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Has anyone else tried one of these. Like anything else, it has take some tweeking and adjustments, but I am sleeping. In 6 weeks, I have gone from 49 episodes down to 10 and we are working on getting those down to below 5. I am sleeping like I haven't in years. I am not being waken in the middle of the night by leaks, or moisture. I can breathe through my mouth, and even tell my kids goonight while wearing the appliance. If you are looking for an alternative to CPAP try it.
Views: 54
Replies to This Discussion
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Permalink Reply by Steven Y. Park, MD on
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Kim,
Glad you're having success with your oral appliance. CPAP or oral appliances are now first line treatment option for mild to moderate obstructive sleep apnea, as recommended by the American Academy of Sleep Medicine. Everyone has different needs and anatomy, so the decision should be customized. Certain people make poor candidates for one or the other, so a good history and exam is essential in figuring out which one to go with initially.
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Permalink Reply by Saz RPSGT on
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In lab testing at our facility they are very hit and miss. If it is improving your sleep then go for it.
We've run several PSG baseline/then oral appliance to thrust the jaw forward/ then CPAP splits.
When you say your episodes have decreased from 49 to 10, that's great. Is the the Apnea/Hypopnea index, or is that the overall RDI that includes OSA, OSH, and Upper Airway Resistance Syndrome events? UARS are the same as an obstructive hypopnea, but it lacks the 3-4% (varies on lab) desaturation to make it count in the more conservative AHI. With UARS present you still wake up tired since it's still waking you up.
A very well know Sleep lab I work for on and off doesn't even count RDI in their reports. Awakenings (arousals) are just written off as spontaneous arousals, or Leg movements with arousals even though there is a clear building of abdominal and thoracic belts and in the nasal/oral airflow sensor. It's just lacking a big enough desaturation.
Getting back to the question though...
It seems the people with low RDIs and AHIs have pretty good success with these when the tongue falling back, enlarged uvula, or sagging soft palate is causing the obstruction. If the obstruction is from another reason or the diagnosis is moderate to severe, then it's very ineffective.
The best thing to do is get evaluated in an overnight sleep study with a Baseline/Oral Appliance/CPAP. The numbers won't lie. If someone refuses to wear and PAP therapy, then a baseline/oral appliance split is done. Mostly the numbers Sleep Disordered Breathing numbers are very similar in a majority of people.
In my opinion, I think there are a great many undiagnosed people that would fall into the "mild" diagnosis catagory and benefit from an oral appliance. It sounds like you are having a great response from it though if you're sleeping like you haven't in years. Keep it up!!! :^)
Jason
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Permalink Reply by Kim Walters on
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Right now my episodes have only been measured by at home pulse-ox, when they get me down to below 5 episodes, I will go for an overnight study in the original lab that diagnosed me. I used to think I would know if I was sleeping better, and would not go for another study as I find them a bit unpleasant, but now I really want to see all the stats.
J. Sazama RPSGT said:In lab testing at our facility they are very hit and miss. If it is improving your sleep then go for it.
We've run several PSG baseline/then oral appliance to thrust the jaw forward/ then CPAP splits.
When you say your episodes have decreased from 49 to 10, that's great. Is the the Apnea/Hypopnea index, or is that the overall RDI that includes OSA, OSH, and Upper Airway Resistance Syndrome events? UARS are the same as an obstructive hypopnea, but it lacks the 3-4% (varies on lab) desaturation to make it count in the more conservative AHI. With UARS present you still wake up tired since it's still waking you up.
A very well know Sleep lab I work for on and off doesn't even count RDI in their reports. Awakenings (arousals) are just written off as spontaneous arousals, or Leg movements with arousals even though there is a clear building of abdominal and thoracic belts and in the nasal/oral airflow sensor. It's just lacking a big enough desaturation.
Getting back to the question though...
It seems the people with low RDIs and AHIs have pretty good success with these when the tongue falling back, enlarged uvula, or sagging soft palate is causing the obstruction. If the obstruction is from another reason or the diagnosis is moderate to severe, then it's very ineffective.
The best thing to do is get evaluated in an overnight sleep study with a Baseline/Oral Appliance/CPAP. The numbers won't lie. If someone refuses to wear and PAP therapy, then a baseline/oral appliance split is done. Mostly the numbers Sleep Disordered Breathing numbers are very similar in a majority of people.
In my opinion, I think there are a great many undiagnosed people that would fall into the "mild" diagnosis catagory and benefit from an oral appliance. It sounds like you are having a great response from it though if you're sleeping like you haven't in years. Keep it up!!! :^)
Jason
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You're right about them being unpleasant! At best it's less than ideal. :^)
With many patients you will see several desaturations that are caused only by movements while awake which don't count.
Really an in-lab test is the best way to go to get a clear and accurate view of your sleep.
Jason
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