Mouthguard, which do you like?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Rob K
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Mouthguard, which do you like?

Post by Rob K » Tue Apr 05, 2022 12:08 pm

Maybe the title should read, which is tolerable. :D

I've been on cpap for 8-9 years. It only improves my quality sleep slightly. Still feel exhausted and bad every day. Over the years I've had several sleep studies, many doctors appointments and much money spent to no avail. Still hanging in there though and I keep trying new things with hope that someday I will get relief.

No meds, just fish oil and D3. In the past I had been prescribe quite a few sleeping meds, none of them helped. I'm not overweight, 5"11" 180lbs.

I've been on the forum for 5 years and use Oscar. My cpap therapy has been optimized long ago. AHI is around 1 most nights and the events that the machine is recording are false, they are just sleep wake junk. My breathing is pretty erratic through the night likely due to a lot of physical activity.

I consciously wake around 8-12 times every night of my life. I suspect the problem is still breathing related and this is obviously why I'm exhausted all the time. Often I feel quite bad when I wake, especially in the morning after a whole night of restless sleep. For people that can't relate I tell them it's like having a hangover every day.

Around the same time I developed apnea I also started moving around in my sleep a huge amount. I end up in different positions all the time. With all my moving around the only time I consciously wake up is when I'm on my back. That is when my apnea is at it's worse so I suspect the problem is still breathing related. The pattern is the same every time I go to sleep. Go to sleep on my side, move around in my sleep a bunch especially when I get to rem stages, end up on my back where I wake up, adjust mask blankets and body position and go back to sleep on my side. This happens every half hour to hour every single night. Once in a while I hear myself snoring when I wake up.

I'm not able to stay sleeping on my side since I move a ton in my sleep. They only way to accomplish that would be restrain my body in a side sleeping position. Not being able to change positions once in a while would be to much pressure on joints and cause to many aches. I've sort of given up on that idea for now.

My latest thoughts have been on mouth guards. If I'm always waking on my back then possibly I'm still struggling with breathing. When laying on my back, my jaw moves back quite a bit even with my mouth closed. This does noticeably restrict airflow. Maybe if I correct that jaw position it will help in some way. I also suffer from bruxism(teeth grinding) so a mouth guard would hopefully be dual purpose. I've also had poor luck with all full face masks since my jaw moves so much and the masks always leak, thus I use nasal masks. I've also have never had a chin strap that helps, they seem to just pull my jaw back further.

I've talked to a couple people now that have said cpap didn't work for them but a mouth guard did. I figure it's certainly worth giving it a try. I've been studying some of the mouth guards and was hoping I can get some feedback on your experiences. Which ones are most comfortable? Which ones to avoid? Which ones work or don't work? From what I've read the MAD(mandibular advancing device) is probably what I'm looking for. They can adjust the position of the lower jaw. Sure looks like a lot of hardware to put in your mouth. :shock:

SnoreRx, ZQuite, Vital Sleep, Sleep Tight seem top most of the lists when I did a search. I'll try anything at this point.

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Conrad
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Re: Mouthguard, which do you like?

Post by Conrad » Wed Apr 06, 2022 6:36 am

I also suffer from bruxism and apnea.

My bruxism is so bad that I've cracked teeth and had 4 implants as a result. My new dentist even suggested having Botox injected into my jaw muscles to weaken them so that I don't chomp down so hard on my teeth. I declined this.

My former dentist made a custom mouth guard (nighttime occlusal device) for me, and I've had good luck with that, been using it for nearly 10 years. Yes, the same mouth guard. It wasn't cheap but it's held up great all of these years. This is what I recommend.

A couple of years ago my wife and I went on a month-long vacation, and I forgot to pack my mouth guard. I got a $10 guard from Wallys, the type that gets emersed in hot water to soften it up and then you bite down on it to form it to your teeth. This worked ok but not nearly as well as the custom device.

YMMV
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ChicagoGranny
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Re: Mouthguard, which do you like?

Post by ChicagoGranny » Wed Apr 06, 2022 7:22 am

Rob K wrote:
Tue Apr 05, 2022 12:08 pm
my jaw moves back quite a bit even with my mouth closed.
Due to human anatomy, I'm skeptical that your jaw moves backward from its normal resting position when the mouth is closed. The jaw does naturally move slightly backward when the mouth opens.

A more common problem is the neck bending forward slightly thus causing the chin to move closer to the chest. This tends to crimp the airway. This may be what is happening that causes your snoring. A firm foam cervical collar can prevent this. I have worn one every night for many years.

Breathing problems could be causing your restlessness and bruxism. Do you know the symptoms of RLS? Look them up to check if this might also be a problem.

I think you have some work to do before investing in a good mandibular advancement device (MAD).

Rob K
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Re: Mouthguard, which do you like?

Post by Rob K » Wed Apr 06, 2022 8:27 pm

If I had normal anatomy I wouldn't be having problems. Just joking around :lol:

My lower jam moves back when I tuck my head. I don't have and overbite but I do when using a pillow or tucking my chin. It gets more pronounced when jaw muscles relax. Also my front teeth are long so I have to move my lower jaw back to chew. When I'm laying down and move my lower jaw to it's normal position the airway opens some and improves breathing. This is why I want to give a MAD a go, also to for bruxism. Will just try one from the store. Dentist made one is likely years away for me. I have cracked teeth but nothing bad enough that I've needed repairs yet.

Yes sleeping with chin tucked to chest makes things worse. I'll look at collars also. I'll have so much hardware I won't sleep. lol

I had the same thoughts, breathing problems may be causing bruxism and restlessness.

I don't have RLS and I do have a little bit of PLM, but nothing significant. Dr says not enough to be causing so much restlessness. Also the PLMs are during deep sleep. Nearly all my movements and restlessness is during light stages and mostly REM.

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Last edited by Rob K on Thu Apr 07, 2022 10:17 pm, edited 1 time in total.

Grenin
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Re: Mouthguard, which do you like?

Post by Grenin » Thu Apr 07, 2022 1:06 pm

As an aside, have you been evaluated for Narcolepsy? Some of your symptoms seem to indicate it might be worth looking into. It can exist with or without cataplexy and ranges in severity so many have it and struggle to get a diagnosis.

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Rob K
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Re: Mouthguard, which do you like?

Post by Rob K » Thu Apr 07, 2022 10:20 pm

No, I'll need to study narcolepsy and see what it's about.

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ChicagoGranny
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Re: Mouthguard, which do you like?

Post by ChicagoGranny » Fri Apr 08, 2022 11:31 am

Rob K wrote:
Thu Apr 07, 2022 10:20 pm
No, I'll need to study narcolepsy and see what it's about.
People come here thinking they have sleep apnea. After a few replies, they think they have 17 other pathologies.

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SJ-Paddler
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Re: Mouthguard, which do you like?

Post by SJ-Paddler » Fri Apr 08, 2022 11:52 am

Rob K wrote:
Tue Apr 05, 2022 12:08 pm
I consciously wake around 8-12 times every night of my life.
Wait is this not normal? I wake up all night also. Sleep on the left side get sore wake up then switch to right, then left, and so on. Sometimes it take a minute to get back to sleep others 10 minutes max. Does anyone on the forum just fall asleep and wake up the next day? Honest question. It is always hard to figure out what is normal or not from your own experience.

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Grenin
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Re: Mouthguard, which do you like?

Post by Grenin » Fri Apr 08, 2022 4:34 pm

ChicagoGranny wrote:
Fri Apr 08, 2022 11:31 am
Rob K wrote:
Thu Apr 07, 2022 10:20 pm
No, I'll need to study narcolepsy and see what it's about.
People come here thinking they have sleep apnea. After a few replies, they think they have 17 other pathologies.
One of the diagnostic criteria for Narcolepsy diagnosis is assessment for and treatment of sleep apnea. So one does have to come before the other in this case at least.

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Rob K
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Re: Mouthguard, which do you like?

Post by Rob K » Fri Apr 08, 2022 6:37 pm

Read up on the symptoms of narcolepsy and it doesn't seem like anything I'm experiencing. I'm just very run down from 8 hours of poor sleep each night. I feel great if I can sleep in 11-12 hour range. I actually feel rested and refreshed if I get 12 hours but that almost never happens.

Pain is not normally a problem, it's just temporary, usually from a day of hard labor. Awakenings are very consistent every single night, every half hour to hour. I used to sleep right through the night in one position and wake up 8-9 hours later. Around the time I developed apnea my sleep started to become very broken and continues to get worse over the last 8-10 years. I feel pretty bad when I wake during the night and the worse is in the morning after a whole night of restlessness.

I've had three different sleep doctors over the years and they don't seem to know what's happening. Sleep studies show apnea, ahi is low with cpap so doctors figure I'm good to go. Most wanted me to take meds for sleeping. I've tried around 10 different ones and none helped, no affect or made me ill.

I've discussed many possibilities with the doctors and they seem to be stumped on this one. My current doctor says probably 30% of cpap users don't feel like they get good rest. In my case I suspect the problem is still breathing related. So I'm still researching possibilities in that regard.

One thing I considered is that I'm very intolerant to cpap. You'd think some of those sleeping meds would have helped me get through the annoyance but they didn't seem to help much at all. The awakenings and restlessness persisted right through all those meds.

Thanks for lending me an ear. I have to keep trying things because I'm miserable. My employer has been more than accommodating but it looks like I may end up losing my job eventually since I'm exhausted and can't perform regularly.

I'll do some more research and try a couple things I haven't tried before, an adjustable mouth guard and a cervical collar. If anyone can help with this stuff in the short term it would be much appreciated. That would save me a lot of money through trial and error.

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Additional Comments: Resmed F10 Mask for colds. When camping on battery power I use P10 mask and PR 560p machine.

Rob K
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Re: Mouthguard, which do you like?

Post by Rob K » Fri Apr 08, 2022 6:43 pm

Has anyone tried any of these mouth devices? SnoreRx, ZQuite, Vital Sleep, Sleep Tight. Some are adjustable so I guess they would be classified as over the counter MAD's.

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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ N10 Nasal CPAP Mask with Headgear
Additional Comments: Resmed F10 Mask for colds. When camping on battery power I use P10 mask and PR 560p machine.

Lindafromgrayslake
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Re: Mouthguard, which do you like?

Post by Lindafromgrayslake » Tue Apr 12, 2022 10:04 am

Hi, I just joined the forum. I wore a Somnamed device - actually a series of 3- for15 years. It never effected my jaw even though I was inconsistent doing the short morning exercises. I had great results.
Then, my weight went from 135 to 150. (I'm a 5 3’ woman) also, I am no longer 55 yrs old but 15 years older. At first I viewed the every morning headaches as a prior neck issue flaring. Went for massage but meanwhile, began to explore if I had tipped over from moderate to worse apnea.
Sleep study on my back ( which I had trained to at advice of massage therapist ) showed me 2 points into severe. Also that the device wasn't helping. During the study, Despite resetting the cranks forward on the device, no attention was paid to my on the back position and only later did I find out that's is known to be a huge factor.
So I then got a CPAP as I was told apneas we're the obvious source of my daily AM headaches. Fast forward 4 months of nightly compliance and my apneas are under control. Still have am headaches but feel clear the rest of the day. I went to Physical Therapy for my neck for 3 of those 4 months and increased range of motion.
I am just now going back to the Somnamed and working hard towards losing the 15 lbs. Overall having the CPAP left me in a more impaired situation. Switching back to side position a few weeks ago is the only obvious improvement I have seen in this whole journey.
Meanwhile CPAP caused GI bubbles and painful TMJ. I am worn down from how involved and stressful it has become to go to bed. Particularly not sustainable when you are
a workaholic anyway. But happy til lately cas I do meaningful work.
My pressure on CPaP is now only 5 so I am jumping ship with agreement from my Sleep specialist DDS.
I will post how this goes but in closing I wish all well and think we might benefit from a bit of Yoga Nidra. This had gotten way too unnatural me thinks.

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ChicagoGranny
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Re: Mouthguard, which do you like?

Post by ChicagoGranny » Tue Apr 12, 2022 11:42 am

Lindafromgrayslake wrote:
Tue Apr 12, 2022 10:04 am
My pressure on CPaP is now only 5 so I am jumping ship with agreement from my Sleep specialist DDS.
Do you use OSCAR to monitor and optimize your CPAP therapy effectiveness?

Rob K
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Re: Mouthguard, which do you like?

Post by Rob K » Tue Apr 12, 2022 4:59 pm

I bought the Vitalsleep adjustable mouthpiece. Seemed a little smaller than the SleepRx and reviews said the Vitalsleep was more comfortable. I used it part of last night but it's to big or to tall I should say. My lips don't close all the way and the cpap ends up blowing air out my mouth at some point. I made an adjustment and reformed it again today to see if I can get it to work.

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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ N10 Nasal CPAP Mask with Headgear
Additional Comments: Resmed F10 Mask for colds. When camping on battery power I use P10 mask and PR 560p machine.

Lindafromgrayslake
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Re: Mouthguard, which do you like?

Post by Lindafromgrayslake » Tue Apr 12, 2022 8:18 pm

Thanks I will check out what OSCAR means.
Also I shoulda clarified Yoga Nidra amounts to laying on the floor having a yoga instructor help you relax down through the layers of relaxing into sleep. Nidra means sleep. Although Im sure regular yoga is way helpful too as are breathing exercises. Thanks for reading - I will now belatedly read the newbie rules that I apologize if I have violated any.