CPAP vs Dental Appliance

I've recently been diagnosed with moderate Apnea (AHI 25) and given a Airsense 10 autoset with the P10 air pillow mask.

My wife is adamant that I not even test this out and that I go to the dentist and get a dental appliance to treat the apnea instead. She doesn't seem to want to give the CPAP a chance and I don't know what to do. I'm very resistant to the thought of paying for a dental device that MIGHT help but that there is no trial or return policy for vs a CPAP that with insurance will cost very little.

She seems to think I WANT to wear a mask and use a CPAP because i'm a technology geek and I don't know how to convince her this is just as inconvienent for me but I need her to support me or it will never work out. Thoughts ?

Rieki, the use of dental devices to treat moderate obstructive apnea has been discussed on the forum many times. Very few of the first-hand users of those devices found them to be worthwhile, and some found they were actually harmful in causing jaw problems, bite misalignment and other complications. CPAP is the gold standard of treatment, and your Airsense 10 Autoset will give you real feedback informing you of your progress and effectiveness in reducing AHI.

The real question here isn't what device to use, but how to get your wife and family on-board to be a supportive part of your therapy. Your decision to use CPAP is the right one, and will preserve your health and well-being for years to come at reasonable cost. A dental device not only costs a lot to start with, but you won't know how effective it is without additional expensive sleep studies.

A dental device works by FORCING the lower jaw forward, all night long. It is very unnatural, and uncomfortable. And it changes your bite. I paid $$$$$ for my dental device. You can have it for free because I am unable to tolerate it. And I have serious doubts if it even kept my airway open.
If you have central apnea, a dental device does not treat that.

I pretty much decided against it, as someone said it forces the jaw into a position it's not really meant to be in. Therefore there are symptoms like TMJ and jaw pain. They aren't great for moderate sleep apnea because they only cut incidents down a half. Therefore you'd still have 14 episodes or so. (I have much the same AHI, so I went thru the same decision making. I actually got a list of dentists and so on, but pretty much decided against it.

jonny515 wrote:I pretty much decided against it, as someone said it forces the jaw into a position it's not really meant to be in. Therefore there are symptoms like TMJ and jaw pain. They aren't great for moderate sleep apnea because they only cut incidents down a half. Therefore you'd still have 14 episodes or so. (I have much the same AHI, so I went thru the same decision making. I actually got a list of dentists and so on, but pretty much decided against it.

Hi Jonny515,

According to a 2011 study (link in my signature) which really needs an update, folks with moderate apnea mostly had a 60% chance of getting their AHI below 5. But your point about the jaw being forced into an unnatural position is a good one and a reason why I am reluctant to pursue them in spite of my struggles with pap therapy.

49er

I first tried the dental device my problem was after 2-3 months i developed tmj which caused headaches, sore jaw, ear issue, equilibrium issue, muffled hearing.. totally not worth it. i figured i would try to be as not evasive as possible. big mistake. after using dental device in morning you have to put on a retainer to bring your teeth back into alignment which takes about 20-30 min minimum. that prolonged the morning routine. cpap seems to be better for me...ask about those issues before spending the money. i was not told about all of that when i choose that route only to have it fail.

As with any medical problem, you need to use the most effective treatment available, and for sleep apnea, that is cpap or bipap. The people here on this forum will help you on your journey to better sleep. The new machines are very quiet when operating and should not be a problem for your wife. Mine is no louder than a fan running in the bedroom. From what I have heard from other members of the forum, the P10 nasal pillow mask is extremely quiet due to it's design.

Troopin wrote:I first tried the dental device my problem was after 2-3 months i developed tmj which caused headaches, sore jaw, ear issue, equilibrium issue, muffled hearing.. totally not worth it. i figured i would try to be as not evasive as possible. big mistake. after using dental device in morning you have to put on a retainer to bring your teeth back into alignment which takes about 20-30 min minimum. that prolonged the morning routine. cpap seems to be better for me...ask about those issues before spending the money. i was not told about all of that when i choose that route only to have it fail.

Troopin,

How does a dental device cause ear and equilibrium issues and muffled hearing?

Thanks!

49er

PS - The rest of the symptoms you are reporting make sense.

Riekl wrote:I've recently been diagnosed with moderate Apnea (AHI 25) and given a Airsense 10 autoset with the P10 air pillow mask.

My wife is adamant that I not even test this out and that I go to the dentist and get a dental appliance to treat the apnea instead. She doesn't seem to want to give the CPAP a chance and I don't know what to do. I'm very resistant to the thought of paying $3,500 for a dental device that MIGHT help but that there is no trial or return policy for vs a CPAP that with insurance will cost me $200.

She seems to think I WANT to wear a mask and use a CPAP because i'm a technology geek and I don't know how to convince her this is just as inconvienent for me but I need her to support me or it will never work out. Thoughts ?

First things first. Book your wife into a marriage counselling session and determine why she does not want you to have the gold standard medical treatment you need. Remember those vows? They didn't say "until it is inconvenient for me".

Unsupportive spouses have no place in the bedroom, hand her a pillow and blanket and point her to the couch or spare room. YOUR life and health depends on making this treatment work.

It is your treatment, and your choice; (and you have wisely chosen the treatment with the best track record.)
Once your wife realizes some of the side effects of good therapy will benefit HER, well, say no more.
Think reduced snoring, fewer midnight pee trips, higher mental functioning, and longer life expectancy.
Some men actually report happier pants!
She probably has no idea what awaits her.
On the other hand, you might threaten to cancel your life insurance.

I could still be right re: stats. Don't really know. IF there is 60% change of an AHI of 5, there is also a 40% chance of more than 5. I also don't think it's great odds. I wouldn't gamble for odds like that. You also don't know if you are the 60% or the 40% or if you could tolerate.

Also if you are struggling, odd because your OP didn't indicate you had even used it, why not discuss the problems here? The people here are good at troubleshooting.

49er wrote:

jonny515 wrote:I pretty much decided against it, as someone said it forces the jaw into a position it's not really meant to be in. Therefore there are symptoms like TMJ and jaw pain. They aren't great for moderate sleep apnea because they only cut incidents down a half. Therefore you'd still have 14 episodes or so. (I have much the same AHI, so I went thru the same decision making. I actually got a list of dentists and so on, but pretty much decided against it.

Hi Jonny515,

According to a 2011 study (link in my signature) which really needs an update, folks with moderate apnea mostly had a 60% chance of getting their AHI below 5. But your point about the jaw being forced into an unnatural position is a good one and a reason why I am reluctant to pursue them in spite of my struggles with pap therapy.

49er

My oral device was an unfathomable amount of dollars. I truly couldn't believe how this malleable piece of plastic could cost so much money. But in my never ending quest to not use CPAP, I jumped in with both feet.
So after a few weeks of wearing this thing, I concluded that I had received zero benefit and that my jaw was painfully moving out of alignment causing my bite to do strange things.

With the help of this incredible community, I have not only discovered why CPAP is the gold standard for the treatment of sleep disordered breathing, but how to tolerate and maximize the benefit.

I imagine that these oral devices may work for some but from what I have read and my own experience, not that many. Your health depends on you making the right choices regardless of what your spouse wants.

I tried an appliance. I had trouble getting to sleep with it, but persevered until I was able to sleep mostly through the night with it. Then my jaw started hurting. Owww! My dentist got me another, much less comfortable to wear and I could never get to sleep with that thing my mouth. Fortunately my insurance paid the cost. Then I got a cpap. Much better. Do you snore? I did, and now I don't. My wife is very, very happy about this aspect of cpap therapy, and your's probably will be, too.

Why on earth is your Wife trying to decide this for you. Does she not realize how difficult it is for people to reconcile themselves to life long treatment? CPAP is the only treatment that is almost 100 percent effective. Talk to her about her concerns, but insist on using your CPAP. It is your health on the line.

I kind of think there is more to it than the reason she gave you. I understand that there can be some reluctance to sleeping with someone who is hosed up, and that, along with other information she has read or has been given, might be driving her position on this.

First off, are you even a candidate for an oral device? From what little I have read, you shouldn't just walk into a dentist office and just buy one. Your study and recommendations from you sleep doctor should be the determining factor. It could be as simple as the doctor not recommending the dental appliance and then no amount of googling or her friends input should make a difference.

I do agree that you need support from your spouse, and hopefully you can sit down have have a meaningful discussion with her.

John