Why did you choose cpap over the OA?

[docjl]

hi
I know everyone here is on cpap, and I'm still debating. So, would you mind sharing why you choose cpap over the OA? I had a hard time falling asleep with it, but I'm sure I could adjust at some month in the future. However, at this point, I have a dentist appt set up to discuss OA .

IF you considered OA and could have been a candidate and, ruled it out would you explain why?
If you weren't severe (I don't' think I'm severe...) and never considered it, would you explain why?

I hate to pry, but I'm just trying to make an informed decision and your case experiences may help me do that.
Thanks so very much!
doceo

I have AHI 28
hypopneas; 51
obstructive apneas: 4
central apneas: 1
mixed apneas: 0

[pootsie]

My TMJ issues ruled me out as a candidate. My apnea is not severe but I should be getting a machine next week

[herefishy]

I don't really have TMJ, but tried a "boil n bite" for a while and my jaw eventually wouldn't go back into its normal place. Scared me, so I quit.

[49er]

Hi Doceo,

Hopefully, Dr. Luisi, a sleep medicine dentist will reply to the questions that you raised on the other apnea board. Meanwhile, you might want to do a search of his posts as they have been very helpful in my opinion. He favors the tap appliance and says there is data supporting its effectiveness.

49er

[chunkyfrog]

Any alternative treatment will need to be evaluated for individual efficacy during a PSG.
These devices work for some people, but not everyone.
Maybe you are one of the lucky few. Just be sure; don't guess.
EDIT: As to why I chose cpap over something else, I never considered anything else.
It is, after all, (wait for it) . . .the GOLD STANDARD.

[caffeinatedcfo]

I'm pretty sure AHI > 25 is considered severe.

I never considered anything but CPAP - it's the recommended treatment and I took to it quickly and comfortably.

[VVV]

I'm pretty sure AHI > 25 is considered severe.

I think the medical establishment says > 30. However, for me personally anything > 5, I consider severe because I am not energetic the next day. If the committee that wrote that scale has an AHI of 28, let's see if they consider their condition moderate. 28 will make a very unhealthy person if left untreated for a few years.

hi
I know everyone here is on cpap, and I'm still debating. So, would you mind sharing why you choose cpap over the OA? I had a hard time falling asleep with it, but I'm sure I could adjust at some month in the future. However, at this point, I have a dentist appt set up to discuss OA .

IF you considered OA and could have been a candidate and, ruled it out would you explain why?
If you weren't severe (I don't' think I'm severe...) and never considered it, would you explain why?

I hate to pry, but I'm just trying to make an informed decision and your case experiences may help me do that.
Thanks so very much!
doceo

I have AHI 28
hypopneas; 51
obstructive apneas: 4
central apneas: 1
mixed apneas: 0

I have an oral appliance and jutting my mandible forward (that is what the device does) does not in the least resolve my apnea.

You think wearing a pressure mask is difficult, then think about wearing a bunch of plastic and metal in your mouth with your jaw jutted out all night for the rest of your life. Not a nice thought.

I had a hard time falling asleep with it, but I'm sure I could adjust at some month in the future.

Then why discuss MAD (mandibular advancement devices) with a dentist?

You should already know what he will say. "I have many patients who could not tolerate CPAP and they wear their MAD every night and their sleep apnea is well treated."

[kteague]

When I started using CPAP nothing else was offered. Once I got used to it and knew it worked, it was easier to keep doing what works rather than rock the boat and risk having less effective treatment, needing yet another sleep study to check it's effectiveness, and having a treatment I could not monitor with data like CPAP. Stability is real important to me as it's been an adventure balancing both my OSA and PLMD treatments. When something is working I'm reluctant to change. Triggering a bout of TMJ pain was also a concern. That pain in itself was once a sleep buster for me. If money were not an obstacle, I do think I'd like to know for sure if a dental device could be an option to CPAP for the convenience of travel. I don't hold out much hope for that since my OSA, once mild, is now in the severe range. From what I've read these are too expensive to just consider it a test drive. One other reason for my reluctance, I have a chronic cough and some lung issues. Sometimes I need to take deep breaths, like I have to "catch up". I've wondered if the dental devise would allow for that. Don't know. Everyone's situation is different. I certainly wouldn't fault anyone for hoping it's a viable option for them just as long as the attempt was made with eyes wide open and followup testing.

[RogerSC]

Talked with my sleep doctor about this on the first visit. Eliminated it on the basis that he said that the best that it would do is bring my AHI down to about 8. And he said that it only works for about 30% of the people that try it, at best. With an AHI around 29 and some minor TMJ problems, decided it wasn't worth all the investment to try it and then give up on it *smile*, so went straight to cpap. Cpap works pretty well for me, so I'm okay with it. Not overjoyed, but it has made my quality of life better on the whole.

On the other hand, I'm looking forward to the next great technological advance that will make today's cpap a thing of the past *smile*.

[RogerSC]

I'm pretty sure AHI > 25 is considered severe.

I think the medical establishment says > 30. However, for me personally anything > 5, I consider severe because I am not energetic the next day. If the committee that wrote that scale has an AHI of 28, let's see if they consider their condition moderate. 28 will make a very unhealthy person if left untreated for a few years.

Yes, my doctor said that as well, AHI >=30 is considered severe. And I've heard and read that several times since then. As I mentioned, I have an AHI of 29 according to my sleep study, which is borderline moderate/severe, although I'm currently losing some weight, so who knows, could go either way (or stay the same *smile*). My AHI sleeping on my side was only around 6, so I try to stay off my back, but haven't taken any proactive measures to make sure that happens.

[docjl]

I had a hard time falling asleep with it, but I'm sure I could adjust at some month in the future.

I also have insomnia. I've eliminated caffeine from my diet years ago, but ... the night of my titration study It took me 3 hrs to fall asleep because of the head straps. I can't say it was because of the mask, just the straps. I can't not sleep for 3 hrs and do my job on 2-3 hrs of sleep, though I wonder if it would balance out on how little sleep I am actually getting in my present state?

Then why discuss MAD (mandibular advancement devices) with a dentist?
Because I assume it won't take me so long to adjust to it and I could be totally wrong here. I also feel it would be easier to travel and I'm goin to retire in 3 years with plans to travel with my husband whom I haven't seen much of in the last decade since he lived everywhere but home

You should already know what he will say. "I have many patients who could not tolerate CPAP and they wear their MAD every night and their sleep apnea is well treated."

I know...that's why I'm trying to get as much info as I can. I do want to make an informed decision, but it isn't easy! My dad, brother, and sister all have sleep apnea and none of them will wear the cpap. Not that their behavior affects me, but many people with this problem (is it called a disease?) will wear their gear.

I'm relying on what I can glean from cpap and sleep apnea forums and the rest of the net. I'm very appreciative of all the info I get at these two places, especially since I've only talked to the sleep tech; I was not referred to a sleep doctor. I located this site http://www.umm.edu/patiented/articles/w ... 0065_9.htm University of MD and it states on the page that side sleepers aren't very successful with it and that it may cause some sleep apnea gets worse. Is that true? I hadn't heard that before!

[zoocrewphoto]

hi
I know everyone here is on cpap, and I'm still debating. So, would you mind sharing why you choose cpap over the OA? I had a hard time falling asleep with it, but I'm sure I could adjust at some month in the future. However, at this point, I have a dentist appt set up to discuss OA .

IF you considered OA and could have been a candidate and, ruled it out would you explain why?
If you weren't severe (I don't' think I'm severe...) and never considered it, would you explain why?

I hate to pry, but I'm just trying to make an informed decision and your case experiences may help me do that.
Thanks so very much!
doceo

I have AHI 28
hypopneas; 51
obstructive apneas: 4
central apneas: 1
mixed apneas: 0

My ahi is severe - 79. Alternatives list success at 50% reduction, which would leave me at 40, still severe. No point in bothering. xpap (cpap, apap, bipap, vpap) is the only treatment that can take somebody of any severity and get them down to less than 5 (normal).

Your ahi is 28. Assuming "success" with any other treatment would get you an ahi of 14. Still in the moderate category. And still not successfully treated my doctor's standards. And most people here find that even 4 and 5 doesn't produce good enough results. Most people don't feel better unless they are under 1 or 2.

Also, keep in mind that most people get worse over time, so your untreated 28 now may be 60 or more in 10 years. Any treatment (even cpap) doesn't cure sleep apnea. It only prevents the events when used. So, as your actual sleep apnea gets worse, you will need your treatment to keep up with it. CPAP machines can be adjusted. And machines with data can help you determine if your treatment is working and if you need to make adjustments.

[Thewino]

I'm like the Zoocrew above me. My AHI in REM is nearly double the definition of severe sleep apnea. My only real choice was CPAP.

TheWino

[mgaggie]

for me it was the difference in cost. OA's cost thousands and you can't send it back if it doesn't work. A cpap machine you can hire or buy, and in my country certain hospitals will let have one indefinately for a small outlay.

Having said that, if I had the money I would still go for a cpap machine. I don't like the idea of my jaw being forced into an unnatural position.

[RogerSC]

I noticed that you mention the mask and head straps as being an issue. There are many different models of masks, and they have different ways of staying on. There's even a new one that is held on orally, anchored to your teeth (like an OA), and has no straps (ideally). This one is the TAP PAP, you can find it on cpap.com, the sponsor of this forum. In any case, one gets used to sleeping wearing one's mask, we are a pretty adaptable species. For the first week of using cpap, I used Ambien to help get to sleep with everything on and going, and after that didn't need it, had become used to it enough to just go to sleep. Don't take your titration experience at the lab as what will happen at home...for my sleep study I only got about 3 hours sleep (no mask, just uncomfortable), and get much more at home *smile*. Just like you will if you give it a chance.

Many people have that feeling, "how can I ever get used to sleeping with all this". Yet many people do. Some people give up, but a lot go ahead with it until they're used to it and it's all very routine.

Hope that this works for you, just give it a chance and see how it goes.