was so uncomfortable and ineffective, there was no way I could sleep with it all night. So, I resigned to using it for short naps. That did not work either - very uncomfortable and ineffective. So, that $1600 device languishes in a drawer.

Get a CPAP and learn how to use it properly with help from the forum members if needed.

[Redonthehead]

My cpap is way quieter than my snoring.

This. Prior to CPAP my wife kept earplugs on the nightstand. On really bad nights she would head to the other bedroom. Not any more. Sometimes my P10 will whistle a bit, but it doesn't bother her - so she says.

[lindalam89]

@midnight strangler: the perception of noise varies from person to person. Although cpap does not seem noisy to you, it is to me. But I did note in my other thread that I'm the type of person who requires absolute silence to sleep. I'm not trying to scare the guy. To be realistic most cpap are about 29 decibels. If you wear earplugs you get a different noise, amplifying of internal breathing.

Everyone is different with noise tolerance and I'm always surprised how people remark the machine makes no noise. Given the choice of hearing a low 29 decibel hum, or wear ear plugs and listen to myself breathing. Not sure which would be better.

Granted cpap is absolutely vital for health. So it might be a matter of learning to get used to the hum.

Anyways I think cpap is the wiser choice if you want effective treatment of your symptoms. Some people have no problems acclimating. And at some point you might need to switch over to cpap so it would be worth trying it out first.

[Midnight Strangler]

I'm not trying to scare the guy.

Forget your motive. Think about the potential consequences of your statements.

CPAPs, properly setup, are very quiet. Ask my wife who has good hearing.

[Goofproof]

I heard somewhere Firemen were a hardy group, the ones I know are. You say they will have a problem sleeping in the room with you with something that makes less noise than a personal fan, come on, I don't buy what your shoveling.

You, are on your way to the outdoor store, to buy a tube and paddle, for that trip down De-Nile. For many it's a one way trip. Jim