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Permalink Reply by Mary Z on May 13, 2010 at 12:32pm

I bought somnomed ap for just those times when I can't wear a mask. I wear a full face mask so being stuffed up wouldn't bother me. But while I waited 20 days for my nose to heal and before I found the FitLife total face mask, I wish I had thought of an oral appliance. I wouldn't go to the expense of an actual dental device (from a dentist made personally for me) because I would need it so seldomly. But, on the theory that something is better than nothing I am keeping one on hand, a OTC boil and bite from Canada- no FDA approval in the US. I've also thought of using the two together, but I'm working on getting my leaks down within reasonable levels to have a level playing field to compare results.

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Permalink Reply by Banyon on May 13, 2010 at 1:45pm

Mike said: If you're able to use an oral appliance and you're stuffed up because of a cold, sinus infection, allergies, etc. , will using an oral appliance instead of CPAP that night be a good idea?

That depends on the individual. A properly fitted and adjusted oral appliance can fully treat some people's apnea, poorly treat others and not treat some at all. You need to know before you get a cold what your case is.

Why not use a full face mask when you have a cold?

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Permalink Reply by Scott D. Moore on May 13, 2010 at 4:23pm

I have included a link to the ASAA (American Sleep Apnea Association) page: Treatement options for adults with sleep apnea for your information. It outlines the indications, usage and efficacy of the oral appliance for patients who suffer from sleep apnea.

In particular (to summarize): an oral appliance "may" be appropriate for patients who have mild sleep apnea and are non-obese, however, they can be used for patients with moderate and even severe apnea - the caveat is that you need to be tested using the oral appliance to make sure that your apnea is eliminated - some cases of worsening of apnea have been reported with use of an oral appliance, so it's important to make sure your apnea is improved if you are using such a device.

Link: http://www.sleepapnea.org/resources/pubs/treatment.html

We certainly recommend the use of a full face mask whenever any type oral appliance is used if using PAP (Positive Airway Therapy - e.g. CPAP, BiPAP, AutoPAP, etc.) therapy. The reasoning is that the appliance will not allow, or significantly hinders, the patient's ability to close their mouth when used, allowing escape of pressure through the mouth and negating the value of the PAP device therapy.

It is considered acceptable for occasional cold, sinus infection, congestion, etc. PAP patients to forgo a few nights use of PAP therapy, assuming they are being treated for the upper respiratory problem that is causing them to have difficulty with their PAP device. Consult your physician about treatment and alternatives to PAP therapy that may be available to you if you are a chronic sufferer of upper respiratory problems that interfere with your PAP therapy.

The addition of heated humidification, in particular, can help alleviate upper respiratory problems caused by PAP therapy. The use of warm moisture added to the PAP can help reduce congestion and lessen the effect of histamine release often caused by dry air being forced through the upper respiratory pathways (ever ride a motorcycle and when stopped, notice that your sinuses seem "congested" and/or your nose is running?) This is a normal response of our respiratory system to the flow of air, thought to help inhibit the impact of dust or other particulates present in unfiltered air.

Of course, make sure your filters and complete circuit are clean - disinfection may be indicated if you do not clean or wash your supplies and humidifier according to the manufacturer's directions.

Again, you may be able to use an oral appliance in lieu of your PAP device, either occasionally as you indicated, or continually to treat sleep apnea. It just requires that you be tested with the PAP device to make sure your apnea is eliminated.

Some sleep laboratories are able to provide what is called a "PAP NAP" - utilizing a less expensive way to determine efficacy of PAP or Appliance therapy - another alternative could be the use of an oximeter, which measures oxygen in the blood through the use of light (non-invasive) to see if you have cyclic desaturation (increases and decreases in oxygen levels) that can be associated with apnea. Ask your physician about either a PAP Nap or Overnight Oximetry test to see if the oral appliance you are using is adequate to meet your needs.

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Permalink Reply by Donald R. Byrd on May 14, 2010 at 7:52am

Whats the cost of an oral appliance? Does insurance cover the cost? I heard using an oral appliance can place you at risk of TMJ, would someone please comment on these questions. Thank you in advance.

Donnie

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Permalink Reply by Scott D. Moore on May 14, 2010 at 12:06pm

Donald - oral appliances to treat sleep apnea are only sold by prescription in the U.S. I have included links to two comprehensive pages I found that address multiple types. Regarding insurance coverage, some insurers do cover oral appliances - check with your carrier. Regarding TMJ - I believe that is a question for your dentist - it certainly may be that an improperly fitted oral appliance can cause such problems, but a dentist who is trained to treat sleep apnea with an oral appliance will be able to evaluate you for the best appliance (presumably, avoiding adverse fitting results).

http://www.ihatecpap.com/oral_appliance.html

http://www.quietsleep.com/oralappliances_description-onecolumn.cfm

I hope this helps.

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