Dental Appliance Verus APAP

I am going to have a test Monday (16) to see if I am a candidate for a dental appliance in place of my APAP machine. I guess I am trying to find out ahead of time, before my test, if any one has succeeded in overcoming OSA using a dental appliance with titrated pressures of 9.5 to 12 CM? Thanks for any replies.

Dan

Some have done well with dental devices, but for the most part people find them a waste of money and time. Xpap, is the Gold Standart of treatment, The Lead Standard of Treatment, is DeNile. Jim

Dan,

I haven't had experience with this, but I did have an appointment this past week with a dentist specializing in sleep apnea appliances. I am tolerating CPAP fairly well, but wanted to check into this anyway. After a short discussion, he told me that he felt I should stay on CPAP because it is the "gold standard" in treating OSA and that he felt dental devices should only be tried if a person couldn't tolerate CPAP or traveled a lot and wanted to use the dental device while traveling. He didn't even test me; just felt like I should stick with CPAP since I'm tolerating it okay.

He sounded very knowledgeable and considering he could have ignored all that and tried to make money off me, I trust what he said.

I wish you well with your appointment. Some people do very well with dental devices. If you haven't already, you could check out this forum, as they have a discussion board for oral appliances. http://www.apneasupport.org/

Pam

there is NO correlation between using an APAP and a dental device. It all depends on your particular anatomy and what you are trying to fix.

It also depends on what your PSG looked like. The main thing to address with any therapy is the dropping oxygen levels but there are other factors to look at.

If you use any therapy other than cpap you better make SURE it is keeping your oxygen levels UP to normal levels or you are just wasting your time. The only way to tell if that is working is to monitor your SAO2 levels regularly or have a follow-up PSG. So I would look at getting a Pulse Oximeter that records during the night.

CPAP does more than just splint your airway open, it many times stabilizes your respiration resulting in better sleep. You can have central and mixed apnea firing off every 30 seconds with NO therapy, put the patient on cpap and it can all disappear. What is going to happen with a dental device in those situations? Yep you guessed it, they continue to have them.

Most people that go on a dental device after using cpap for only a short period of time do so because they are marginal OSA and/or what I call wusses. They are mild cases of OSA at most, certainly not severe OSA by any means. Then when you go read their posts over on the Dental forums they are just complaining about the same things they complained about on cpap. My teeth hurt, it pops out of my mouth, give it 6 more months. Finally 6 months later they are gone, they most likely stopped using even the dental device.

Fact is there are just as many obstacles to overcome using a dental device as there is with cpap (just go read at TAS). Cpap may be uncomfortable but it doesn't hurt like sore teeth or a sore TMJ joint. I also have the comfort of knowing that by using it every night that air pressure going down my airway is keeping my oxygen levels up even if I do experience apnea.

With a dental device there is no forced oxygen going into your system as with cpap, if you stop breathing from a mixed or central apnea there is nothing. PSG's are important so you know what disorders you have and are trying to fix and if things are working with any therapy like they are supposed to.

Getting use to CPAP is very hard, no doubt about it, it is uncomfortable more than it is comfortable but once you get used to it it is no big deal.

As for looks, I don't care what I look like at night, no one sees me sleep but the dog, if your partner has a problem with how you look when you sleep they aren't much of a partner. I do know when I get up I can take off the mask and be just as normal as the next person.

Your best bet if you want to learn about the dental devices is go over to Talkabout sleep on their dental forum. They can answer any question you may have about the dental device. We don't talk much about dental devices here because it always turns into a pissing contest and the bottom line is we are here to help people having problems with cpap NOT dental devices. If you want information on dental devices go where they talk about dental devices.

http://www.talkaboutsleep.com/message-b ... m.php?f=10

The reasoning is: It is already difficult enough to tolerate cpap (or any treatment for that matter), when a person is having difficulty with their cpap therapy we don't need replys saying "you should spend $1700 for a dental device..yep that is what you should do", they have no idea what the persons PSG looked like, if they have severe OSA or have other issues the dental device obviously won't address like irregular breathing.

I can see if you are young and your OSA is mild, I can't blame you for wanting something else, go for the dental device, but just keep tabs on its efficacy and keep using it, if you don't use it for any reason use cpap because the effects may not bother you now but they do catch up to you when you get like 45-50. Then it is much harder to fix a failing heart, clogged arteries or reverse the effects of a stroke.

I have friends that have been on dental devices, some are still using it but some 2-3 years later give up on them. Then what do you have? no treatment.

Thanks to everybody who replied to my post, just got back from visiting the dental appliance forum and wasn't to encouraged from reading the end results. Also most that did receive some relief were or had few apneas/hypopneas. I just received my sleep study reports in the mail today and they don't look too good. first study shows, 218 apneas, of which 142 are OSA..central=33, mixed=43 and hypopnea=107...total=325. MY RDI was 63.2. Sp02 was AOS=94.8%..lowest was 80% but only for a few seconds. Snore time was68 minutes, number of episodes=306. First study was for 06:27 H:M.

Second study wasn't much better, RDI dropped a little57.5 compared to 63.2 and Sp02 was AOS=94.1% lowest=72% for 1.1 minuet.

My third study on cpap of 10cm: apneas=0, OSA=0, centrals=0, mixed=0 and hypopnea= 9, A or H/hr=1.1 and RDI=1.1. Sp02=AOS=96.2% and lowest was 89.0% for 0 minutes. My A+H/hr=1.4 for 353.6 minutes and 0.6 for 105.6 minutes.

So with the results of my CPAP study, I find that a dental device may not be able to improve on the results of my CPAP machine or even match it, but I will see what the the dentist has to say after he does his test. It would be great if he says that it is possible to match the results of my CPAP study, but I don't hold to much hope for that to happen, will find out Monday and when I do, will let you know the results of the test and his prognosis, thanks all.

Dan

WearyOne--I do some traveling and hate having to take all the stuff involved with CPAP on the plane. I would like to talk to a dentist about the dental appliance but haven't been able to find one in Roanoke and noticed from your info that you are in Virginia. Would you mind telling me where you found the dentist you were talking about?

[quote="sleepngo"]Thanks to everybody who replied to my post, just got back from visiting the dental appliance forum and wasn't to encouraged from reading the end results. Also most that did receive some relief were or had few apneas/hypopneas. I just received my sleep study reports in the mail today and they don't look too good. first study shows, 218 apneas, of which 142 are OSA..central=33, mixed=43 and hypopnea=107...total=325. MY RDI was 63.2. Sp02 was AOS=94.8%..lowest was 80% but only for a few seconds. Snore time was68 minutes, number of episodes=306. First study was for 06:27 H:M.

Second study wasn't much better, RDI dropped a little57.5 compared to 63.2 and Sp02 was AOS=94.1% lowest=72% for 1.1 minuet.

My third study on cpap of 10cm: apneas=0, OSA=0, centrals=0, mixed=0 and hypopnea= 9, A or H/hr=1.1 and RDI=1.1. Sp02=AOS=96.2% and lowest was 89.0% for 0 minutes. My A+H/hr=1.4 for 353.6 minutes and 0.6 for 105.6 minutes.

So with the results of my CPAP study, I find that a dental device may not be able to improve on the results of my CPAP machine or even match it, but I will see what the the dentist has to say after he does his test. It would be great if he says that it is possible to match the results of my CPAP study, but I don't hold to much hope for that to happen, will find out Monday and when I do, will let you know the results of the test and his prognosis, thanks all.

Dan

Snoredog, my position statistics, were as follows, supine=164.8 or 39.9%, left=195.4 or 47.3%, prone=29.1 or 7%, right=0, upright=0, unknown=0 and movement=24.2 or 5.9% for a total of 413.5 minutes or 100% and 16 transitions in two hours. Not sure what all this means but my position statistics really improved compared to the above study without CPAP.

Supine=353.6 or 67.5% with A+H/hr=1.4, left=21.3 or 4.1% with A+H/hr=0.0, prone=0, right=105.6 or 20.2% with A+H/hr=0.6, upright=0, unknown=0, movement=43.1 or8.2% for a total of 523.7 minutes. This was the study done while using CPAP of 10CM, big improvement over the study without CPAP. Is that what you were talking about Snoredog?

Dan

Snoredog, I posted my list before looking at the web site you posted. After going to that web site I can say for sure I have no problems like those indicated, but if I did I certainly would seek help, thanks for the list, it is really disturbing to know people experience such disorders.

Dan

[quote="sleepngo"]Snoredog, my position statistics, were as follows, supine=164.8 or 39.9%, left=195.4 or 47.3%, prone=29.1 or 7%, right=0, upright=0, unknown=0 and movement=24.2 or 5.9% for a total of 413.5 minutes or 100% and 16 transitions in two hours. Not sure what all this means but my position statistics really improved compared to the above study without CPAP.

Supine=353.6 or 67.5% with A+H/hr=1.4, left=21.3 or 4.1% with A+H/hr=0.0, prone=0, right=105.6 or 20.2% with A+H/hr=0.6, upright=0, unknown=0, movement=43.1 or8.2% for a total of 523.7 minutes. This was the study done while using CPAP of 10CM, big improvement over the study without CPAP. Is that what you were talking about Snoredog?

Dan

[quote="Snoredog"][quote="sleepngo"]Snoredog, my position statistics, were as follows, supine=164.8 or 39.9%, left=195.4 or 47.3%, prone=29.1 or 7%, right=0, upright=0, unknown=0 and movement=24.2 or 5.9% for a total of 413.5 minutes or 100% and 16 transitions in two hours. Not sure what all this means but my position statistics really improved compared to the above study without CPAP.

Supine=353.6 or 67.5% with A+H/hr=1.4, left=21.3 or 4.1% with A+H/hr=0.0, prone=0, right=105.6 or 20.2% with A+H/hr=0.6, upright=0, unknown=0, movement=43.1 or8.2% for a total of 523.7 minutes. This was the study done while using CPAP of 10CM, big improvement over the study without CPAP. Is that what you were talking about Snoredog?

Dan

Snoredog I didn't get that last post to come out the way I wanted, but I assume you got my reply that I am doing just fine on cpap, but would prefer a good alternative, such as a dental device.

Dan

Clickable LINKS to surgery, turbinates, Pillar, TAP experiences
viewtopic.php?t=2836

rested gal wrote:Clickable LINKS to surgery, turbinates, Pillar, TAP experiences
viewtopic.php?t=2836

Thanks Rested Gal, a lot of material to digest, but I will read as much as I can before my dental appliance test scheduled for Monday. There is so much information out there, that it tends to muddy the waters a bit. I will let everyone know the results of my test, that is if he gives me one, he hasn't seen my sleep study reports yet, but he will before he goes through with the test, hoping everything goes well.

Dan

Dental devices work for some folks. CPAP works for some folks.
Be grateful that you have choices! Get educated and be your own
advocate for your health. If you read enough forums you can find
people who have strong opinions just about anything. My world
has all kinds of color in it. Some folks have just Black and White.