oral appliance vs CPAP

[keysgate]

newbie here and was just curious if anyone here has tried a prescribed oral appliance fitted by a dentist such as MAS? I have just started my journey with sleep apnea with upcoming appointment with a sleep specialist. I have been doing research on the treatment of sleep apnea with oral appliances and would much rather go in this direction then having to have the mask on my face and air blowing down my throat. The deciding factor also is the cost. My insurance will pay all the cost of CPAP, but only a percentage of an oral appliance. So that is why I am asking if anybody has had any experience with the oral appliance option. Thanks

[jnk...]

When I started out, an oral appliance helped make my CPAP successful as I used both together.

Using an oral appliance alone, though, except in rare circumstances, is not nearly as effective as CPAP in treating OSA. That is why most reputable medical people do not recommend oral appliance as a first-line approach to OSA. They generally reserve the use of them for those who, for some reason, can't, or won't, use PAP therapy, since PAP remains the gold standard against which all other approaches are measured.

That said, for those who can't, or won't, use PAP, an oral appliance can be a very useful thing, since it may slightly reduce the severity of the OSA for them.

The larger issue is the inability to measure how successful the appliance is over time. That makes it a very dangerous approach indeed for many, perhaps the vast majority, of OSA sufferers.

[WindCpap]

My Niece went from CPAP to an oral appliance, and she likes it much better. There is a huge convenience factor when you don't get tied to a hose. I wouldn't get one for a few reasons:

1. (as mentioned). There is no way to know if things have changed, and the appliance needs to be adjusted without another sleep study (although they can do this with home studies).
2. I don't like sleeping with something in my mouth. I could never get used to a night guard.
3. The misalignment of your jaw may could future TMJ problems. CPAP, on the other hand has no long term side effects.

[ChicagoGranny]

air blowing down my throat

CPAP doesn't blow any air down the throat.

[keysgate]

air blowing down my throat

CPAP doesn't blow any air down the throat.

where does it blow?

[ChicagoGranny]

where does it blow?

If you have it operating properly, the only place it blows air is out the exhaust vents of the mask.

Inside the body's airway there is no blowing, only a pressure that splints the airway open. There is a big difference between a pressure and a "blowing" (flow).

[Wulfman...]

where does it blow?

If you have it operating properly, the only place it blows air is out the exhaust vents of the mask.

Inside the body's airway there is no blowing, only a pressure that splints the airway open. There is a big difference between a pressure and a "blowing" (flow).

If I may add a little to CG's post........the "splint" allows/helps the user to breathe more normally and naturally (and better).
These machines aren't "ventilators" that actually do the breathing for the user. These machines are in a class called of devices called "Flow Generators", that are non-invasive and the air pressure/flow is much lower.

As far as the oral devices, there have been many discussions about various types of them over the years (if you do a forum search). As was previously mentioned, depending on the circumstances, they may assist the user while still using the CPAP devices, but only in very limited applications could/should they be used instead of CPAP devices. Much of it depends on the nature/source of the Obstructive Sleep Apnea.


Den

.

[keysgate]

When I started out, an oral appliance helped make my CPAP successful as I used both together.

Using an oral appliance alone, though, except in rare circumstances, is not nearly as effective as CPAP in treating OSA. That is why most reputable medical people do not recommend oral appliance as a first-line approach to OSA. They generally reserve the use of them for those who, for some reason, can't, or won't, use PAP therapy, since PAP remains the gold standard against which all other approaches are measured.

That said, for those who can't, or won't, use PAP, an oral appliance can be a very useful thing, since it may slightly reduce the severity of the OSA for them.

The larger issue is the inability to measure how successful the appliance is over time. That makes it a very dangerous approach indeed for many, perhaps the vast majority, of OSA sufferers.

thank you so much , I am very lucky to be in a city that has a sleep apnea dental center run by a doctor who is a certified member of the (AADSM). they work with your sleep specialist to make sure the appliance is working as its supposed to , and makes adjustments as necessary.So every once in a while I would imagine I would have to redo the home test part of it to make sure there are no changes. I already know that I would need a full mask PAP as I am a mouth breather and just looking at the pictures of this setup gives me insomnia worse comes to worse I can always fall back on CPAP

[Sheffey]

air blowing down my throat

CPAP doesn't blow any air down the throat.

Granny, I'm surprised you did not give him your, "Would you rather treat your condition with an appliance crammed into your mouth or an appliance sitting on your nightstand?"

That was a classic.

Keysgate, I have both, but will only use the nice one sitting on my nightstand.

[Sheffey]

I would need a full mask PAP as I am a mouth breather and just looking at the pictures of this setup gives me insomnia

You've defeated yourself at CPAP without even starting. Go with the mouth appliance.

[palerider]

air blowing down my throat

CPAP doesn't blow any air down the throat.

where does it blow?

out the vents on the front of the mask.

think about it, for a second. even though kneejerk reaction are much easier...

if there was air blowing down your throat, WHERE DOES IT GO? it has to go somewhere, or you'd swell up like a macy's thanksgiving day parade balloon and then BOOM, red gloopy bits all over the walls, ceiling, nightstand, family pet... what a mess.

unless, of course, you have gills on your side for the air to exit, then it could blow down your throat.

[keysgate]

I would need a full mask PAP as I am a mouth breather and just looking at the pictures of this setup gives me insomnia

You've defeated yourself at CPAP without even starting. Go with the mouth appliance.

com'on man, I gave the statement a wink. I haven't gave up on anything, and I can adapt to anything. I will get a taste of the CPAP when I go for my sleep analysis to at least try it. I am only stating that for me at this point I seem to gravitate towards the mouthpiece. My wife says no way is she going that route, so to each their own. Just looking for folks inputs on different treatments. There is a lot of gear with the CPAP, also alot of keeping the gear clean, the mouthpiece is a small (or maybe large) appliance. Maybe when they hook up the machine to me I may change my mind on the spot and say, hey, this ain't so bad. I will definitely let you all know how it all comes out.Also everything will have to be approved with the sleep specialist, so I may not even have the option.

[palerider]

There is a lot of gear with the CPAP, also alot of keeping the gear clean,.

mostly written by lawyers afraid of getting sued by stupid sue happy people.

I wipe off my mask, and change the filters. when using a FFM, I'd wash it once a week and wipe it off nightly.

[Julie]

Remind your wife that it's not about looks or even little bits of extra sound, but life and death. We all believe strongly, for instance, that Justice Scalia likely died of sleep apnea - it can provoke strokes, heart attacks, diabetes, kldney disease, etc. Plus who cares when lights go out?

[keysgate]

Remind your wife that it's not about looks or even little bits of extra sound, but life and death. We all believe strongly, for instance, that Justice Scalia likely died of sleep apnea - it can provoke strokes, heart attacks, diabetes, kldney disease, etc. Plus who cares when lights go out?

thanks, we both know. What I meant with that statement was she did not want to go with a dental appliance, she couldn't stand something in her mouth like that. She wants to go with the CPAP. Now you have me looking up Scalia's death.