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Permalink Reply by Mike on May 14, 2009 at 9:02pm

Dean, I'm happy that you've found a solution that works for you. I think the ability to get effective treatment from such a device depends on one's anatomy. Also, it's not clear that compliance is any greater than with CPAP, and it may be worse: http://www.sleepguide.com/forum/topics/oral-appliances-compliance/

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Permalink Reply by Dean Rodgers on May 14, 2009 at 9:36pm

It definitely doesn't work for everyone. However, the anatomy argument is one I question. My initial sleep medicine guy told me that the oral appliance would absolutely NOT work based on my size/weight. He was dead wrong. I suspect the oral appliance stats about compliance are badly flawed due to the facts that:

1) The sleep medicine community so often goes straight to CPAP so a very small percentage of people actually try oral appliances. My understanding is that the profit margins on CPAP are high enough that they discourage other forms of treatment -- this is shameful.

2) Many dentists who set patients up with the devices don't really understand sleep apnea/sleep apnea treatment. They just set up a device and leave the patients to themselves.

3) The "boil and bite" appliances -- which don't work -- are thrown into the mix.

The place that did my appliance is a genuine sleep medicine place that has dentists and sleep medicine professionals. They tell me that the oral appliance doesn't solve the problem for everyone (but it does let virtually everyone at least switch to a lower pressure -- wich can be a huge benefit in and of itself for those who have their CPAPs cranked all the way up.

I could not tolerate my CPAP (which was set to 20). It leaked, was uncomfortable, gave me zits, etc., etc., etc. The oral appliance is 100X more comfortable for me. YMMV.

I am currently experimenting with a hybrid CPAP/oral appliance that is showing promise. I'll report back on that once I have some data.

Thanks for setting this forum up.

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Permalink Reply by Chris on May 14, 2009 at 9:56pm

Thanks. The oral appliance is plan B for me. Just started cpap a week ago and like most people I dont like it. I was thinking of trying pap and oral appliance if I have to but I would like to ditch the pap machine If I can. What do you think of the oral appliance so far? Not as bad as having a mask on you face is it?

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Permalink Reply by RockRpsgt on May 14, 2009 at 10:55pm

Dean did you have a sleep study with yor device in?

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Permalink Reply by Dean Rodgers on May 15, 2009 at 12:38am

I did have a sleep study with just the appliance. I still had a few arousals per hour, but it was only a tiny fraction (I think fewer than 7 per hour down from 40+). I'm told that if someone suspected of having OSA got results like I did from that study that they wouldn't bother with a CPAP.

My combo unit is pretty cool. It has a mouthpiece holds my lower jaw forward, but not as much as the stand-alone appliance. It is connected to a liberty mask, which surrounds the mouth and incorporates nose pillows. Since the mask is attached to the mouthpiece, no straps are required and it stays very still no matter how much I move. I'm using an HPAP set between 6 and 12 (my former CPAP was set at 20). Still trying to get used to it, but I think it is going to work out well.

I'll use the stand-alone for travel or if I just don't feel like being hooked up to anything.

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Permalink Reply by RockRpsgt on May 15, 2009 at 12:57am

Sounds great! I have not performed a study with any of these devices yet. I am excited to hear that it works in conjuction with the mask so well. I am really glad it is working for you. Duane will be interested in your treatment as well.

Dean Rodgers said:

I did have a sleep study with just the appliance. I still had a few arousals per hour, but it was only a tiny fraction (I think fewer than 7 per hour down from 40+). I'm told that if someone suspected of having OSA got results like I did from that study that they wouldn't bother with a CPAP.

My combo unit is pretty cool. It has a mouthpiece holds my lower jaw forward, but not as much as the stand-alone appliance. It is connected to a liberty mask, which surrounds the mouth and incorporates nose pillows. Since the mask is attached to the mouthpiece, no straps are required and it stays very still no matter how much I move. I'm using an HPAP set between 6 and 12 (my former CPAP was set at 20). Still trying to get used to it, but I think it is going to work out well.

I'll use the stand-alone for travel or if I just don't feel like being hooked up to anything.

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Permalink Reply by Duane McDade on May 15, 2009 at 4:58am

WOW !! Thats something else CPAP 20! We have a DDS who builds these devices, that we test from time to time. I am talking about a mouth/device attached to Nasal Pillows . If the oral ap. works as well as you say then that proves your tounge was your only problem! and 20cm/h20 would mean you have a heavy one. It just sounds sort of weird to me. Good luck and health to you my friend! be careful of 6-12 that needs to be narrowed down to like 9-12 or 6-9. a difference of 6 is way to big! 3 should be the maxium, this is just what I have found to be true.
I am not here to step on anyones toes, but 6 gives the machine a lot of room to screw up your Sleep.

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Permalink Reply by Dean Rodgers on May 15, 2009 at 9:29am

Duane McDade said:

WOW !! Thats something else CPAP 20! We have a DDS who builds these devices, that we test from time to time. I am talking about a mouth/device attached to Nasal Pillows . If the oral ap. works as well as you say then that proves your tounge was your only problem! and 20cm/h20 would mean you have a heavy one. It just sounds sort of weird to me. Good luck and health to you my friend! be careful of 6-12 that needs to be narrowed down to like 9-12 or 6-9. a difference of 6 is way to big! 3 should be the maxium, this is just what I have found to be true.
I am not here to step on anyones toes, but 6 gives the machine a lot of room to screw up your Sleep.

I just started working wtih the combo device so I'm sure I'll narrow that window substantially once we get it dialed in. Keep in mind that the appliance didn't solve the problem outright, it just helped substantially. There also seems to be a huge difference between what pressure I need sleeping on my back vs. on my side (which is about half the time). This makes a lot of sense.

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