Alternatives To Cpap???

[tommie1]

Hi. Anyone have personal experience with, or know of anyone, who has used some sort of MOUTH device to treat their SA? I was diagnosed with moderate SA (24.7/hr) and can't seem to tolerate the CPAP with its hose, FFM, etc.
Just wondering if there have been any recent advances which are less cumbersome. Thanks.

[Goofproof]

Dying in your Sleep, massive organ failure, none personally because I use my XPAP every night, the Gold Standard! Jim

[Doublev]

I am curious to hear about any experiences with the mouth appliances also

[zoocrewphoto]

Hi. Anyone have personal experience with, or know of anyone, who has used some sort of MOUTH device to treat their SA? I was diagnosed with moderate SA (24.7/hr) and can't seem to tolerate the CPAP with its hose, FFM, etc.
Just wondering if there have been any recent advances which are less cumbersome. Thanks.

With cpap, the medical definition of success is under 5 ahi. That is still 5 sleep disturbances an hour, and many of us don't feel better until under 2 per hour.

With mouth devices, their definition of success is an ahi reduction of 50%. In other words, your doctor would consider the treatment successful if YOUR ahi went down to 12 per hour. That is still mild sleep apnea with an average disturbance every 5 minutes. And that doesn't include how long they might be.

Honestly, you will probably have much more success with cpap. We can help you dial in your settings to what really works for you AND feels comfortable.

[Guest]

Hi. Anyone have personal experience with, or know of anyone, who has used some sort of MOUTH device to treat their SA? I was diagnosed with moderate SA (24.7/hr) and can't seem to tolerate the CPAP with its hose, FFM, etc.
Just wondering if there have been any recent advances which are less cumbersome. Thanks.

Why not mention the problems you are having to see if there are solutions.

[ChicagoGranny]

can't seem to tolerate the CPAP with its hose, FFM, etc

I'm guessing that you haven't spent any time here letting the members help you to optimize and adapt to your CPAP therapy. You should do that before chasing inferior alternatives to CPAP.

[robysue]

I am curious to hear about any experiences with the mouth appliances also

This is a cpap support forum more than just a sleep apnea forum. So there are not many (if any) regular posters here who have much experience with oral appliances for OSA.

The literature out there on oral appliances is mixed. Most studies I am aware of define "successful oral appliance therapy" as cutting the untreated AHI in half. Cutting your untreated AHI in half still leaves you with an AHI = 12, which is on the high end of "mild" OSA. So if you decide to go the oral appliance route, you need to ask a lot of questions about how the dentist who prescribes and adjusts the device will decide that the therapy is successful.

It's also important to find out whether a follow-up study with the oral appliance in place will be done to objectively verify that the device is working and how much it has cut your AHI. Not all dentists are willing to fight an insurance company for authorizing a follow up study.

It's also important to keep in mind some people find that it is no easier to sleep with an oral appliance that forces the lower jaw into an unnatural position than dealing with CPAP. And a few people are unlucky enough to experience some serious movement of teeth with an oral appliance.

[CPAPPED-ADAPT]

Hi. Anyone have personal experience with, or know of anyone, who has used some sort of MOUTH device to treat their SA? I was diagnosed with moderate SA (24.7/hr) and can't seem to tolerate the CPAP with its hose, FFM, etc.
Just wondering if there have been any recent advances which are less cumbersome. Thanks.

I too was diagnosed with moderate OSA but also developed treatment-emergent complex apnea and use CPAP, a mandibular adjustment device (MAD) and positional therapy. The three combined keep my AHI very low, and the latter two assist keeping the machine pressures lower than without them. I seem to be sensitive to the higher pressures required, and too high a pressure (both E and I) can result in headaches/nausea.

The mandibular device is no picnic, and was more costly than my ASV pap machine. It has resulted in TMJ and tooth discomfort as well, so I keep it only on the least agressive setting. It does help keep my pressures a bit lower, however.

My opinion would be to avoid the MAD altogether, unless you've a very narrow throat opening (as I do), or at least until you've given CPAP a very thorough try-out and failed it. By that, I mean many, many months of trying, and perhaps tweaking, with the help of some seasoned veterans here. I wish I could give you something easier to swallow, but there is no magic bullet in dealing with OSA. Just the gold-standard CPAP, as has already been mentioned.

[chunkyfrog]

I had a colleague who had TMJ, and I would hear her moan involuntarily when the pain was too great.
She was not enjoying it.

[CPAPPED-ADAPT]

I had a colleague who had TMJ, and I would hear her moan involuntarily when the pain was too great.
She was not enjoying it.

Reading that makes me cringe, I hope this person is doing better. My TMJ lasted about nine months, where I was completely unable to use the MAD. A steroid dose knocked down the initial severe pain, but it was a constant low-grade ache after that. My MAD is merely a means of keeping my jaw from complete collapse, as a cervical collar just does not do the trick. In the past I'd adjust the advancement to +2mm, then wake up with lock-jaw / severe pain, and have to start all over again. Dum-Dum doesn't do that any more. Ain't it great we don't have to start over from 4 cm after a bad night of CPAP?

[D.H.]

The OP has not replied yet! I hope (s)he is ding better. While CPAP is the "gold standard" at this time, it's not for everybody. However, I am hoping it can be for most who need it! Better compliance monitoring and patient follow-up can make this happen! It probably is not realistic to start in the U.S., but perhaps one of the smaller wealthy countries with a Single Payer Plan can make this happen in its own borders!

[LSAT]

The OP has not replied yet! I hope (s)he is ding better. While CPAP is the "gold standard" at this time, it's not for everybody. However, I am hoping it can be for most who need it! Better compliance monitoring and patient follow-up can make this happen! It probably is not realistic to start in the U.S., but perhaps one of the smaller wealthy countries with a Single Payer Plan can make this happen in its own borders!

==========

cpap is the least worst treatment for OSA
for other problems is is poor

compliance monitoring is counterproductive
patient follow up is a joke
we just get told to use it 4 hours a night or else
or else being they wont get paid by insurance

we certainly hope we never get stuck with some fascist/socialist single payer con game

Learn the rules......It's just 4 hours per night 70% of the time during a 30 day period in the first 90 days. After that there is NO compliance requirement. Why is Compliance monitoring a joke...If the patient is not using the machine...why should insurance pay for it. You are the joke!

[LSAT]

Obviously you have a crappy DME.....Why don't you go elsewhere? Unless you are in small town in the middle of nowhere, there are lots of DME's around...OR...pay out of pocket and tell the DME to get screwed. A brilliant engineer should be able to pay out of pocket.

[Goofproof]

Obviously you have a crappy DME.....Why don't you go elsewhere? Unless you are in small town in the middle of nowhere, there are lots of DME's around...OR...pay out of pocket and tell the DME to get screwed. A brilliant engineer should be able to pay out of pocket.

A brilliant engineer, living at home in mommies basement should be rolling in money!

[RogerSC]

There are a couple of podcasts from the "Breathe Better Sleep Better Live Better" series by Dr. Steven Y. Park:

"7 Reasons Why I Like Oral Appliances for Sleep Apnea"

"8 Reasons Why Oral Appliances May Not Work for You"

I found these by searching iTunes, and found them to be interesting:

https://itunes.apple.com/us/podcast/bre ... 95799?mt=2

The two specific podcasts that I mentioned above are #26 and #27 on the list, in case they don't stand out *smile*.