Received Dental Device

Sleepy Cpaper · Post by **Sleepy Cpaper** » Thu Dec 08, 2005 11:54 am

Swordz-

Its gat that you are feeling better, but feeling better isn't subjective enough to indicate efficacy of treatment. There was a dentist on sleepnet that fell into the same trap and in fact the dental device made his AHI worse!

Don't lull yourself into a false sense of security, make sure you do the followup study, and ensure that you are getting the best possible treatment.

And remember not to be dis ouraged if it doesn't appear to be doing enough, the combination in the link from rested gal has results from people that have both and are well treated.

sleepylady · Post by **sleepylady** » Thu Dec 08, 2005 11:57 am

Lori,

The excessive saliva production (love the description ) never did go away. It seemed just as bad the last day as the first. Even with the inconvenience, I'm much happier with my CPAP.

Swordz,

Good luck with your device. I hope it works for you. I'll be rooting for you.

Melinda

Sleepy Cpaper · Post by **Sleepy Cpaper** » Thu Dec 08, 2005 11:59 am

Swordz-

Its gat that you are feeling better, but feeling better isn't subjective enough to indicate efficacy of treatment. There was a dentist on sleepnet that fell into the same trap and in fact the dental device made his AHI worse!

Don't lull yourself into a false sense of security, make sure you do the followup study, and ensure that you are getting the best possible treatment.

And remember not to be dis ouraged if it doesn't appear to be doing enough, the combination in the link from rested gal has results from people that have both and are well treated.

Sleepless on LI · Post by **Sleepless on LI** » Thu Dec 08, 2005 12:24 pm

Cory, you are being very wise to go slowly with your expectations although after your first night, it sounds quite positive. If all the wishes for you to do well is enough to make you successful, then I'm sure you will do great. Glad to hear you felt so much better. It's funny how that adrenaline from being so excited just takes over and, in this case, made you have trouble falling back to sleep. That, coupled I'm sure with the fact that you got some good rest finally. Here's to an even better night tonight, and so on, and so on. Best of luck.

Melinda, thanks for the fast reply.

kikisue · Post by **kikisue** » Thu Dec 08, 2005 3:53 pm

Cory - hope this works well for you - I think it's great that companies are trying to come up with new treatments. Like masks, probably the same apnea treatment doesn't work for everyone so why not have multiple options?

I just wanted to comment on a couple things - the teeth pain and salivation with dental devices that have been raised. I use a custom-designed nightguard for teeth grinding/TMJ issues. The first few days I wore it, my teeth hurt HORRIBLY when I took it out and I was afraid I wouldn't be able to adjust. However, it gradually went away and now I don't have any problems with it. I can't sleep without it - sort of like "Pap when you nap", I have to use the guard when I nap!

On salivation - I noticed a big increase in saliva with the guard. Even now, I still salivate quite a bit through the night.

Not much fun with the CPAP - with my FF mask, I get wet inside the mask, against the cushion - ew - or with my nasal pillows, I tape my mouth and that's a yucky feeling too. But, the pain without the guard isn't worth preventing the saliva.

Not really relevant to CPAP directly - but for those wanting to try dental devices, thought my experience might be helpful in adjusting to them in your mouth. Even though the devices are different, the mechanism seems similar.

Karen

snork1 · Post by **snork1** » Thu Dec 08, 2005 6:11 pm

Swordz, have you considered taking an Alleve or similar to help deal with the mild discomfort/pain and help you sleep at night.
I sometimes take a single regular strength aspirin to help with CPAP sleep if you of my interfaces is going through an especially irritating phase.

You dental appliance might be working a bit even without advancing it because it would still keep your jaw from falling back during the night.

I hope people appreciate just how careful you are wording the sharing of your experience. This would not be the solution for everyone even if it is the solution for you, and for that matter still might be good for some people if it doesn't work for you.

I firmly believe the combined causes of Apnea are much more complex and variable from person to person than our cookie cutter sleep docs would have us believe.

meister · Post by **meister** » Thu Dec 08, 2005 6:39 pm

The thing I really like about my DD is that it keeps my mouth closed
and I don't get cottonmouth! Plus I can use a reduced pressure via
the combination of the DD and PAP. The DD pulls my jaw forward but
doesn't fix my palate. For that I will probably try the Pillar. Just
waiting for RG to finally break down and give it a try so I can read her
review. Some interesting work is being done with magnets to keep the
airway open via repelling forces. The DD took me about two weeks to get
used to, but I was able to keep it in the first night. The PAP was a good
six month struggle to find the right machine and mask.

rested gal · Post by **rested gal** » Thu Dec 08, 2005 7:10 pm

meister wrote:Just waiting for RG to finally break down and give it a try so I can read her review.

heheh, well, you won't see that happen because I'm very comfortable with the mask(s) I use and am getting good treatment with my autopap(s). Besides, you know how addicted I am to those good ol' homemade strap thingies!

Nonetheless, I'm always extremely interested in reading about any and all treatments that work well for others, especially when the progress is reported by people who have followup PSGs, as Swordz intends to do.

snork1 stated it well:

I firmly believe the combined causes of Apnea are much more complex and variable from person to person than our cookie cutter sleep docs would have us believe.

In much the same way that not every mask suits everyone, no one type of treatment suits everyone. Until the day comes that there are better ways to diagnose the areas to target, and until the day comes (as if!!) doctors from various specialties cooperate in tailoring treatment, lab rats have to do their own trial and error experiments.

Thanks for keeping us apprised as you go through the maze, Swordz!

LINKS to surgery, turbinates, Pillar, TAP experiences

GoodKnight · Post by **GoodKnight** » Thu Dec 08, 2005 9:28 pm

Here is a quick summary of my experience with a MAD.

It took me a period of 6 weeks to get to a position where I felt it was doing me some good.

A sleep study then showed that it improved my oxygen desat considerably to a point that was marginally acceptable, but my sleep architecture was still very bad and my sleep efficiency was also low.

It reduced my titrated pressure from 15 to 11.
This is a very significant reduction and it allowed me finally get some comfortable sleep without mask leaks.

I also have a bad problem with mouth leaks and this device did not help that so I still have to seal my mouth. I use a modified Oracle mask to do this. No one else here seems to like it, but it works for me.

I have a problem with excessive saliva production and I now just put up with it. This may be the reason that the modified Oracle works for me because tape just got wet and leaked. In fact, I have to keep the Oracle in place with tape because the saliva makes it slip.

So the bottom line is that the MAD has made this therapy tolerable and effective for me. It was not before.

The addition of an APAP instead of a CPAP has also worked wonders for me.

Hope this helps. Good luck.

Swordz · Post by **Swordz** » Fri Dec 09, 2005 12:21 am

snork1 wrote:You dental appliance might be working a bit even without advancing it because it would still keep your jaw from falling back during the night.

Yes!!! I just realized the Somnomed actually is made to advance your jaw some distance, without the screws being advanced any. I can tell that my jaw is forward when I have it in with no advancement, as I usually have a overbite and my bite is almost normal. I definitely feel that I did sleep well last nite when I actually did sleep.

snork1 wrote: I hope people appreciate just how careful you are wording the sharing of your experience. This would not be the solution for everyone even if it is the solution for you, and for that matter still might be good for some people if it doesn't work for you.

I am trying to "tread lightly" as I express my success with my treatment. I see far to often how CPAP-bashing or whatever treatment being discussed gets verbally assaulted. Like I said, however you get treated, just as long as you do. CPAP and dental devices are proven, but CPAP has stronger results and improvement in condition. But what good is the treatment, no matter the studies, if you can't use it? Dental devices, Pillar, CPAP, etc, all have thier place and should be studied and looked @ subjectively and discussed THOROUGHLY with all doctors associated (dentist, ENT, pulmonologist).

snork1 wrote: I firmly believe the combined causes of Apnea are much more complex and variable from person to person than our cookie cutter sleep docs would have us believe.

I think you are one of the people that has really studied not only apnea and its effects, but the root physical causes of it. My sleep doc was definitely one of those people, and wouldn't even discuss dental device. I went blindly into this on my own until I came across my ENT and dentist, whom both work together and really support my treatment efforts.

Its depressing when your doc isn't behind you, but its enlightening, eye-opening, and uplifting when they are behind you. I am very blessed to have stumbled upon two good docs, both at the same clinic (University of Kentucky Hospital).

Swordz · Post by **Swordz** » Fri Dec 09, 2005 12:26 am

kikisue wrote: Like masks, probably the same apnea treatment doesn't work for everyone so why not have multiple options?

I completely agree with different treatment options. See post above this responding to Snork1's comments.

kikisue wrote:...the teeth pain and salivation with dental devices that have been raised. The first few days I wore it, my teeth hurt HORRIBLY when I took it out and I was afraid I wouldn't be able to adjust. However, it gradually went away and now I don't have any problems with it.

Fortunately I have some thorough research and taken into consideration postings regarding user's experiences with MAS's (Mandibular Advancement Splint). I was aware of the pain, whether TMJ or teeth. But its one thing to read it and another to experience it! I know I've gotta do my time in terms of adjusting to it. Most treatments aren't easy, but you gotta stick with them and really try to see them through. Thanks for the support and thoughts, I really appreciate them!

This thread has gotten WAY more posts and responces than I thought. I really appreciate the time and thought all posters have put into my situation.

kurtr · Post by **kurtr** » Fri Dec 09, 2005 8:26 am

Swordz,

What info influenced your selection of this dental device? I am currently trying to decide on one and wondered why you selected this one.

Thanks,
Kurt

Guest · Post by **Guest** » Fri Dec 09, 2005 11:43 am

kurtr wrote:Swordz,
What info influenced your selection of this dental device? I am currently trying to decide on one and wondered why you selected this one.

First you need to do some research:

www.quietsleep.com and select "Oral Appliance Description"
This website is quite invaluable and provides all the necessary information regarding all FDA-approved devices.

Second, I suggest you ask ?'s regarding what you are looking for, and what is the severity and complexity of your sleep situation (RDI, CPAP usage, etc). Poor advice will be given without knowing your full story. Posting on here is great, but a dental-device specific board is located @:

www.talkaboutsleep.com/message%2Dboards/ and click on "Dental Sleep Medicine"

Thirdly, find a dentist whom specialized in Sleep Medicine and appliances.
[bhttp://www.dentalsleepmed.org/FindaDentist.aspx[/b] This is by far the biggest challenge, becuase you want a doctor whom is willing to work with you, and is willing to really follow your progress. My dentist had never made a Somnomed before, but I was able to initiate contact between him and the company. It took several weeks to get a preview model and so forth, but the effort and time was more than worth it.

Reasons I chose a Somnomed MAS:

You can talk with it in. You can drink with it in. You do have some jaw movement, as some devices allow movement front/back or side/side. The device in your mouth doesn't protude out of the mouth, and is very smooth with no rough edges. The Somnomed also doesn't restrict tongue movement. The device is titrateable, which is KEY in being able to do a sleep study to get specifics numbers (RDI,AHI) and see how far it needs to be advanced to see maximum results.

I am very happy with the device so far, and my tooth pain was probably half of what is was the 1st night (I'm done with 2nd night now). I will be posting PSG results hopefully by mid-Jan.

By any means, if you have more ?'s or need more help either post or PM me. But remember, its $5.00 for any answer/help given...

Swordz · Post by **Swordz** » Fri Dec 09, 2005 11:44 am

Seriously, I need to start remembering to log-in! Last post was me.

Sleeper · Post by **Sleeper** » Fri Dec 09, 2005 12:07 pm

Swordz,

Congrats on starting your new treatment!!

Wondering if you or others came across in your research whether these appliances also alleviate bruxism, or teeth grinding... I know it's not the primary indication, but I'm curious about it.

Received Dental Device

Dental device adjustments

It makes a great chin strap!

Re: Dental device adjustments

Mask

Additional Comments: Breeze nasal pillows

Mask	Humidifier