Newly diagnosed. Dr. Recommending oral appliance instead of CPAP

[Don in Austin]

I think any oral appliance that displaced your jaw (I am assuming that's what it does) would hurt. But what do I know I have not tried it, sounds like a cramp waiting to happen. Cpap is no picnic so it's up to you. I didn't have a choice and I am happy for Pap and that it works.

I have no significant comfort or compliance issues with my oral appliance after a year and a half. You want a good sleep dentist to fit one custom.

I was not fully satisfied with the apnea reduction and am now going back to CPAP, but still using the oral appliance so I can keep the CPAP at lower pressures.

Absolutely the oral appliance can work for some people. For others, it may not be enough or it may cause discomfort.

Don in Austin

[Don in Austin]

I would ask your doctor how he intends to track the effectiveness of the oral appliance. I think for some people they can do wonders, the main problem with them is there's very few ways to tell if it is actually working.

The best home method is to use an oximeter at night. But this only works if you are one of those whose blood oxygen saturation rate dropped during the night due to obstructive sleep apnea.

The most expensive method is to wear it during yet another sleep study.

The pulse oximeter will track O2 and heart rate.

If your O2 levels do not dip accompanied by pulse rate spikes can you really be having significant problematic apnea? Isn't the pulse rate spike and O2 starvation what is bad about an apnea?

A home sleep study is a compromise solution for monitoring a program.

Don in Austin

[Lukie]

Also it loosened my teeth and I have read it can displace your crowns.

[danf183]

So I finally got a copy of the results. Going to see the Dr. soon but I'd love to hear some of your opinions:

Sleep efficiency: 90.3%
Latency: 17.2 minutes (fast for me)
Stage N1: 14.2% (increased)
Stage N2: 59.4% (increased)
Stage N3: 7.8% (decreased)
2 REM sleep periods: 18.6% total (decreased)

REM sleep latency: 147.5 minutes (this concerns me a bit)

Overall AHI: 7.3
REM Specific AHI: 16.9
Obstructive apnea index: 0.0 events/hr (doesn't make sense to me?)
Obstructive hyponeas: 44 recorded with mean duration 20.4 (I guess I have hyponeas and not apneas?)
RDI: 7.9
Mean o2 Saturation: 95.6%
Lowest Saturation: 86%
48 arousals related to respiratory events making the index 7.9/hour
69 spontaneous arousals (11.4/hour)

I'd appreciate any insights you guys have into this report.

Thanks!

[steveg11sings]

I wanted to share my experience with an appliance. Firstly it cost me $2000 and my health plan did not cover it. I tried it for several months and eventually went into a sleep clinic to test if it was working. Nope. My apnea level was as high or higher than ever ( explains why I was still tired while using it ).
Secondly it displaced my jaw slightly enough that my teeth do not quite align the same any more.. Stay away from this solution !

[Don in Austin]

I wanted to share my experience with an appliance. Firstly it cost me $2000 and my health plan did not cover it. I tried it for several months and eventually went into a sleep clinic to test if it was working. Nope. My apnea level was as high or higher than ever ( explains why I was still tired while using it ).
Secondly it displaced my jaw slightly enough that my teeth do not quite align the same any more.. Stay away from this solution !

That is your experience.
Mine is different.

Don in Austin

[PaytonA]

I wanted to share my experience with an appliance. Firstly it cost me $2000 and my health plan did not cover it. I tried it for several months and eventually went into a sleep clinic to test if it was working. Nope. My apnea level was as high or higher than ever ( explains why I was still tired while using it ).
Secondly it displaced my jaw slightly enough that my teeth do not quite align the same any more.. Stay away from this solution !

That is your experience.
Mine is different.

Don in Austin

But Steve's experience points out what is possible. Then one must make up one's mind if it is worth the risk.

[danf183]

Thank you all for your input. Looks like insurance will pay for my appliance or CPAP. I think I'm going to see how it goes with the appliance then move on from there.

[archangle]

Thank you all for your input. Looks like insurance will pay for my appliance or CPAP. I think I'm going to see how it goes with the appliance then move on from there.

Will it cover CPAP later if the oral appliance fails? Will it pay for the second sleep study to confirm that the oral appliance works?

There's a good change the oral appliance will fail. Not everyone's apnea is caused by an abnormal jaw position, or can be fixed by pulling the jaw forward.

Good luck with whatever you try, however.

[tjbrit]

THERE
THERE IS A VERY BIG DIFFERENCE BETWEEN A CPAP AND A DENTAL GUARD.
THE DIFFERENCE = DOT (DEPARTMENT OF THANSPORTATION RULES)
THE DOT RECOGNIZES THE CPAP.
THE DOT DOES NOT RECOGNIZE A DENTAL GUARD.
IF YOU HOLD A CDL AND HAVE BEEN DIAGNOSED WITH SLEEP APNEA, YOU WILL HAVE TO CUDDLE UP WITH THE CPAP. OF COURSE, IF YOU DO AN IN-HOME SLEEP STUDY, NO ONE REALLY KNOWS IF YOU USED DENTAL GUARDS OR NOT.

HAVING STUDIED THIS ISSUE SINCE ITS BEGINNING, THE MAIN ISSUE IS MONEY - - LOTS AND LOTS OF MONEY TO BE MADE BY THOSE WITH THEIR HANDS IN THIS PARTICULAR TILL.

MOST OF THOSE WHO MAKE "THE RULES" ALSO HAVE THEIR HANDS IN THE TILL, WITH SLEEP STUDY "FACILITIES" AND STOCK IN THE CPAP MACHINES AND SUPPLIES.



==================================

Hi all-

After 3 in lab sleep studies, and 2 home studies, I finally have a diagnosis. My most recent in lab study showed an AHI of 9.4 during NREM, and 16.9 during REM sleep.

I understand that this is moderate sleep apnea. My doctor recommended trying the oral appliance first before a CPAP machine. After searching through this board, it seems like most people opt for CPAP. Is there any reason I shouldn't try the oral appliance first and go straight for a machine?

Any input would be greatly appreciated.

Thanks,
Dan