packitin wrote:Yes, I will keep you informed. I never had any faith in dental devices either, until the consultation session with this young, enthusiasitc, and energetic dentist, who is obviously on top of the latest treatments for OSA. This will be a customized device for my particular jaw structure. The adjustment and alignment will be ongoing, not just an installation and out the door you go. The goal is to "train" my brain, through this device, to keep my jaw forward so that my lower teeth will be meet my uppers. This will be a gradual process. My brain has to "relearn" how to hold the jaw forward. That's what this is supposed to do. I also have a small neck size - up until I was about 40 yrs. old, my neck size was 14.5. I'm also hoping my tongue will not collapse backward so easily. I'm praying this will work. Apap has not done the job I hoped it would. (past year: AHI 3.7; leaks 2.2; usage 4:40 hrs per ngt) My goal is to use both Apap and the mouth piece.
BEEN THERE DONE THAT!
Of course the young dentist is enthusiastic! He a) isn't using the device for his own OSA b) he's likely making an obscene (IMO) profit with the device c) he has no experience other than likely just theory.
My customized Klearway device was made and had the same goals as yours might. I had x-rays taken, jaw measurements done, the whole shebang. I went back for many many checkups & alterations over a 2 year period. I did not just go for one fitting and then out the door. This was all done through a university sleep center / orthodontist who "specializes" with OSA. However, even amongst the other sleep specialists at the University, I found out in the long run that their experience is that VERY few people gain much help from such devices and that the devices do not have much respect compared to PAP therapy.
As mentioned in another post, if perhaps a device such as the TAP in 2005, ONLY provided an AHI goal of 5 and was deemed a success, then I'd suggest that the TAP is next to useless, as an AHI of 5 +/- will still keep many people very very tired, it certainly does me.
I'd also suggest that FIRST, before you go for a fitting, work with your APAP Pressure and Range AND your SLEEPING POSITION, and LEARN TO SLEEP IN A SIDE POSITION or force yourself to. I'd suggest that perhaps your lack of success with APAP could be the wrong pressure and range and especially from being in a supine sleeping position, which is not good for OSA, no matter what device you are using. Fix your sleeping position FIRST, because if you don't, then you will likely fail miserably with the dental device and APAP in a supine position. Realize too, that the head AND body need to be in a side position, and that they will change position independently during the night. Both must be in a side position, but especially the head / neck.
I'd argue that your tongue is NOT the problem as much as just loose tissue in the neck to which the dental device does nothing to help open. Only air pressure from CPAP / APAP will do that and a side sleeping position. The tongue is a red herring compared to the neck / throat, IMO. My tongue has next to no impact compared to the throat sagging and the jaw opening to close the airway as well.
Personally, I think that you are being conned, and like most victims of con jobs, they actually want to be conned. I know I was and did, as I desperately wanted to feel normal and at that time I would almost try anything.
Forget the dental device for now. Video record your sleep to find out HOW you actually sleep and what is ACTUALLY going on. Otherwise you and your enthusiastic Dentist are only guessing. The device is no skin off his nose as YOU are the one dealing with OSA and he has your money. Next work on your sleeping position. I'll bet that will give you better results than the dental device and improve your APAP therapy, assuming that your APAP is set correctly enough, (which you may not know until you SEE your sleep videos AND compare the software results).
A supine sleep position is IMO, THE main thing to solve along with enough CPAP OR APAP pressure in a narrow range. Few people know what position that they sleep in all night long (many think that they know), which you won't truly know without several nights of video evidence.
I do use my device WITH APAP but only to keep my jaw closed and so instead of mouth taping, as my jaw must stay closed or it closes my airway when it drops open. However, a much less expensive device with no need for jaw advancement would do the same thing. This and my sleeping position were all convfirmed ONLY through video evidence becasue after 2 wasted years with the dental device, I was still as tired as ever. The video evidence had me fix my sleeping position and get me to go back to APAP.
Finally, I don't think that you may realize how severe the results of jaw advancement may be in side effects. Be careful of what you wish for as the results are not all good. it's also EASY for the dentist to say this or that. It's theory but on YOUR teeth and jaw. Get him to wear one along with you and then see how things go.