New Lip Seal and TAP appliance Adjunct + TAP w/CPAP

[socknitster]

Since I'm getting a TAP appliance soon (it came in but had to be sent back for more adjustment) I was very interested to see this info:

http://www.comfortacrylics.com/appliance/appliance.html

and then there is info on using TAP with CPAP:

http://www.comfortacrylics.com/appliance/article.html

another view of the SAAMS system:

http://www.ihatecpap.com/oral_appliance.html

This is all new to me. I'm going to try to get more info on all of this.

jen

[Guest]

I tried the mandibular advancement device and guess what, I stopped snoring (but my oxygen levels were dropping into the 70% range. 200.00 copay down the drain.

[socknitster]

O,

I'm sorry it didn't work for you! Some have had really good success with it, so I remain hopeful.

jen

[oceanpearl]

O,

I'm sorry it didn't work for you! Some have had really good success with it, so I remain hopeful.

jen

Really thought that I was being succesful until the sleep doctor ordered an overnight oximeter test.

[socknitster]

So, it felt good? It wasn't hard to wear? I will be having another psg after I get mine. If I need to stay on xpap I may decide not to use it or I may try one of these devices on the page I listed above--it would be nice to not have all the harnesses and tape on my head!

jen

[jla930]

I don't want to rain on anyone's parade, but I recently attended an A.W.A.K.E. meeting with a dentist as a guest speaker. This guy stopped practicing "everyday" dentistry and is solely in business to provide oral appliances for OSA folks.

The success rates of oral appliances aren't very high, especially for severe OSA. Mild OSA people have a better rate of success. I'm sorry I don't remember the sucess rates. But they didn't floor me. The overall impression I got from the lecture was that oral appliances are a last resort therapy, especially for severe OSA. In fact, the guy said that he can't look a severe OSA patient in the eye and tell him/her that oral appliance therapy will work for sure.

Someone please correct me if I'm under the wrong impression.

Now if you have mild to moderate OSA, go for it.

[Guest]

So Jen, you're going to send me your NAII and buy a DIFFERENT NASAL PRONGS MASK?

You sure the pain of your toe injury isn't making you hallucinate?

LOL,
B.

[snork1]

As opposed to the CPAP compliance rates being so high????

I guess I am just lucky. The TAP is working great for MY moderate apnea, but if its not tongue position related apnea, its certainly not going to work, and its certainly not THE solution for EVERYBODY.

Oximeter report stays above 90% for me at night too, in addition to stopping the snoring.

Its been well over a year for me.

I GAINED weight on CPAP, which is highly unusual. I have actually lost about 20 pounds since switching to a dental device from CPAP, and I wasn't particularly overweight to begin with.

Any solution that works is NOT a "last resort". I just wish that apnea sufferers were allowed to TRY more reversible options before figuring out WHICH compromises and problems they want to put up with.

There is NO PERFECT SOLUTION to apnea. Its ALL a matter of compromises.

[socknitster]

I don't want to rain on anyone's parade, but I recently attended an A.W.A.K.E. meeting with a dentist as a guest speaker. This guy stopped practicing "everyday" dentistry and is solely in business to provide oral appliances for OSA folks.

The success rates of oral appliances aren't very high, especially for severe OSA. Mild OSA people have a better rate of success. I'm sorry I don't remember the sucess rates. But they didn't floor me. The overall impression I got from the lecture was that oral appliances are a last resort therapy, especially for severe OSA. In fact, the guy said that he can't look a severe OSA patient in the eye and tell him/her that oral appliance therapy will work for sure.

Someone please correct me if I'm under the wrong impression.

Now if you have mild to moderate OSA, go for it.

That may be true when you group all oral appliances under one umbrella. However, the TAP appliance has pretty much been singled out as the best of the bunch and it was recently FDA approved for even severe OSA. My oral surgeon NEVER told me I would get off cpap. He said it was a minor possibiltiy. Mainly at that time we were focusing on two things:

1) making cpap possibly more comfortable (at the time I was not tolerating the high pressure I was on, I have since been able to reduce my pressure needs thru treating silent GERD and tonsilectomy) and

2) if TAP "cures" you, then you are clearly a candidate for the MMA/GA surgery.

I am all about exploring my options. For me, I would rather go into debt and explore things than live a suboptimal life. Fortunately for me, my insurance is covering most of the cost. It is a medical device, not a sheister act.

If there is a chance I could get off cpap, I'm not going to lie, I would be ecstatic. Popping a dental device in my mouth is far less intrusive and easier to pack than this machine!

Like Snork said, everyone is different. My particular issue is a receded jaw and large tongue. It is obvious to me, once it was pointed out to me. My mouth is SMALL. Moving my lower jaw forward should open the airway, especially now that my gigunda tonsils are out of the way.

Not everyone is going to have the same issue--this is a complex disorder. Each person has to find out what works for them. I'm not stabbing in the dark here. I have RESEARCH and INFORMATION to back me up. My doctor is great--I feel confident if the TAP wouldn't help me, he would have told me so. But he never said the word CURE--he made that very clear. That is why you see these TAP-CPAP related components emmerging. Many, many people are letting their cpaps collect dust because they can't stand the high pressures they have been prescribed--if this could make it easier, why discourage them.

If a percentage of folks who would die young from noncompliance with cpap can find help with the TAP, my goodness, how could you discrourage them? Live longer with TAP vs. die young with cpap in closet. Hmmm. I'd rather live. I'm not in that category, but a helluva lot of people are!

Babs, I never hated the NAII. I just didn't see much point in toughening up my nostrils for it when I like the swift II so much better. If I could get all the headgear off my head--chin strap and mask straps, I would give up the swift II in a second. Can you imagine, just popping a thing in the mouth and then shoving the pillows/prongs up your nose without all the stuff getting stuck in your hair, leaving marks on your face etc. That would be worth it to me.


Snork, thanks for popping in. Have you seen these things yet? Did you know that my prescription was bipap 16/12 and now after treating silent GERD and tonsilectomy, my machine is titrating my 90% pressure at 11/7! I'm thinking it is possible now that the TAP might work for me. Trying not to get my hopes up too much, but hey, this is exciting stuff! I'll find out more when I get the TAP on Oct 3.

Jen

[jla930]

I absolutely agree that everybody is different, and diffferent people respond differently to different therapies. I've been a hosehead for only a month, but long enough to know that everybody's different.

I NEVER said the success rate with oral appliances is zero. I NEVER said the success rate with CPAP is 100%.

But when even the dentist stands there and says, "If you've got severe OSA, I can't look you in the eye and tell you that oral appliance therapy will work", well then....

Yes, I know there are no guarantees with oral appliances, CPAP, BiPAP, or even the old bag over the head.

My point was this: generally speaking, if CPAP doesn't work out for someone, he/she shouldn't walk into oral appliance therapy expecting it to be the cure-all. And for severe OSA, it IS a last resort therapy, if all else failed. You can dispute me all you like: I'm quoting the dentist. He said that if you have severe OSA, the success rates for oral appliances are lower than other methods.

I'm not trying to discourage ANYONE.

I'm relatively new at all this, and I certainly confess I can learn much from all of you. I'm not arguing with anybody here. I'm telling you what my understanding was from a lecture I attended given by a professional.

ADDED: found this on a web site:
(I'm sure there are other sites that dispute it.)

"Barbara Phillips, MD, Director of the Sleep Center and Sleep Fellowship at Samaritan and University of Kentucky Hospitals, notes that while oral appliances can be effective for treatment of snoring and mild sleep apnea, "they are definitely less effective than CPAP [continuous positive airway pressure]. Further, their use probably declines over time. For this reason, it is important for the practitioner who recommends or provides the oral appliance to be fairly certain that the patient has simple snoring, not sleep apnea." Oral appliances appear to be more effective than surgery for sleep-disordered breathing and probably for snoring, she says. Dr. Phillips recently joined the NSF Board of Directors."

[socknitster]

My point is:

These may be a helpful ADJUNCT to CPAP therapy. I NEVER said it would REPLACE my therapy, nor that it should anyone elses.

If the very least this does for me is get all the straps off my head and lower my pressure so that I can sleep on my side, (I have terrrible problems with aerophagia) then it will be worth $800 to ME.

Knowledge is power. I'm just bringing something new on the market to anyone's attention that it might help. I'm not calling it a cure and I'm not telling everyone to go chuck their cpap and try this appliance. Far from it.

Your doctor's opinion is ONE opinion of ONE medical professional. I have read many, many opinions online about this appliance and most are favorable, from both medical professionals and lay people like SNORK who have had great success. I'm not interested in getting into a debate about it with you. Everyone is entitled to their own opinion. But knowledge is always power.

Jen

[snork1]

[quote="jla930"]I absolutely agree that everybody is different, .........
ADDED: found this on a web site:
(I'm sure there are other sites that dispute it.)

"Barbara Phillips, MD, Director of the Sleep Center and Sleep Fellowship at Samaritan and University of Kentucky Hospitals, notes that while oral appliances can be effective for treatment of snoring and mild sleep apnea, "they are definitely less effective than CPAP [continuous positive airway pressure]. Further, their use probably declines over time. For this reason, it is important for the practitioner who recommends or provides the oral appliance to be fairly certain that the patient has simple snoring, not sleep apnea." Oral appliances appear to be more effective than surgery for sleep-disordered breathing and probably for snoring, she says. Dr. Phillips recently joined the NSF Board of Directors."

[Snoredog]

That may be true when you group all oral appliances under one umbrella.

need a theme song for that umbrella:

http://www.defjam.com/site/promo/quickt ... cktime.php

[socknitster]

Snoredog, I'm not sure what you meant by that video, but Harry (my 4 year old) and I enjoyed watching it with my mouse planted on the x at the top right of the screen in case it got racy. Harry liked the music. I'm sure you enjoy the beautiful young girl!

I don't mean to get so defensive on this topic. But really--imagine you have been here at cpaptalk.com struggling with your cpap therapy and then you try the TAP, life isn't a struggle anymore and you find yourself not needing to tweak all the variables associated with cpap. Maybe you just move on to other things and never come back here to tell others. Especially if you were a lurker.

Fortunately, we have Snork who has stuck by us to tell us that it DOES work--at least for some.

I am 35 years old. While cpap has helped me more than I can measure, it is a frustrating construct. I feel that there has to be a better way. I can't see myself fighting aerophagia and a hose strapped to my head for the next 45 years. And I am not interested in any more surgery. That leaves me with trying reversible, non-invasive alternatives to either:

a.) eliminate the apnea without cpap OR

b.) try to make cpap as comfortable as possible.

I'm willing to spend my money being a guinea pig. I realize to some that may seem foolish, but to me, that is the scientific method. We all of us moan about how annoying cpap is. Science can't come up with something better unless people are willing to try it. Someone has to try it.

I will--and report my findings. I am going to have another psg and possibly a pulse oximeter to see how I do on it. As with everything else related to cpap--your mileage may vary.

jen

[RosemaryB]

Jen, I'm interested to hear your results with the TAP over time. One question I have is whether it seems to help with TMJ problems or does it worsen them?