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UARS - Different country, Same Story - jmagic - 12-22-2021
Hello Apneaboard-Colleagues,
I am writing today my first post altough im registered since 2019. I always had the feeling that breath and sleep badly and convinced my doctor to make an sleep study with me (went really bad and i barely slept 3,5 hours). In the meantime I do not wanted to wait and bought an Airsense 10 and tried a bit to CPAP myself.
Unfortunately it was not really successful. I really tried hard to get used to it and followed as much as guides as possible. I thought this will rescues me. But when my doctor called me and said I have no Apneas everything is okay. I gave up... And tried to live my life with depression and bad sleep.
3 Weeks ago I bought from a dental technician a professional device (MAD - Mandibular advancement device) and gave it a try. 3 days ago I received it and tried it. Boom. I had the first time open eyes after I slept and I actually dreamed vividly. Hope in my life.
So I bought this time an Aircurve 10 ST (BiPAP) and wanted to give it a try with it. But I dont really know what exactly to aim for? I mean I dont have really Apneas.
What EPAP/IPAP Pressure would you recommend for me for the beginning? What's the goal to maintain when you actually breath but have airway ristrictions? What should be the maximal gap between EPAP/IPAP?
I'm sorry to bomb you with so much information...
Thanks in advance for every answer/help! I don't take it for granted!
Best regards from Germany,
Jmagic
RE: UARS - Different country, Same Story - gaydolphinorgy - 12-22-2021
Hi sorry I don't have any advice to give as I'm new on this journey myself but please could you tell me how you found the dental technician that gave you the MAD? What kind of dental technician was it?
RE: UARS - Different country, Same Story - jmagic - 12-22-2021
Hey Gaydolphinorgy,
No problem! My journey can wait. In Germany we call this MAD Schnarchschiene/Snoring Splint. In general you have to visit a dentist who knows about this apnea topics and takes imprints of your upper and lower teeths. Afterwards he sends them to the "dental technician" and he make it for the dentist. The dentist in Germany wants 750 € - 1250 € for it. In my Area it's around 750 €.
But I went immediately to the dental technician. I found a website/onlineshop from a technician who sends the preparation set for the imprints out. The customer makes the imprints and send them back to the technician. After 2-3 weeks you get the perfect individualized MAD Appliance back with extra customizable side sticks (where you can adjust the millimeters you want to set your back or forward).
The good thing on it, it is the same MAD like from the dentist but just for 395 €. It's a high class medicine product made in Germany and nothing from ebay/amazon for some bucks.
I read a lot of positive feedback about it and I just can confirm it helps! But it just should help you for a while or when you have travel and can’t use your PAP machine etc. Because on the long-term it will damage your Jaw joint for sure. That’s the reason I want to try it again with BiPap.
After a night you have to adjust your jaw back and you feel it wasn’t really healthy for your jaw joints. Because your jaw is under constant full tension and when you lie on your back your jaws are straight. But if you move and lie on your side, your jaw which is already under full tension will get in contact with your pillow and this is not very funny over night. Furthermore it’s just a tool to open your airway mechanically, you dont have a guarantee that you will have 0 Apneas. But it is proven by studies! It helps! But I'm sure there are also MAD supplier in the US, but the US is extreme expensive in terms of the medicine sector. They actually make a large business out of the health of people. Maybe you contact
Website of dental technician/onlineshop:
(EDIT: I can't post the website until I have 4 posts. You can write me a PM. But the website is on German. Maybe you should find something in your country.
This is the device:
RE: UARS - Different country, Same Story - CorruptAlligator - 12-22-2021
I'm starting to think that jaw being pulled back is due to gravity when on supine position. And during the supine, if you have a full face mask that pushes against under your lips around the chin, would push it even more. This I think is why high flow limitations is detected and often times OAs occur.
The easy solution is to sleep on the side and not use full face masks. Go with nasal type masks that doesn't cover your mouth.
I cannot wear a MAD because I already have a mouthguard for treating TMJ during the night for hard teeth clinching. I'm afraid MAD would make my TMJ much worse.
But, MAD does sound like an interesting solution to keep your jaw forward. I would like more data on this. Perhaps somebody can test with and without MAD and it's effect on FL and OAs while in supine? It would be interesting to see the test results from CPAP machine and a sleep test kit.
Good thinking on skipping the dentist and getting the device from the source. That is, if the source knows what they are doing. The high cost of the device is the dentist being involved. The value of inflated very high.
RE: UARS - Different country, Same Story - mper6794 - 12-22-2021
_hi,
_ on titration, what worked for me, ultimately, after attempting for some 1year, was just simply going for the Resmed protocol for S-mode (later back to Vauto mode).
It took me only some 15 days to get what still look my tailored psarameters (actually, maybe I should say, balanced parameters, as for instance, maybe my Ipap should be a little higher than 12.8, however, leaking starts getting too high through my unreplaceble ffm air fit f20).
All the best and good luck
RE: UARS - Different country, Same Story - mper6794 - 12-22-2021
https://document.resmed.com/en-us/documents/products/titration/s9-vpap-tx/user-guide/1013904_Sleep_Lab_Titration_Guide_amer_eng.pdf
RE: UARS - Different country, Same Story - jmagic - 12-23-2021
Hi Mper,
Thank you very much for this PDF/Instruction! I just saw now the guides pinned on this forum and I will try do optimize everything.
Best regards from Germany
Jasmin
RE: UARS - Different country, Same Story - jmagic - 12-23-2021
Hi Corruptaligator,
It is just a temporary solution and will harm your jaw in the long term. But for people who have problems with xPap compliance, it can be a game changer. A lot of people showed a lot of improvement with this device. "Many ways lead to Rome."
I have now 4 posts and can share links. Here is a study which I foung on ncbi.
NCBI Study:
"The mandibular advancement device and patient selection in the treatment of obstructive sleep apnea"
Study results:
"Conclusions: The application of MAD significantly improved nocturnal respiratory function and sleep quality in patients with OSA, even in patients with severe OSA. In patients with OSA, MAD can be used as a good alternative treatment modality regardless of severity because it is noninvasive, easy to manufacture, and has good treatment results."
Best regards from Germany,
Jasmin