Has anyone's bruxism been helped by xPAP?

[phoebe368]

I also want to mention that individuals with UARS have difficulty adjusting to cpap because their central nervous systems are highly aroused by all the nightime flow limitations. Don't feel bad it also took me a long to adjust to cpap like a whole year. I was one of the hardest things I have ever done almost like training for a marathon. Initially I would wear it during the daytime while doing something relaxing like reading or watching tv just so I get accustomed to have something on my face. Then I would try to sleep with it. For the first couple of weeks I couldn't sleep with it on at all. The best thing to do is not stress over it so much, If you don't fall asleep with it just remove it and try the next day. Soon, I began to sleep with it for 1 hour, then 2 then 4 etc. It was not uncommon for me to find the mask on the floor in the middle of the night. I don't even remember removing it. Than after awhile like the 8 month mark I was sleeping with it on all through the night.

[abigailrivers]

I too suspected that I had some sort of sleep disorder since I my sleep was always unrefreshing and I felt tired during the daytime. I also bruxed so bad I would get migraines. I had 2 sleep studies which came back negative, just listed snoring and unexplained arousals. I then went to the world famous Stanford Sleep Disorders clinic and was finally properly diagnosed with OSA - Respiratory index of 14 and many flow limitations. I tried the cpap route which helped with the bruxing and then finally had surgery. I am young and thin but suspect my sleep apnea was caused by receding jaws which was exacerbated by extractive orthondontics. My first suggestion to you is to get properly diagnosed because without being properly diagnosed doctors and insurance companies won't take you very seriously. I don't know what kind of insurance you have but try to get your sleep study done at Stanford as they have better, more sensitive testing equipment than other sleep labs. I also recommend reading this article by Dr. STeven Park on UARS:

http://doctorstevenpark.com/sleep-apnea ... e-syndrome

Thanks for the reply, phoebe! I'm glad you've found relief.
What kind of surgery did you end up having?

That's really amazing that your disorder could remain masked through two negative studies...I also had two negative studies, same as you, snoring and some arousals. I've looked into Stanford; I even called them and they charge $900 for an initial consult and $12,000 for the actual study. I'm uninsured and I don't have that kind of money, so I bought an APAP and started looking for flow limitations on my own using sleepyhead. But there don't seem to be any. Although, the moral of your story seems to be that the "data" is often wrong...and I'm guessing the data picked up by a home APAP is less sensitive than even the crappy regional sleep center where I had my studies at, so...

[abigailrivers]

I also want to mention that individuals with UARS have difficulty adjusting to cpap because their central nervous systems are highly aroused by all the nightime flow limitations. Don't feel bad it also took me a long to adjust to cpap like a whole year. I was one of the hardest things I have ever done almost like training for a marathon. Initially I would wear it during the daytime while doing something relaxing like reading or watching tv just so I get accustomed to have something on my face. Then I would try to sleep with it. For the first couple of weeks I couldn't sleep with it on at all. The best thing to do is not stress over it so much, If you don't fall asleep with it just remove it and try the next day. Soon, I began to sleep with it for 1 hour, then 2 then 4 etc. It was not uncommon for me to find the mask on the floor in the middle of the night. I don't even remember removing it. Than after awhile like the 8 month mark I was sleeping with it on all through the night.

When you started looking at your data yourself (I'm assuming you did)- did you see flow limitations?

Thanks for the encouragement. I am currently sleeping with it for a couple of hours per night, although I've made it through the whole night twice now.

[Pugsy]

Abigail...what do the flow limitation graphs look like on your S9 reports in SleepyHead?
Even if for just a couple of hours.
I don't think you are going to get much help from the AHI portion of the scoring because you never had many apnea events in the first place.
Do you have the SleepyHead software up and running yet?

Here's what nice normal flow limitation graph looks like...not much to look at. Compare yours to mine.

[MrGrumpy]

I really recommend against any type of surgery to treat obstructive sleep apnea. I would never have the UPPP, read so many negative things about it. And my experience with a tonsillectomy totally trainwrecked my CPAP therapy which had been going OK. I did not do the tonsillectomy to help my sleep apnea, I had a tonsillectomy done because I was experiencing repeated bouts of simple tonsillitis (infections) that were leaving me exhausted, but to be honest nowhere near as exhausted as I became after I had to tone my AutoPap down.

Ive just not read or heard of many people having positive surgical approaches to treating sleep apnea. Maybe nasal obstruction surgery for sinus problems, I could maybe see that. Or I could see having a simple tonsillectomy BEFORE you ever started CPAP, if it helps reduce your fatigue great, if not, move onto a real OSA therapy.

That Inspire surgery looks OK, but looks expensive and it appears only for severe OSA which I dont have. But the Inspire surgery is not really classic surgery its more like an implant.

My attitude about surgery and sleep apnea is CAVEAT EMPTOR! Let the buyer beware. CPAP really is the gold standard, it works well if you can tolerate it and its not that expensive anymore, either.

[grayghost4]

interesting reading

http://askthedentist.com/night-guard-for-grinding/

[esel]

I definitely have suffered from unrefreshing sleep for a long time, and my life has been pretty much controlled by depression due to low energy since I was a kid. (I have also sought out every possible means of treatment for the depression, short of electroconvulsive therapy or brain implants, and again, nothing has worked.)
On my own, I've acquired an APAP machine (Resmed S9 Autoset) in the hopes that it would help my unrefreshing sleep and bruxism. I suspect I have UARS rather than full-blown apnea. I'm trying to get used to sleeping with the machine (very difficult, going on a month now and have been able to keep the mask on all night only twice) and to learn to use sleepyhead.

Well, you have gone quite a way...

I think APAP is worth wile trying. You will have to work out the settings that may work for you. Main criteria is how you feel after a week with one setting before trying an changing parameters. Post graphs from SleepyHead and ask questions.

Concerning depression, you will find that sleep disorder is likely the culprit. IMHO it could be the other way around or a vicious cycle.

One more thing you may want to try. Bacteria in our digestive truck play important role for many things. A little diet and taking a mix of bacteria can do a lot. If Interested I can tell you more about it.

a quote from wiki:
"A systematic review from 2016 examined the preclinical and small human trials that have been conducted with certain commercially available strains of probiotic bacteria and found that among those tested, Bifidobacterium and Lactobacillus genera (B. longum, B. breve, B. infantis, L. helveticus, L. rhamnosus, L. plantarum, and L. casei), had the most potential to be useful for certain central nervous system disorders."

[abigailrivers]

Hi Pugsy,
Here's a recent night's data.

What do you think?

[Pugsy]

If you look at the flow limitation line it's a little bit active but I have seen much worse.
Then look at the pressure line and you can fairly easily spot the times when the pressure goes up and the flow limitation line is also a bit more active at the time of the pressure increase.

This is to be expected since flow limitations are part of what the algorithm for these apap machines will increase the pressure for.
Snores, flow limitations as well as OAs and hyponeas are what the machine will try to prevent with more pressure.

Your flow limitation graph isn't all that bad. Do you have much of a problem with nasal congestion at all?

[abigailrivers]

Thanks for the reply. No, I don't ever have a problem with nasal congestion.
So I wonder if it's worth it to try to continue with the APAP?

[Pugsy]

Since the only reason you are trying the APAP is for the bruxism....I dunno if it is worth continuing.
The whole idea is that some people with sleep apnea or sleep disordered breathing will sometimes do the bruxism thing because of the apnea...and if you fix the apnea then the bruxism gets fixed.
Unfortunately bruxism can happen for some other reason than sleep apnea and when that's the case using cpap can't fix the problem because the problem isn't related to sleep apnea. The machine can only fix problems related to sleep apnea..it can't fix problems related to something else no matter how much we want it to.

This apap experiment was just to see if it helped with the bruxism...is that correct? You have no other symptoms that might point to sleep disordered breathing of any kind...is that correct?

If it were me though....even if bruxism was the only problem...you really haven't had a chance to use the machine all night for several nights in a row. I think I would give it more time.....it's not hurting anything except maybe the usual sleep quality issues that we all have had when trying to get used to this therapy.
You have to decide if it is worth continuing..
Your software results are going to be pretty much boring since you don't have sleep apnea.

CPAP can't fix bruxism if the bruxism isn't related to sleep disordered breathing. Unfortunately there's no marker we can use except trial and error when there's no sleep disordered breathing going on to measure the results.
It might be that there's a tiny bit of UARS going on...your flow limitations aren't horrible but you have some...compare yours to mine and you can see that you do have more than I have. Now we don't know if a little flow limitations for sure means UARS..but it could. Since you don't have nasal congestion we can't blame those flow limitations on nasal congestion fooling the machine.
It wouldn't be impossible for you to have maybe some UARS going on.....and cpap is the first line of therapy for UARS.
Would UARS cause bruxism....that's an unknown and it's really going out on a long skinny limb to make that correlation.
It wouldn't be impossible but it's a stretch.

I don't have an example of a really "bad" flow limitation graph from someone with very likely UARS (it's a difficult diagnosis to make) so you can see what I mean. I will poke around a bit to see if I can find one.

As to whether you should continue the experiment...I dunno...if all you were wanting to fix is the bruxism...and it was a stretch to blame the bruxism on sleep apnea...it's a tough call. I assume you haven't noticed a change but then you really haven't gotten to the point where you used the machine all night for weeks either.

[Pugsy]

viewtopic.php?f=1&t=111340&p=1068739&hi ... h#p1068739
Above thread has an example of ugly FL graph.
Change the scale in yours to make it compare with the scale in hers. Right now you have so many graphs in one image that it makes for all the graphs being tiny...so make the FL graph bigger so you can see the scale better.
The you will be better able to compare.

I just don't know if your FLs are much of a problem or not. My gut says they aren't which means most likely they aren't responsible for your bruxism.

[abigailrivers]

Thanks for the thoughtful response and the ugly FL graph, Pugsy. That gives me a much better idea of what severe flow limitations look like.
I do have other symptoms of sleep-disordered breathing besides bruxism- but they are all, also, symptoms of depression. Daytime fatigue/sleepiness, brain fog, things like that. I do fit the UARS "profile" but then again, those symptoms are pretty nonspecific too. My understanding of UARS was that it was also correlated with bruxism.

I think I'm going to try setting my APAP pressures to min 4, max 4. Then, the data should tell me how bad my flow limitations are without any significant pap support. Then I'll know if my FL graphs of late- with pressures from 8-12- indicate a treated FL problem instead of just a baseline level of low flow limitations.

[Pugsy]

Sounds like a plan to start with and it may give you some answers.

[Jeanne Ellen]

Hi Abigail,
I've also had bruxism, and it was a problem for me for many years. Have you ever tried a mandibular advancement device? It's a two-piece mouth guard that prevents clenching and holds your lower jaw in a position that advances it beyond your upper jaw, helping your airway stay open. I know you said you'd tried everything, but I didn't hear you mention this. Mine was very expensive, about $2,000, and of course, insurance didn't pay anything. However, there's lots of models on the market in a range of prices. Mine was made by a dentist who specialized in TMJ. He spent months working with me to get it advanced to an optimal place. It worked pretty well for me for about ten years, until my OSH got to the point where I had to give it up and go to cpap--and even then, my case of OSH is very mild compared to most people. These devices aren't going to work for people with serious cases of OSH, but it may be an option for you.

I also had a history of seasonal allergies. I never felt this interfered with sleeping, but my doctor told me to go to an allergist and get some tests done. It turned out I had significant allergies to dust, trees, and grass. So I started taking allergy shots and using prescription sprays at night before bed. And it helped. So if you've ever had hay fever in the springtime, you might look into a visit with an allergist.

The combination of the MAD and the allergy treatments, allowed me to sleep like a normal person for a long time. Hope this helps. Good luck!