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[Equipment] Oral Appliance NOT An Effective Treatment [Swedish Study]
#11
The thing is, with a modern APAP machine you get data that will tell you exactly how well or badly your treatment is going. That's one reason I wouldn't want a mouth insert - how would I know that it's working?
Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
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#12
(08-14-2015, 10:30 PM)eseedhouse Wrote: The thing is, with a modern APAP machine you get data that will tell you exactly how well or badly your treatment is going. That's one reason I wouldn't want a mouth insert - how would I know that it's working?


The new home sleep study devices just have a cannula in your nose and
a band around your head to monitor your brain waves.
That might be a better 'control' situation for this kind of experiment.

However I remain dubious of claims for the dental device which only
can exert mild control at best over apnea.
Apnea does not occur in the mouth as such.
the problem is deeper down in the throat where only air pressure has be shown
to *reliably* keep the airway open.

I will continue to believe that the dental appliance is at least as effective as
a copper bracelet for this health issue.

EI: I'm from Missouri, Show Me! Smile

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#13
There is also the very real possibility of developing secondary medical issues with an appliance such as clicking of the jaw or TMJ/TMD unlike xPAP.
Coffee
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#14
(08-15-2015, 09:54 AM)Shastzi Wrote:
(08-14-2015, 10:30 PM)eseedhouse Wrote: The thing is, with a modern APAP machine you get data that will tell you exactly how well or badly your treatment is going. That's one reason I wouldn't want a mouth insert - how would I know that it's working?


The new home sleep study devices just have a cannula in your nose and
a band around your head to monitor your brain waves.
That might be a better 'control' situation for this kind of experiment.

However I remain dubious of claims for the dental device which only
can exert mild control at best over apnea.
Apnea does not occur in the mouth as such.
the problem is deeper down in the throat where only air pressure has be shown
to *reliably* keep the airway open.

I will continue to believe that the dental appliance is at least as effective as
a copper bracelet for this health issue.

EI: I'm from Missouri, Show Me! Smile

Shastzi,

Did you read the study from the 2011 link I previously posted? Maybe I am missing something but I thought it was done well and clearly showed that at least adjustable appliances have a good chance of working with apnea severities of mild to moderate to getting the AHI below 5. According to the study, the TAP appliance was used as the adjustable one which the sleep medicine dentist who used to post on the now defunct ASAA board said had the best research behind it.

He also felt this was the only appliance that had even a chance of working with severe apnea as I think he quoted a success rate of around 35% if I remember correctly. Interestingly, in this study, a the adjustable appliance seemed to have a good chance of working for a few severity levels but it seemed to mostly correlate with what this guy had found.

Obviously pap therapy should be the first option if at all possible. But for many people, pap therapy does not work no matter how hard they try. I speak from personal experience.

Anyway, people need to be given as much information as possible on viable options if they are struggling big time. I don't claim that the 2011 study is the ultimate truth but at the same time, I don't think anybody who is a dental appliance skeptic can honestly point to any studies that prove they don't work. The link mentioned in the OP fell short big time as Don excellently pointed out.

Studies aside, I think if someone is going to pursue the dental appliance route, they need to find a sleep medicine dentist who focuses strictly on dental appliances and isn't doing them as a way to add revenue to his/her practice. Obviously, that isn't a guarantee of anything but I really feel it increases the odds of success.

49er

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#15
(08-14-2015, 10:30 PM)eseedhouse Wrote: The thing is, with a modern APAP machine you get data that will tell you exactly how well or badly your treatment is going. That's one reason I wouldn't want a mouth insert - how would I know that it's working?

The day after my rare good nights on the pap machine, I was able to accomplish tasks I hadn't gotten done in months and multitask when I usually am unable to do it. I assume (which I know is a dangerous thing to do), that a similar type experience would be a good indication the dental device is working.

I agree it would be preferable to have data but obviously, for some people who haven't succeeded at pap therapy in spite of their best efforts, that isn't an option.
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#16
(08-15-2015, 02:06 PM)49er Wrote: The day after my rare good nights on the pap machine, I was able to accomplish tasks I hadn't gotten done in months and multitask when I usually am unable to do it. I assume (which I know is a dangerous thing to do), that a similar type experience would be a good indication the dental device is working.

Well it might be an "indication" but without numbers to look at you don't know for sure. I'd call it anecdotal evidence, and the placebo effect is a real thing and affects everybody.

On the other hand if my APAP machine reports an AHI <5 I can be pretty sure my apnea has been treated.

I use supplemental oxygen with my machine. Quite a low pressure seems to keep my obstructive apneas under control and I suspect that if I slept with only the oxygen I might be just as well treated, but I wouldn't know for sure. So I keep the APAP machine for nightly sleep.

During the day if I feel the need for a nap I just use the oxygen via a cannula. A half hour on that while listening to the radio, music, or TV generally takes care of the drowsiness until bed time.
Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
Reply


#17
Just as a late personal addendum to this thread, I recently got an oral splint/device for apnea. I thought it was worth a go for when I was travelling or camping. Mine was not adjustable - which essentially means the first week is very uncomfortable as you are stretching ligaments, etc to the max on day one. Putting aside that discomfort I found the device didn't help me at all such that by the third day of use I have had to discontinue. I would appear to be an ideal candidate for this device too - BMI 22, no other medical issues and between 40-50yrs of age with only moderate apnea at 17. By the third day I was feeling dreadful. All the energy and clear headedness I have had the last 8 months on using the CPAP dissipated by the end of the third night such that I have a constant headache. At least in my case, no luck Sad
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#18
(09-06-2015, 04:37 AM)Dafod Wrote: Just as a late personal addendum to this thread, I recently got an oral splint/device for apnea. I thought it was worth a go for when I was travelling or camping. Mine was not adjustable - which essentially means the first week is very uncomfortable as you are stretching ligaments, etc to the max on day one. Putting aside that discomfort I found the device didn't help me at all such that by the third day of use I have had to discontinue. I would appear to be an ideal candidate for this device too - BMI 22, no other medical issues and between 40-50yrs of age with only moderate apnea at 17. By the third day I was feeling dreadful. All the energy and clear headedness I have had the last 8 months on using the CPAP dissipated by the end of the third night such that I have a constant headache. At least in my case, no luck Sad

Hi Dafod,

Sorry it didn't work for you but according to the link I posted, the adjustable appliances are alot more effective than the fixed ones. Of course, you still could have had the same results but I think it is important for people reading your post to know that about the link to the study I posted.

49er

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#19
It seems to be available here without paywall:

http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=29343
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#20
(06-13-2015, 08:59 PM)Mark Douglas Wrote: I would love to see how I would score with a jaw appliance and my machine set just high enough to overcome mask resistance but not. A home jaw appliance effectiveness study if you will.
Hmmm...not a bad idea. I have a SomnoDent mandibular advancement splint on order and am meeting with the sleep doc later this week to hopefully schedule a sleep study using the device.

I have been successful with cpap for two years but have lost some weight and was told by the sleep lab PA that I have a good chance of getting off the mask. So I decided to gamble $2k on an oral device.

When I get the oral device, I will attempt the test you invented and let you know how it goes. My autoset is on 9 -14 and averages 10.5 with a high of 13.5. My AHI averages about .20.

I will wear the device and the cpap mask with the pressure set at 4 and report back on the AHI I experience. Is that what you had in mind?

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