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Trying a Oral Appliance
#1
Trying a Oral Appliance
I have severe OSA and 100% corrected by my cpap.  Been using a CPAP for many years, with no issues.  However, I have an extended backpacking trip coming up, and the thought of lugging 3.5 lbs of cpap equipment on top of my gear, just isn't attractive.  A friend suggested a MAD.  However, not wanting to spend thousands on a sleep study and dentist just to find it didn't work, I decided to just try an OTC version.  I used my PR System One as a measuring device by setting the max and min pressure to 4 (which doesn't provide therapy), and did a control sleep without the MAD.  Of course, AHI off the chart and woke up with splitting headache.  Tried the MAD, and AHI was at 0.8, and I was shocked.  I have tried the MAD now for 2 weeks, at first it was a bit painful as the device moves your jaw forward.  After a while, I was quite pleased that I didn't have any issues with jaw pain.  I am doing the recommended exercises immediately each morning to ensure I don't develop jaw displacement issues.

Right now, I my AHI is varying between 0.8 and 5.7 depending if the device slips or not.  Even on nights where it slips, I usually wake up and reposition, so the worst AHI I have recorded is 5.7.  I have tried to use head bands to keep the jaw closed, but they are ineffective.  I did use the device on a week long business trip, without the cpap to measure.  No headaches, no issues of tiredness, no symptoms of OSA problems, so I know it isn't the CPAP at pressure 4 affecting the results (yeah, I need a sleep study). I guess at this point I need to just spend the $$ and have a professional one made and fitted. 

I am just not sure I want to continue with the MAD after my trip.  I am interested in the long-term problems anyone has had with a MAD.  Also, has anyone else tried OTC devices with the same success?
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#2
RE: Trying a Oral Appliance
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#3
RE: Trying a Oral Appliance
The chin strap has greatly improved my sleep quality. There are different types of chin straps out there and I prefer the double band style as it stays on better.  You need to find one that stays on properly.

The double band chin strap worked for me.  I never tried it without my VPAP because I have mixed sleep apnea.  I never tried it with my dental device but maybe a combination of dental device and chin strap might work better for some.
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#4
RE: Trying a Oral Appliance
That is a surprising result, not that it worked but that it seems to work so well.  If you choose you are a case that could consider benefit from going to a MAD device.  I do understand that when fitted properly they are painless.

1: realize that you are lessening your apnea with your pressure of 4 and as such I would suggest a sleep study to see if it is effective.  I would suggest it be a multiple night study because 1 night does not make a trend.

Also do your research and find a dental sleep clinic, a place that specializes in this device rather than a "corner dentist".
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