Dental Appliance (Mandibular Advancement Device)

[So Well]

Sorry, I am probably in the wrong forum to ask this. But could you point me to resources in the U.S. which survey the different devices and their approximate costs? I have no insurance and I want to buy a cheap one to experiment with. I am hoping it could be used as an adjunct to CPAP. In the best case, maybe it could replace CPAP and then I would be willing to buy a more expensive appliance if necessary.

I learned much from your forum and have the software with my CPAP to monitor therapy when I try out an appliance.

[Velbor]

http://www.talkaboutsleep.com/message-b ... m.php?f=10

http://www.aadsm.org/

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

http://www.quietsleep.com/

[Mtnviewer]

I've been using the Klearway appliance for 2-3 years (sorry I forget), and first by itself and for the last 10 mths with APAP. I am a severe mouth breather and my apneas are especially bad when I'm on my back.

My experience is that the oral appliances is not anywhere nearly as effective for me (or I'd bet most anyone else) as PAP therapy for apnea reduction, vs. just snoring reduction and even then, one would have to have the jaw and tongue moved so far forward (unless it's an extremely mild form of OSA), that jaw problems and tooth movement result.

For keeping the mouth closed, I prefer the oral appliance over a chinstrap. Also have you tried a full face mask like the Quattro? I use it and like it but I still need something like an appliance to keep my mouth closed, AND I MUST stay off my back to remove or reduce OSA. The mask alone, or the appliance alone, or sleeping on my side alone, are not enough vs. the combination of all, is what I'm finding works for me and even then, some nights sleep are still just not great.

For me, the real key to a good sleep is staying off my back, even with the oral appliance and PAP therapy. So after much trial and error, I have devised a sort of squarish backpack to wear to keep me off my back pretty much 100%. This is after first trying tennis balls in my night shirt and then trying Remate products (the T shirt & the Belt & together), both of which were too small and overall ineffective for me, but which might work for others who are smaller or more easily disturbed from sleep, whereas I got used to them too quickly and just rolled onto my back. The Rematee products are well made and very nice but too soft for me, and too small even when the air bags were replaced with blue solid construction grade insulating styrofoam bocks. They are also not cheap if you are on a budget and would not likely be more effective than devising your own similar system, though probably more elegant than your own system.

So like you are suggesting, try an inexpensive device first, though I don't know which one is cheap and that works, but let me know if you find one! But I'd also suggest trying to figure out if your main need is to a) just keep your mouth closed, b) if jaw advancement is really needed or not, c) if sleeping on your back is causing more apneas.

I'm not a big fan of the idea of jaw advancement after having tried it for about a year. I think that it might work ONLY for a very specific few and would be like winning the lottery if it did work for someone. They are too expensive for the very low effectiveness. IME and IMO, the side effects of tooth movement, changed bite, overall discomfort and low effectiveness are downplayed by dentists, as these things are HUGE profit generators.