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One must understand that mild-to-moderate sleep apnea may be successfully treated with a custom made oral appliance. The reported success rate is >85% with one-year compliance @ >85%. Too often an oral appliance is over-looked and only considered when CPAP cannot be tolerated. When in fact, oral appliance therapy should be recommended for the initial treatment of mild-to-moderate sleep apnea.

On the other hand, severe sleep apnea should be treated with CPAP. And, oral appliance therapy used as an adjunct to CPAP therapy or in cases when patients are not compliant with CPAP. Patients who have severe sleep apnea should understand that oral appliance therapy may improve their condition to mild or moderate sleep apnea, but, may not eliminate the apnea all together.

CPAP is an excellent tool for helping to reduce the deleterious effects of sleep apnea. Other therapies must also be considered: Oral Appliances, Weight Loss, Diet and the Sleep Environment should be considered for all patients who have been diagnosed with sleep apnea.

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Comment by dr. martin bassiur on July 11, 2010 at 9:51pm
TAP is a fine appliance- there are many appliances available and there are a few exceptional appliances- the selection of an appliance should be made by the provider and the patient - there are some variables in the selection process. You should be abel to discuss your concerns with your provider and together decide on the appropriate applaince for your particular needs.
Comment by PATRICK SULLIVAN on July 6, 2010 at 12:19am
I suspected this was true, even though 'sleep' doctors deny it.
I've had moderate success with TAP, I think, but just feel there must be better available. Can you suggest a good one? This s/b like buying a car, you take a test drive.
Comment by Judy on March 17, 2010 at 8:35am
Thank you, Dr Bassiur. That original local DME provider is still a sheister. I am on Medicare now, I wasn't then. I finally went in for another sleep evaulation in 2006 and was started on CPAP and since 2008 have been switched to a VPAP (bi-level). I have COPD. But I am fortunate to have a good local DME provider this time around. Thank God for these online sleep apnea support forums or most likely I would NOT be where I am today w/xPAP therapy. And I'm fortunate to have a good sleep lab to work with. Altho my impression so far w/their sleep doctors is still up in the air. They are pleasant but so far nothing to rave about. Unfortunately, you will find I am NOT one w/a particularly favorable impression of the sleep profession.
Comment by dr. martin bassiur on March 17, 2010 at 7:59am
I am sorry you had an inital bad experience with the DME provider- Did you discuss your problem with your Healthcare Provider at that time? I do hope you are having treatment for your sleep apnea- today. Most insurance carriers will reimburse payments for oral appliance therapy. Some will reimburse the provider
directly and some will reimburse the patient- it is depends upon each individual insured policy. May I suggest you discuss your individual concerns with one of the dental providers listed on this website- As of today the only carrier I know who does not cover the oral appliance is medicare. But some doctors will make special arrangement for patients who have medicare.
Comment by Judy on March 17, 2010 at 5:36am
Yes, I often got a chuckle out of my first sleep evaluation study's sleep doctor's dictated results. I'm 5' 4" and weighed 117 lbs and one of the recommendations for my then mild sleep apnea was that I lose weight. It was obvious a couple of the recommendations were "canned" SOP recommendations stuck in this sleep doctor's every dictation. To his credit he did included that I might benefit from a "trial" w/an oral appliance. Given the cost of a dental appliance and success rate and the cost of CPAP and success rate I opted for the CPAP. And I was 100% compliant w/that CPAP for 2 1/2-3 1/2 months - and most likely would have stayed compliant - IF - the local DME provider had been at all supportive and cooperative and of assistance when the mask finally just plain wore a "hole" on the bridge of my nose - OR - if the sleep doctor/sleep lab had given me any encouragement to return to them w/any problems. Neither occurred, I was left entirely on my own so I returned everything to the DME provider and went another 10 years before seeking help again.

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