Oral appliance user -- should i go to cpap??

[Goofproof]

Wether you treat with CPAP or not depends on one thing, do you want to live longer and better, or are you happy with wasting your time on earth. Figure that out and you have the answer, I'm using my XPAP every night all night, I use my mouth for food input only. (To well) Jim

[Xney]

I wouldn't consider an AHI of 15 on it good enough. Some doctors are confused and think that if you're not "severe" it's alright.

AHI of 5 or less I would consider the minimum acceptable. If the oral appliance doesn't deliver it, then you have to seek it elsewhere.

[SleepingUgly]

This is not the site to get advice on oral appliances.

[ChicagoGranny]

Hello all, and Thanks ahead for your help. I am a newbie as this is my first post. Just found this site and have learned a few things. To my question--- I have been using the silent nite appl. 3.5 weeks and while my wife does say it helps with the snoring [ I now PURR] I've not noticed much improvement in energy level and still wake up often with a headache. Should I give it more time or just go ahead to the CPAP.. Anyone have any insights, suggestions it would be much appreciated. THANKS Steve

If you have been sleeping on your back, even for short periods, try sleeping exclusively on your sides or stomach and wear the appliance starting tonight and of course see how you feel in the morning.

Wear something on your back (tennis ball or small backpack) to prevent rolling onto your back.

For many people sleep apnea is most severe on the back. This is because gravity is directly pulling your soft palate and tongue into the airway causing blockages.

If you think you can tolerate the appliance for the rest of your life I would work through this before considering CPAP. Get used to sleeping on your sides while using the appliance and if you feel this is fully treating your condition get that ox study that Pugsy mentioned.

If you don't find success soon then get a CPAP. Make sure you get recommendations here on the model machine. This can be a huge factor in failure or success. You don't want to start out with the wrong machine like many do.

BTW, the pressure on the jaw from the appliance could be causing the headaches.

[ChicagoGranny]

This is not the site to get advice on oral appliances.

And pray tell where is a forum which offers better advice on oral appliances?

[SleepingUgly]

This is not the site to get advice on oral appliances.

And pray tell where is a forum which offers better advice on oral appliances?

apneasupport.org at least has a knowledgeable sleep dentist posting to it.

[Rooster!]

How much did the appliance cost? Did insurance pay for it?

[Goofproof]

This is not the site to get advice on oral appliances.

And pray tell where is a forum which offers better advice on oral appliances?

Magic anti-snoring devices .com, they also sell magic bean stalk seeds. Jim

[steeve]

How much did the appliance cost? Did insurance pay for it?

Yes the insurance co. is paying their part of course after the deductible. Price was I think right at $4oo Ongoing discussion with them about "their part". My local dentist has done few of these ,as I live in a small town and this is a medical procedure covered under health ins. not dental But this is just like the cpap ,you have to have a prescription written for one , you can't just go buy one.

[steeve]

Hello and Thanks to all for your interest and help. I did contact my sleep Dr. and will tomorrow pick up a pulse oxygen meter to check my ox. sat. levels sleeping with the "silent nite" oral appliance. I think it was Pugsy that mentioned I may need to adjust the tension of the appl. It came with 5 different lengths/strengths of bands that are relatively easy to change. My Dentist had installed the next to the longest one on it when I picked it up from him. After a couple weeks I decided maybe I needed more pressure pulling forward on the lower jaw so I installed the next shorter one. Such a small change I almost went one more but decided I better try that one first. After two nights I went back to the previous bands as it had my teeth hurting.
So here I sit wondering what now? As I said earlier I do feel better- somewhat , just not the new man that I've heard others describe after starting cpap. I have a friend who said the z quiet oral appliance stopped his snoring or at least greatly lessened it. He had a sleep study done and supposedly did not have any apnea ,just the snoring. Saw the ad for this thing ,as you all probably have and thought what the heck; at the time it was $39 . They are I think $69 now. Don't know about the comfort as it is one size fits all but it's not $400 and you don't need the RX or the $1500 sleep study.
But it is our health we are talking about , I am glad I had the sleep study, now if we can find the right combination of things to right some of these interferences. God has been better to me than I deserve but I would still like to be around to see my Grandchildren grown.

[zoocrewphoto]

This is not the site to get advice on oral appliances.

The person was asking if he should start using cpap instead of a dental device. It is completely on topic, and he will likely be a new cpap user.

This is a great place for him to ask his question.

[steeve]

You should be working with your dentist to titrate your oral appliance. I can't imagine that 3.5 weeks is enough time to know it's a bust, but then again, I don't know much about how much you can advance the bite with that device (and I've read that for some people, a middle range is better than full advancement). You already have the device, so it seems you might want to work with the dentist before abandoning it. No harm in using a pulse ox to check your SaO2 as you sleep with it, and even help you titrate it, IMO.

This is exactly where I am, thinking the oral appl. is not going to give the desired results, not yet ready to chunk it completely. After all I can stick this thing in my pocket [if I wanted to] it doesn't use electricity, I have yet to knock it off the night stand or get tangled in the hose whilst turning over, I can even talk-though not so clearly-the southern drawl still comes through and drink water with said appl. in place. It does have it's +'s

Yet I think others have gained more with cpap than what I am experiencing. So exploring options, gaining insight wisdom-knowledge from good people like you who have" been there -done that" .

I don't always agree with my regular Dr. but I still try to listen closely to everything she says.

Thanks Loads; Steve

[SleepingUgly]

From what I've read on the other board from that dentist I told you about, I don't think you have the most efficacious device. He is a big fan of the TAP. But maybe there is more than can be done with your device. Shame that your dentist doesn't know more about these, as that's also a limiting factor.

[49er]

From what I've read on the other board from that dentist I told you about, I don't think you have the most efficacious device. He is a big fan of the TAP. But maybe there is more than can be done with your device. Shame that your dentist doesn't know more about these, as that's also a limiting factor.

To add to SU's excellent post, you might want to review this thread:

http://www.apneasupport.org/mas-for-mil ... 30584.html

The sleep medicine dentist that she refers to mentions initially thinking that the choice of a dental appliance didn't matter for mild sleep apnea. He talks about how he realized after some of his patients struggled with other appliances, that he needed to go with the device that he referred to as his heaviest gun which is the TAP

Also, Steeve, as an FYI, you might want to PM him and ask any questions. I found his responses to be very helpful.

49er

[jnk]

Even though it is allowable for some patients to try an oral appliance instead of (or before) trying PAP therapy, many sleep doctors do not consider that route (or order) the most logical approach, since PAP therapy remains, by far, the most effective treatment for sleep-breathing disorders. Doctors who fully grasp that fact understand that all second-best treatments are only valuable once it has been documented that the first-best form of treatment does not work for a particular patient--for reasons such as a patient's being unable or unwilling to make PAP therapy work for him or her.

In the balanced words of respected researcher and expert authority in the field Dr. David Rapoport, as recorded in 2008:

CPAP is the most effective treatment for sleep apnea, but about 25% of patients are unable to tolerate the device. If a person has tried using it and is at his/her absolute wit's end, there are other, less-reliable treatments. A surgical treatment that involves the removal of tissue from the back of the throat has about a 30% success rate. There is also an oral breathing device that helps keep the airway open, this is recommended for those with mild sleep apnea. However, both options have low success rates and with both treatments, you have to pay for them before you find out if they work. There is a lot of research being done in the field and within the next few years, there will likely be other treatments available. But as of now, no treatment works as well and is as predictable as CPAP. -- http://www.health.com/health/condition- ... _2,00.html