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CPAP mask and Oral Device
#1
Has anyone else tried a combination of your CPAP Mask with a Oral Device ?

( Oral device keeps you teeth seperated and jaw slightly open)

Before I recieved my CPAP machine last year, which took 5 long weeks...... I bought several of the cheap Oral devices to help with my Apnea's.

Even the cheap $1.00 Walmart unit was better than without.
Several units on E-bay worked slightly better.

They definately helped reduce my number of events and I felt a lot better.

Using my full mask and strap, the tension on the straps tend to pull my jaw back and close up my airway.

I have found that using the CPAP mask with my Oral Device gives good results. It definately reduces my Obstructive Events (aalthough I still have Central events .Cool

The down side is it is one more thing to attach to my face at night......... And using a full mask is still a challenge for me even after 9 months.

Eric

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#2
We'll assume you use a full face mask (FFM) because you breathe through your mouth at night.

Have you tried a chin strap and a regular mask?

On the oral device alone, how did you know it reduced your events? Did you use an oximeter?

The oral device is not going to help your central events at all.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#3
Ithought of using one, but for another reason - with my nasal pillows I tend to clamp my jaw shut at night and I wake up with sore teeth...
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#4
Hi u2canbuild,
WELCOME! to the forum.!
I haven't had any experience with the oral device.
Hang in there for more responses to your post and best of luck to you.
trish6hundred
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#5
In response to Paul02

Eric Responds...........

Yes, full face mask (FFM)

"because you breathe through your mouth at night"..........

Good point, I use FFM because that is what they gave me...... I do not usually mouth breath...........

"Have you tried a chin strap and a regular mask?"

No...... good idea.......... let upgrade that to a Great Idea!Thanks


"On the oral device alone, how did you know it reduced your events? Did you use an oximeter?"

Yes, CMS-50F Recording Oximeter with Arlam


"The oral device is not going to help your central events at all."

Your right; but it does reduce the Obstructive events, therefore reducing my total AHI.

What would you suggest for my central events?Huh

Great ideas and questions

Thanks,Cool

Eric


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#6
A FFM is leaky, uncomfortable and usually the last resort. If you don't breathe through your mouth at night, then ditch it and try something else.

The only thing that treats CSA is the correct kind of PAP. Well, that would be incorrect. If they do not know the cause, then PAP is the only way. If they know the cause, then there's things that can be done like treating whatever the cause is (medications, brain injury, etc).

Wilorg, I don't clench my jaws but my lower jaw falls forward so the front of the bottom teeth presses against the back of my upper teeth. As a result, they are all loose and the top teeth are crumbling. I need to go to the dentist (I'd rather have brain surgery) and talk to them about it. I've considered getting some sort of mouth guard but have no clue where to start.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#7
Paula,
We seem to have similar problems from opposite reasons. In both cases, we're loosening the ligaments on the teeth through pressure. In theory any simple mouth guard would do the trick; I was toying with the idea of going into the 3D lab (we have neat toys here - we make real human ears using 3D printers, and other body parts as well, and all sorts of prosthetics, even cloned human skin for burn victims - medicine has come a loooong way since I was a kid) and making something small that would either fit over the front teeth or the back teeth that would separate the jaws just enough to keep them from clashing and maybe push the lower jaw forward at the same time, while allowing easy swallowing. In theory, at least, any gummy block separating the jaws would work, and there are certainly a lot out on the market with "low profiles" meaning they don't make you look like a hockey goalie when you have it in, and allow you to keep your lips easily closed. I am pretty sure that there would be lots of off the shelf appliances that would work - me, I like to fiddle with things - I have been constantly modding my mask and what not - I do the same to my computer - my screen gui looks like SGI's 4DWM instead of mickeysoft, etc. I have been working on an improvement to my brick to quieten the airflow even more, and just improved on a surgical cannula we use for liposuction. If I see a problem, I'll muck in. I'm just a born fiddler....
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#8
(03-16-2013, 03:17 PM)u2canbuild Wrote: What would you suggest for my central events?Huh

Were you diagnosed with simple obstructive apnea? If so, then the central events are presumably caused by the CPAP therapy itself. But before we get too far with that line of reasoning, how long have you been experiencing central events, how large is your CA index, and has it changed any in recent months? The usual treatment is to lower the pressure, but that cause an increase in obstructive apneas and hypopneas, so you have to be careful there.

A couple of other questions. Why were you given a VPAP machine instead of a simpler CPAP machine? Did you have trouble exhaling against the pressure during your sleep study?

And, did you have trouble with air leaking out of your mouth when you wore your mask during your sleep study? That's the usual reason to prescribe a full face mask instead of the more comfortable and less prone to leaking nasal masks.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
(03-16-2013, 08:02 PM)Sleepster Wrote:
(03-16-2013, 03:17 PM)u2canbuild Wrote: What would you suggest for my central events?Huh

Thanks everyone for the great questions and informationShy

I will try to respond to the questons raised.

After digging thru my paperwork on my first sleep study, I initially had simple obstructive apnea........... the second test , I am not sure, but I remember that it indicated "worse" AHI.

I still need to get a copy of that second report and data.

I did not consider that cranking up the pressure would increase my central events...........Thinking-about

When the DME switched me from a CPAP to BIPAP, They lost the 3 months data....from the CPAP.

With the BIPAP set at a differental pressure I had trouble ( increased events and low 02 events and feeling "starved for air") I fiddled with the pressures and now I am essentially using my BIPAP as a CPAP.

I do not know what a CA index is.

When I first started with the BIPAP I had centra events / obstructive events 50% / 50% and lately 70% / 30% .............. uh, must be due to my increasing the pressure from 6/9 and lastly up to 12.8/12.8Huh

I do not remember wether or not I had trouble breathing out my mouth during the sleep study......

I did buy outside of DME knowledge and try , on my own a Nasl Mask. I made what I felt were the approiate adjustments to the CPAP machine to accommodate it. I was able to not mouth breath sucessfully, However my number of events went up and I did not feel good so after a few days I went back to the FFM.

A couple of questions still nag me, Last week another DME wanted me to reduce my pressure down to 6/8 because that is what my first sleep study indicated.

The first sleep study was done 9 months ago....... and several medications I take for other reasons have been changedThinking-about.


Not considering that my total AHI was lower using my "self prescribed" increased pressure, (although the ratio of central to obstructive events had shifted towards the central side)
.
The first sleep study was done 9 months ago....... second one 6 weeks later.

Lastely, my recording SP02 meter has been recording and (the arlam waking me) when my SP02 drops below 87%..........? If I do not wake up, my SP02 sometimes drops a low as 84%...???

Thanks once again,

Great group of people and equally great ideas!Thanks

Eric2

Were you diagnosed with simple obstructive apnea? If so, then the central events are presumably caused by the CPAP therapy itself. But before we get too far with that line of reasoning, how long have you been experiencing central events, how large is your CA index, and has it changed any in recent months? The usual treatment is to lower the pressure, but that cause an increase in obstructive apneas and hypopneas, so you have to be careful there.

A couple of other questions. Why were you given a VPAP machine instead of a simpler CPAP machine? Did you have trouble exhaling against the pressure during your sleep study?

And, did you have trouble with air leaking out of your mouth when you wore your mask during your sleep study? That's the usual reason to prescribe a full face mask instead of the more comfortable and less prone to leaking nasal masks.


"What would you suggest for my central events?"

Thanks everyone for the great questions and informationShy

I will try to respond to the questons raised.

After digging thru my paperwork on my first sleep study, I initially had simple obstructive apnea........... the second test , I am not sure, but I remember that it indicated "worse" AHI.

I still need to get a copy of that second report and data.

I did not consider that cranking up the pressure would increase my central events...........Thinking-about

When the DME switched me from a CPAP to BIPAP, They lost the 3 months data....from the CPAP.

With the BIPAP set at a differental pressure I had trouble ( increased events and low 02 events and feeling "starved for air") I fiddled with the pressures and now I am essentially using my BIPAP as a CPAP.

I do not know what a CA index is.

When I first started with the BIPAP I had centra events / obstructive events 50% / 50% and lately 70% / 30% .............. uh, must be due to my increasing the pressure from 6/9 and lastly up to 12.8/12.8Huh

I do not remember wether or not I had trouble breathing out my mouth during the sleep study......

I did buy outside of DME knowledge and try , on my own a Nasl Mask. I made what I felt were the approiate adjustments to the CPAP machine to accommodate it. I was able to not mouth breath sucessfully, However my number of events went up and I did not feel good so after a few days I went back to the FFM.

A couple of questions still nag me, Last week another DME wanted me to reduce my pressure down to 6/8 because that is what my first sleep study indicated.

The first sleep study was done 9 months ago....... and several medications I take for other reasons have been changedThinking-about.


Not considering that my total AHI was lower using my "self prescribed" increased pressure, (although the ratio of central to obstructive events had shifted towards the central side)
.
The first sleep study was done 9 months ago....... second one 6 weeks later.

Lastely, my recording SP02 meter has been recording and (the arlam waking me) when my SP02 drops below 87%..........? If I do not wake up, my SP02 sometimes drops a low as 84%...???

Thanks once again,

Great group of people and equally great ideas!Thanks

Eric2
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#10
[quote='u2canbuild' pid='31765' dateline='1363448626']
Has anyone else tried a combination of your CPAP Mask with a Oral Device ?

( Oral device keeps you teeth seperated and jaw slightly open)

Eric
Yes I used a snorban (boil and bite) dental device with my nasal cpap for a long time then I had a dental infection not related to the device so I quit using it while I had dental implant work done on three teeth. I agree that holding the lower jaw (and tongue) forward can help reduce apnea because it increases airway area behind the tongue. My dental work is now done and my teeth can contact and grind the new implants possibly causing problems because the implants according to my dentist and the internet do not have the flexibility and give of natural teeth. I read that it is a good idea to wear a protective dental device to protect the implants so I am again wearing a nasal mask and dental device again with my cpap and feel that it is improving my treatment. I also use a chin strap and do more to make sure that I do not mouth breath or leak with my nasal mask. I use a nasal mask when I can because I seem to get a better seal than with my full face mask.

Everyone is different and maby they are not comfortable or are concerned wearing both devices at once but I think it is a good option for me. A number of years ago my doctor and surgeon examined me and thought that my apnea problem was caused by reduced airway area behind my tongue. I then had glossius sp? advance surgery to move my lower jaw (and tongue) forward so I do not think it makes sense for me to push my jaw back now with my cpap treatment if I can keep it forward with a dental device and still use cpap.

GeneS


Using my full mask and strap, the tension on the straps tend to pull my jaw back and close up my airway.

I agree.
Genes



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