mouth devices

Almost a year ago I started on cpap, and as hard as I tried I could not adapt to the mask. I tried sleep aids to try to get me to fall asleep, they didn't help either. So now I will be trying the oral device and I am wondering if anyone has had success in wearing it. Do you feel better since wearing it? I want to feel human again so bad, but now I am afraid this too won't work. Any advice would help. Patty

Hi, were you diagnosed with mild or moderate sleep apnea? the dentist I am working with on the dental device has some good data on it, but I have yet to see it in my sleep lab. So keep me posted how your doing and good luck!

I tried a mandibular splint from a company in Brisbane Oz that do nothing else but fit and sell mandibular splints. Cost me $500, with a money back guarantee if not satisfied after 3 months.
Used it exclusivley for 2 months, found it pretty good, but had a sleep study, using it, and the result was that it was not as effective as my cpap. I opted for money back, but am sorry now that I didn't keep it, as I recently bought a $100 mouthguard/mandibular splint, just to use for overnight trips, so I don't have to take my cpap with me. The $500 model was more effective than the $100 model.
My sleep apnea is at the lower end of moderate, have my cpap set on 10.
The MS was certainly more convenient than cpap, and stopped my snoring completely (according to my wife) but I did feel a little more tired after using it, compared to using cpap.
The $100 model stops the snoring, not sure what else. It was from ebay, put it in hot water and mould it to the desired shape etc. i.e. lower jaw pushed forward so that upper and lower teeth are at least aligned, or even lower teeth as far forward as you can tolerate.
If you can't adapt to cpap, worth a try.
Good luck

Ken D
Bris Oz

If you search the forum for oral devices, oral appliances, etc., you'll come up with other threads and info. Not many have had great success with these devices as you'll read. PAP therapy is nearly, if not always more successful. Oral appliances can also be VERY uncomfortable, even expensive custom made devices, and like masks could or will take time to get used to. They are not a magic bullet by any means. It all depends on you and your OSA severity. Personally I wouldn't recommend an expensive one for the possibly very little benefit that you might get, but everyone is different. Be skeptical and realistic first, rather than just hopeful.

If you try one, or if you don't, PLEASE look at and consider your sleeping position. See in what position your OSA and snoring occurs. A side sleeping position alone might be of more benefit than an oral appliance (and save you a ton of money). The trick here is to figure out a way to STAY in a side sleeping position the entire night. For me, in a supine (back) sleeping position, an oral appliance is useless as it just can't fight gravity closing your airway as well as the air pressure of a PAP machine can.

If I were you, I'd try more masks AND work on my sleep position (both of which work FAR better for me than my nearly useless and too expensive oral appliance).

Keep us posted with whatever you try.

mapatty56@gmail.com wrote:Almost a year ago I started on cpap, and as hard as I tried I could not adapt to the mask. I tried sleep aids to try to get me to fall asleep, they didn't help either. So now I will be trying the oral device and I am wondering if anyone has had success in wearing it. Do you feel better since wearing it? I want to feel human again so bad, but now I am afraid this too won't work. Any advice would help. Patty

Thomas F. has been working with an oral device made special by a dentist. He is using an oximeter and the Epworth sleep scale to determine its effectiveness. I hope he might say something about his success here.

I'm a little leary of the boil-and-bite order-by-internet types that are out there. They are specifically advertised as 'snore-reducing' devices and are probably prohibited from advertising as sleep-apnea prevention devices.

In any case, try not to rely on just how you feel. Get a recording oximeter. If you don't see measurable improvement with a recording oximeter, as in the case of Thomas F., you're probably fooling yourself.

My Klearway device was also custom made by a "sleep specialist dentist / orthodontist", the inventor no less. But that mattered not in the end, it just meant that the device cost more. I also used an oximeter, Epworth scale, how I felt diary, and results recording with APAP software (using APAP set at 4 as min/max pressure). I also discussed with the Drs. or tried to, the next to poor results with the device and I kept pushing for the follow up sleep study with the device that was promised, but which after nearly 2 years, never happened. I eventually found out by myself that this $2600+ expenses & time lost oral device at various mandible extensions (except for possibly REALLY SUPER extended which I would not try due to severe side effects) was pretty much useless in a supine sleeping position. The Dr. would not accept my findings but only insisted that the jaw advancement be increased severely despite the side effects to me, which I had to sign a waiver prior too (THAT did not give me confidence either). I found that for ME, the jaw advancement just could not pull enough or all of the soft tissue restricting my airway forward enough to stop or prevent enough apneas, hypopneas and their effects compared to how well air pressure can keep the airway unrestricted. I'm also a thin guy with a thin neck and no jaw or mouth or tooth problems (until using the oral device), so I didn't have much soft tissue to actually pull forward, compared to another type of patient. I should have had excellent results with this device compared to others with more tissue to clear the airway (Dr.'s diagnosis prior to 2 years of ny wasted time, money & therapy). Also, the negative side effects of extended jaw advancement were not worth the risks to me, vs. better results I got wtih increased pressure using PAP therapy, as well as PAP's better oximeter results, Epworth scale results and how I felt results. It took me 2 trials at masks to find the Quattro that worked great for me.

However, THE BEST RESULTS of all came with the discovery of my positional OSA. A side sleeping positions of BOTH the head/neck and body produced excellent results, FAR better than the oral appliance or PAP therapy in any position other than side sleeping. I also found it imperative that both the head and body stay in a side position, as the two can twist independantly if one is restricted. For me, both need to be restricted. In this case I often get zero or 1-2 apneas and great reductions in all other events. Oximeter tests results also show this to be the case, as well as my PAP software info, Epworth scale and how I feel diary. This is also far more comfortable than a supine sleeping position with a much higher pressure along with the accompanying leaks. Another benefit besides lower pressure with this positional therapy is a very narrow pressure range, or just CPAP.

Having gone through all of these experiences, so much trial and error and much reading on this forum, I found that for me, a side sleeping position (especially head & neck) along with PAP therapy produces the best results. An oral appliance is just along for the ride and just helps keep my jaw shut, as if my jaw drops / mouth opens wide, then that too can restrict my airway. I don't think one needs an expensive or custom fit oral appliance for that.

If one insists on a supine or any sleeping postion, then my experience shows that an oral appliance custom fit by a dentist or not, will be pretty much useless and not all that comfortable either with at minimum the accompanying drool that never seems to end, along with other side effects.

DreamDiver wrote:Thomas F.[/url] has been working with an oral device made special by a dentist. He is using an oximeter and the Epworth sleep scale to determine its effectiveness. I hope he might say something about his success here.

Sorry for my delay in commenting. My dental appliance brand is called SUAD. It was fitted by a dentist and is rather expensive >$1,000. As DreamDiver states I was having some success with it without using my CPAP/APAP. However, as time went on I was feeling more tired. I was getting about 92-93% average oxygen levels which I believe are pretty good numbers but when you add a bunch of 92% nights together you don't feel so great - or at least I don't. My O2 levels (O2 events) fluctuated greatly with just the dental appliance - about 40 O2 events per night

For the last 3 nights I am using the dental appliance + CPAP (10.5 pressure and no Flex). I'm using the Liberty Hybrid Mask. I', feeling much better again, My O2 events have dropped to 15 and I have average O2 level of 96%. Using the dental appliance with CPAP allows me to run with lower pressure which is a benefit.

In the end I think I can achieve same benefits using a boil/bite type appliance which is much less money and probably more comfortable.

Thomas F. wrote:... As DreamDiver states I was having some success with it without using my CPAP/APAP. However, as time went on I was feeling more tired. I was getting about 92-93% average oxygen levels which I believe are pretty good numbers but when you add a bunch of 92% nights together you don't feel so great - or at least I don't. My O2 levels (O2 events) fluctuated greatly with just the dental appliance - about 40 O2 events per night

For the last 3 nights I am using the dental appliance + CPAP (10.5 pressure and no Flex). I'm using the Liberty Hybrid Mask. I', feeling much better again...

So, if you had to use the dental device for a few nights alone during a power failure, it's better than nothing. I'm sorry it didn't work out as something you could rely on more frequently.