changes in response to dental appliance

[brainchild]

I have been using a mandibular advancement device, a dental appliance, for treating my sleep apnea for some months.

I have two questions, and I greatly appreciate any help you can offer.

As recently as several weeks ago, I was sleeping very well, and in fact an (in home) sleep study showed that my sleep was similar to that of the general population.

Since that time, treatment has become less successful, and at many times, it appears that my quality of sleep is even lower than it had been before beginning therapy.

One noticeable change to my body has been that over the course of treatment, I have gained substantial flexibility in my ability to advance my lower jaw through voluntary action.

My questions are:

1) Does the fact that I have gained flexibility mean that it might be necessary to use a greater lower jaw displacement distance in order to achieve the same therapeutic benefit?

2) Since I have using the device for some time, would one expect symptoms of withdrawal (i.e. feeling less rested than before) if I use the device less frequently, at a lower displacement, or at the same setting as I gain flexibility?

If either or both answers are "yes", then it would help explain my observations. Otherwise, I am confused and troubled.

Please help.

[Daso]

I have been using a mandibular advancement device, a dental appliance, for treating my sleep apnea for some months.

I have two questions, and I greatly appreciate any help you can offer.

As recently as several weeks ago, I was sleeping very well, and in fact an (in home) sleep study showed that my sleep was similar to that of the general population.

Since that time, treatment has become less successful, and at many times, it appears that my quality of sleep is even lower than it had been before beginning therapy.

One noticeable change to my body has been that over the course of treatment, I have gained substantial flexibility in my ability to advance my lower jaw through voluntary action.

My questions are:

1) Does the fact that I have gained flexibility mean that it might be necessary to use a greater lower jaw displacement distance in order to achieve the same therapeutic benefit?

2) Since I have using the device for some time, would one expect symptoms of withdrawal (i.e. feeling less rested than before) if I use the device less frequently, at a lower displacement, or at the same setting as I gain flexibility?

If either or both answers are "yes", then it would help explain my observations. Otherwise, I am confused and troubled.

Please help.

Brainchild, I had been diagnosed with mild OSA got the Cpap, hated it after a week and had a glidewell silent nite made at my dentist. Over two months it really seemed to help with the symptoms of daily sleepy Ness and I would get fewer days where I was dragging but not the feelings of regained energy that people on cpap mention. I did get some tmj pain and headaches and struggled with dry mouth but I kept at it over cpap. After the second month my wife started to notice that I was snoring with it in my mouth some nights. I advanced the MAD one more mm and after a few weeks I was getting noticeably tired again and my wife would once in a while say that I was still snoring here or there (I am not a big snorer). Scare of advancing the MAD further I decided to give cpap a try again as unsexy as it is and I dreaded the thought. Here's the bad news, after 20 days, I have to say I feel much better on the cpap (so far), I wake up more alert and definitely have more energy than with the MAD (I'm using bad relatively as I really wanted the MAD to work). I think that my jaw must have started to get used to the displacement of the mad and I would have needed to keep advancing it to an uncomfortable level. You might be experiencing the same thing. I could see using the MAD for short trips but cpap won this round. Now my next attempt is the didgeridoo for sleep apnea. Looks funny and sounds like a crock but people say it works if you do it right and for 20 min a day. Sorry for long reply but hope this helps. Pm me if you have questions.

[trish6hundred]

Hi brainchild,
WELCOME! to the forum.!
I haven’t heard too much good about the dental appliances and most of the time, people who use those devices have to wind up using CPAP therapy but of course, YMMV. Hang in there for more answers to your questions.
Much success to you with your therapy.

[love_to_sleep]

dental device worked for me better than CPAP. it was going good.. well not the perfect sleep but okay and better than CPAP. Then the doctor did one strange thing. I was using it for 3 months. Doctor asked if my sleep is okay. I said yes. Then doctor asked me if I snore. I said little bit. then doctor said "Hmm then you should increase the length" ! I find it strange.. why should the doctor be worried about my snoring when I did not complained about snoring? My only problem was sleep and I am getting it.

I look at this behavior by doctor with suspicion. I think by extending my jaw the doctor gets some benefit . But I don't know what it is.

I am now on the second day of extending. and I don't see any benefit. yet. But I getting 'feeling' in my jaw .. earlier that was not there.

[Lukie]

Because my first two sleep studies were inconclusive because I did not sleep, I was prescribed a MAD. I wore it for a few months with some relief but after a while my teeth shifted and my bite was off and finally I got terrible jaw pain. So I threw it in the drawer. Twenty years later my cardiologist asked me if I had sleep apnea. Needless to say, twenty years without being formally diagnosed did a number on my heart and I was having tachycardia. So my GP sent me for a sleep study and this time they gave me a sleeping pill to knock me out so they could see if I had apneas. I did and I was given a CPap machine. Now a year later I feel much better.
I also tried the didgerido. Total fail.

[OpalRose]

I have been using a mandibular advancement device, a dental appliance, for treating my sleep apnea for some months.

I have two questions, and I greatly appreciate any help you can offer.

As recently as several weeks ago, I was sleeping very well, and in fact an (in home) sleep study showed that my sleep was similar to that of the general population.

Since that time, treatment has become less successful, and at many times, it appears that my quality of sleep is even lower than it had been before beginning therapy.

One noticeable change to my body has been that over the course of treatment, I have gained substantial flexibility in my ability to advance my lower jaw through voluntary action.

My questions are:

1) Does the fact that I have gained flexibility mean that it might be necessary to use a greater lower jaw displacement distance in order to achieve the same therapeutic benefit?

2) Since I have using the device for some time, would one expect symptoms of withdrawal (i.e. feeling less rested than before) if I use the device less frequently, at a lower displacement, or at the same setting as I gain flexibility?

If either or both answers are "yes", then it would help explain my observations. Otherwise, I am confused and troubled.

Please help.

Hi brainchild,
First let me say that I am not a doctor and have no experience with the dental appliances, but I am very skeptical of them. It just seems logical that at some point you would experience jaw displacement. I have to wonder if these devices could permanently change the position of your jaw.

Even with usage, how do you know if your AHI numbers are improving? You state that an "in home" sleep study showed you are sleeping similar to the general population. Which means what? Please don't get me wrong, I am not criticizing you, but if you are starting to feel that your quality of sleep has deteriorated, maby it's time to reconsider CPAP therapy.
OpalRose