Mild OSA now...going to oral appliance need advice

I had a new sleep study this past year and with my tonsils removed, my sleep apnea has been reduced to a "mild to mild moderate" degree. I had a new titration study following that and it showed I still need a pressure I cant tolerate anymore post-tonsillectomy.

So my new sleep doctor recommended either surgery...forget that no more surgery for me. Or an oral appliance, actually thats what this new guy is pushing. So I was like, "OK I gotta do something." Went to a dental surgeon who does the oral appliances, he told me I needed some teeth repaired before I got the oral appliance put in. So I got three teeth repaired including two gold crowns put in. Now I am good to go and proceed with the oral appliance.

I am basically ditching CPAP, my stomach cant take it anymore post tonsillectomy. Im still using my Resmed AutoPap nightly but ranging it like I do, 4-20 to minimize aerophogia/stomach pain on left side, it gives me minimal restorative sleep, I dont wake up on it anymore like I got some sleep during the night like I did when I ran the thing from a starting pressure of 10.

Long story short, I am going to a Somnodent oral appliance and paying for it out of pocket. This thing has a three year warranty and is the flex model. My understanding is, the flex is pretty comfortable as far as oral appliances go.

Any advice from any successful OA users? I dont have severe apnea, its not really even moderate anymore. So I am anticipating some success with the OA.

One thing Im concerned about is durability long term. Whats the most durable oral appliance out there? Which ones last a long time? I typically get three to three an a half years out of an AutoPap machine, will I get that out of a Somnodent oral appliance, typically?

Also, I use a full face mask. I mouth leak bad. Thats with air blowing down my nose and throat from CPAP. With the Somnodent I wont have any air blowing down my nose and throat, so will the "mouth breather" thing still count?

I should have done this two or three years ago, btw. But the sleep doc I was using back then never suggested it and I was too fatigued after the tonsillectomy to pursue it on my own.

Thanks for any advice.

Sounds like your surgery paid for his tires, but he still needs a new top for his convertable.

Use your XPAP, let him and the dentist, ride the bus. Jim

I did not get the tonisllectomy for sleep apnea reasons. I had constant infections, tonsillitis issues, separate from sleep apnea. I really had no choice. It got rid of one problem, tonsillitis but created a brand new problem, CPAP intolerance.

I gotta do something, man. Like I said its "mild" apnea now.

Goofproof wrote:Sounds like your surgery paid for his tires, but he still needs a new top for his convertable.

Use your XPAP, let him and the dentist, ride the bus. Jim

If you want help with staying on Cpap, we can do that. If you want help to ditch Cpap and go onto oral devices, you're on the wrong forum.

As an FYI, I tried the Somnodent Herbst briefly and found it more intolerable than using a mask. Initially, I had a very hard time breathing through my nose although it seemed to get better when I advanced the device a tiny bit forward.

And what really concerned me was when I woke up after three hours, my jaw already felt out of alignment with the device hardly advanced. I was scared to death what would happen with more use even with exercises in the morning to get it back into position.

I have no idea about the efficiency of this appliance but you might want to go to, http://www.oasyssleep.com/ because the device allegedly serves as a nasal dilator as well as its prime function as a sleep apnea dental device. If you mouth breath, by dilating your nasal passages when you sleep at night, it might lessen the problem. Don't know for sure and obviously, it would be something to discuss with the dentist.

Regarding your pap therapy issues, have you considered looking into a bipap as that is supposed to lessen aerophagia issues which is what you are describing? You might want to search the archives to see if you can find relevant posts.

Whatever you decided to do, I wish you luck.

49er

Yeah, as part of the recent complete re-evaluation of my OSA, the sleep doc tried a BiPap. I got a Resmed Bipap and had the same aerophagia problems as I get with raising my minimum pressures on my AutoPap. Absolutely no differences. Basically it comes down to this, all I can tolerate anymore is Autopap and letting it "range" throughout the night, starting from 4 and on up. Right now my 95th percentile is 11ish.

Its not a good situation. I found losing a lot of weight (100 pounds) in 2014 and 2015 reduced my pressures to around the 10s, sometimes the mid 9s. It also reduced my fatigue levels SOME, but not enough and I still felt nowhere like I used to feel from normal pressure CPAP/APAP. Unfortunately, I have gained about 90 lbs back in one year.

Im not here to bash CPAP therapy or anything, I wish I could still get that same sleep quality I got on it. Im just desperate, doctor recommended an OA, its the current first place to turn to if you absolutely cannot tolerate CPAP/BIPAP, for any reason. Its also recommended for mild apnea, which as I mentioned is what Im basically diagnosed with now.

One area I have not gone down is pursuing legal action to find out if something happened in the tonsillectomy surgery, such as my trachea being scarred or something of that nature. I am too exhausted to pursue anything like that, least right now. My suspicion is a properly made oral appliance will give me enough therapy again (consistent, the same all night long) to "get it together" good enough to get a job again and maybe get back on my feet so to speak.

Very fatigued...

49er wrote:
Regarding your pap therapy issues, have you considered looking into a bipap as that is supposed to lessen aerophagia issues which is what you are describing? You might want to search the archives to see if you can find relevant posts.

Whatever you decided to do, I wish you luck.

49er

I am so sorry to hear that a bipap didn't help you. I just remembered this thread that you might want to check out this thread started by someone who has been treating people with sleep apnea with oral appliances for several years. Obviously, you have to register for the forum.

https://myapnea.org/forum/problems-your ... appliances

I sure hope this guy helps and you find the appliance helpful.

49er

That's an unfortunate situation. I don't have anything to offer really other than an oral appliance didn't go well for me (that was before CPAP). My significant overbite meant a lot of force on my lower teeth to get enough jaw movement to do any good. My teeth started migrating forward enough that my teeth were at risk of permanent damage/loss. If you don't have much of an overbite and don't need a lot of jaw movement, it could be a pretty good solution. Hopefully others can chime in with any other possible solutions for the aerophagia problem.

The last thing you need to worry about is how long it will last.... you won't use it that long.... most of them wind you in a drawer or on a shelf in the medicine cabinet (like mine)

Oh yeah? How come overall compliance with CPAP is below 50% but with oral appliances its above 50%?

grayghost4 wrote:The last thing you need to worry about is how long it will last.... you won't use it that long.... most of them wind you in a drawer or on a shelf in the medicine cabinet (like mine)

My $500 oral appliance sits in the draw. It was the cause of EXTREME jaw pain. My dentist even referred to it as "yoga for your jaw". It's not the magic bullit they claim it to be.
And BTW, just because your apnea is mild or moderate, does not mean it can be treated with a dental device.

Well maybe I should just go fucking shoot myself in the head then and give up? Geeeez come to a sleep apnea forum and ask about oral appliances and people come down on your like you are dog shit or something.

Cardsfan wrote:My $500 oral appliance sits in the draw. It was the cause of EXTREME jaw pain. My dentist even referred to it as "yoga for your jaw". It's not the magic bullit they claim it to be.
And BTW, just because your apnea is mild or moderate, does not mean it can be treated with a dental device.

you might want to ask about new tires for you car here also

If I had been successful with my MAD ... I would not be here helping people with Cpap's

I do use an oral night guard device every night .... along with my Cpap, and my therapy would not be successful with out it !

After getting the Adjustable MAD and going through a titration sleep study... so the dentist could get paid by Medicare..... that the device was not going to work for long term use and when I put a cpap mask on the hard device and the steel wires cut my cheeks.
So I keep trying ... and found that a cheep and simple boil and bit mouth guard worked better than the $1200 MAD.

Good luck Special Snowflake. With your attitude, you are going to need it.
Have a sleep study using the mouth appliance to see IF it successfully treats the apnea.

I am 100% positive my $2800 Somnodent OA will handle my OSA with ease and without aerophogia. Just because you were too xxx of a sissy to handle the "jaw pain" of an oral appliance does not mean I cant adjust to some "jaw pain" over the course of a month or six weeks, with the help of some Motrin and ice daily!

Cardsfan wrote:Good luck Special Snowflake. With your attitude, you are going to need it.
Have a sleep study using the mouth appliance to see IF it successfully treats the apnea.