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Oral Orthotic for Sleep apnea; Has anyone tried this?
Topic Started: Dec 15 2005, 03:51 PM (1,234 Views)
Oh So Tired
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I was just diagnosed with severe obstructive sleep apnea. When I did the CPAP tritation, I got very little sleep and felt horribly claustrophobic. My doctor suggested that I try an oral device designed to help sleep apnea. It is supposed to move the lower jaw and tongue forward so the back of the throat is open and breathing is not obstructed. I can't find alot of information other than sales or patent information. Has anyone tried this device?

Also, I'm supposed to see an dentist/oral surgeon who specializes in this device. It seems he is the only one in town who can do this, and he's not in my insurance plan, so this is causing me alot of problems.

I would be grateful for any information or suggestions.

Thanks,
Oh So Tired
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henry
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Ohsotired, what pressure setting are you supposed to be at?
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OhSoTired
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I actually don't know. I was never given the results (numbers), I was just told that I have severe sleep apnea. I understand where the numbers are important for a CPAP, but do the numbers make a difference for an oral device? My doctor suggested that I go with the dental appliance because the CPAP freaked me out during the test. At this point, the appliance is probably moot because I can't get the insurance o.k. to use the dentist, and I'm tired of fighting with them, so I'm going to try a CPAP first.

Thanks...Oh So Tired.
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henry
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OhSoTired
Dec 21 2005, 08:33 AM
I actually don't know. I was never given the results (numbers), I was just told that I have severe sleep apnea. I understand where the numbers are important for a CPAP, but do the numbers make a difference for an oral device? My doctor suggested that I go with the dental appliance because the CPAP freaked me out during the test. At this point, the appliance is probably moot because I can't get the insurance o.k. to use the dentist, and I'm tired of fighting with them, so I'm going to try a CPAP first.

Thanks...Oh So Tired.

I'm wondering your pressure setting, because sometimes, if your pressure setting is not high enough, you get a feeling of suffocation when using CPAP (you can't seem to get enough air).

I know that when I went through a titration, they started me out at the lower levels (8 or 9) and I felt that way.

Also, what might help is if you get a CPAP with a "ramp up" option, that slowly raises your pressure to the prescribed level over a 15 minute period, to help you adjust.
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nosbig17
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We don't have Hilary Care (that's where you are locked into a healthcare plan and are made a criminal if you go outside of it and pay for other healthcare) yet. Are you in charge of your health or have you given that responsibility to someone else? In any case something should be done, the question is what?

We are talking about YOUR well being. If you have severe OSA your heart, brain, liver etc.,etc. are being starved for oxygen when you sleep.

What is the success rate for this oral device?
What does it cost?
How much is your well being worth?


Ten years ago I went to one ENT who wanted to operate on my throat the next day after I was diagnosed. Went another Dr. who told me that there were three different procedures that she could do, none of which had greater than a 36% success rate. She said that the success rete for cpap was between 94% and 98%.

Since you have elected to TRY the cpap:
(Might be better if you were determined to make the cpap work for you, rather than only try.)

Hopefully you can be fitted with a mask that is reasonably comfortible.

You can expect to have leaks waking you up until you get the adjustments right and find a suitable sleeping position. I never used a pillow before cpap, now I use a buckwheat husk pillow and sleep on my side most of the time.

Who ever gets you started will probably try to start you out using the ramp (start with low pressure and gradually increase) feature. That is when I get claustrophobic, so I never use the ramp feature.

Another issue will be the use of a humidifier, heated or unheated, and rainout escecially if you sleep in a cold room.


Good luck with your theropy.

Don't evey think about sleeping without your cpap.

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Guest
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Thank you so much for your answers. It give me some info to work with.

"Nosbig17 asked: What is the success rate for this oral device? What does it cost? How much is your well being worth?"

I know the cost is about $ 3,000.00 out of pocket. I don't know know anything about the success rate because I can't find anyone who has ever used the oral device. Yes, I think my health is worth it, but I don't have the money to cover this myself, especially not this time of year. I need something now. At this point I'm determined to make anything work, because I'm miserable, and my husband is always worried sick about me. I have headaches every day, sometimes so bad that they are more like migraines.

"Nosbig17 said: "Another issue will be the use of a humidifier, heated or unheated, and rainout especially if you sleep in a cold room."

Can you tell me what "rainout" is? I know there is an exit for the carbon dioxide, it that the same thing?


'henry said: "Also, what might help is if you get a CPAP with a "ramp up" option, that slowly raises your pressure to the prescribed level over a 15 minute period, to help you adjust." Nosbig17 seemed to disagree. It takes me a while to actually fall asleep. henry, do you have this problem while the machine ramps up?

I like to sleep with my are over my eyes and on my side. Is there a CPAP out there that will allow me to do this comfortably? I hated the pressure against my sinuses from the one I wore at the sleep clinic.

Thanks again for the information,
Oh So Tired.


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nosbig17
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Rainout: Usually occurs when a heated humidifier is used in a cold room. The air coming out of the humidifier becomes saturated and condenses out inside the hose. You may hear a gurglling sound and get water in your mask. There are several things that can be done to counteract rainout; 1) Use a heated hose. 2) Set the humidifier heat to a lower setting. 3) Insulate your hose. 4) Increase the room temperature. Sometimes a combination of actions have to be taken to solve the problem.

Ramp-up Feature: It is understood that those who have higher treatment pressures find this option helpful, easing the pressure up gradually while they are falling asleep. I think that it's a useful feature, but I don't use it for the reason stated.

Finding the interface (mask) that works best for you is probably the key to successful cpap therapy. Some use the nasel pillows type devices with good results. If you sleep with your mouth open then a full face mask might work better, or a chin strap to help hold your mouth closed. For others the nasel mask works best.

I have found that the hose that comes with most machines have large clunky cuffs on the ends and they interfere with the seal of the mask. I use a cuffless hose made by Quest.

I also started 20 min. arobic exercises three times a week in conjunction with my cpap therapy.

Keep us posted on your progress.

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ConnCarl
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Oh So Tired
Dec 15 2005, 02:51 PM
<snip> Has anyone tried this device? </snip>

Tired, I tried a dental appliance once, and the short version is, it wasn't worth the powder to blow it to Hell.

That said, they are a number of mandibular repositioning devices out there and yours might be the Holy Grail. Unfortunately, that isn't likely. In general, only patients with mild to moderate OSA respond positively to dental devices, and even then, the odds are pretty poor.

Your best bet is a home CPAP trial. I know it's claustrophobic, I know that it can be difficult to get used to. I spent years crying and whining about CPAP and generally feeling sorry for myself. But it wasn't until I gritted my teeth and suffered through a couple of months of regular CPAP use that my daytime somnolence began to improve. Now I wouldn't sleep without it.

Good luck whatever you choose to try.

Carl
"You knew the job was dangerous when you took it, Fred." - Superchicken
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sandygalsleeps
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Hi Interested to read about the different options. I have had CPAP now for many many years and I will admit that at first it is a bit like suffocating, but believe me it is well worth the perserverance to use it compared to not sleeping. I do believe my memory was of two to three weeks to become comfortable and now it is like a baby and its dummy, no machine, no sleep. I can be not tired and it will put me to sleep.
The humidifier that I have is a very important piece of equipment as I did get bronchial irritations from the cold air when Ifirst started using CPAP without the humidifier and I have found the best way to control the build up of water in the hose is to have the humidifier set at a lower setting than what it is when the water starts to condense.
I am having probs. with sleep at the moment, but my life has changed enormously health ways and that is why I am going to have another sleep assessment.
I wish you well in establishing all this stuff and I speak from experience that you will feel like a new person once you have settled down to bed with your CPAP and humidifier.
I will add, I have a hubby who snores now and he doesnt have sleep apnoea, but boy his snoring is irritating.

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sandygalsleeps
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Hi, me again.

Just forgot to add as far as sleeping positions go, I do sleep on my side or on my stomach with my mask on and don't have a problem.
I had an argument with a sleep technician at one of my sleep assessments, he tried to tell me I couldnt sleep on my stomach and I told him I did. This was when he was sticking one of the many wires on my leg. I told him I was going to sleep on my stomach and that the wire was too short. After he had to reconnect the wire 3 times, he conceded defeat and put a long wire on.
I personally have taken my CPAP camping with me in a tent and various other places, never without a problem. The only thing I must remember too is to place the CPAP on top of the humidifier so that water wont run backwards into the CPAP, as one drop of water in the CPAP is all it takes to mess em up. I know I did it once.
Anyway, good luck
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