(12-29-2013, 08:43 PM)me50 Wrote:
(12-29-2013, 08:25 PM)Don in Austin Wrote:
(12-29-2013, 02:30 PM)Lukie Wrote: I had an oral device for a while but after some time with it I got TMJ (jaw pain) something awful. Also I choked on something in my sleep and had to rip the device off my teeth while I was half asleep. After that I found the device on the floor in the morning. I had thrown it across the room in my sleep.
A custom fitted oral appliance combined with a "bumper belt" to discourage sleeping on my back has been working pretty well for me for almost a year now. I rate success by perceived quality of sleep and a recording pulse oximeter. Jaw discomfort is minimal.
I am just curious if you ever had a sleep study and if so, what were the results of your sleep study? Have you used CPAP before and it wasn't working for you?
Two sleep studies at two different clinics. First clinic was really crummy. Sleep study said maybe just positional therapy would work for my high moderate OSA. Second sleep study with far better doctor, (actually an excellent certified nurse practioner) they put me on CPAP. I tried all manner of different masks and leaks and discomfort would wake me up repeatedly. So I went to a sleep dentist. I now make it through the night with maybe one awakening or often none, whereas I had been waking up every hour or two before treatment. I understand the pulse oximeter is not as comprehensive as a full-fledged sleep study and does not give you the same data as CPAP software, but it makes it clear that staying off my back helps and that the dental device helps. I bought my own recording pulse oximeter so I could take many readings and not rely on just one night's data. The two approaches combined seem to be doing a decent job and my sleep specialist agrees.
I have received strong criticism for using the dental device. It has been pointed out that it is not as good as CPAP. Sometimes that criticism failed to address the fact that I supplement the dental device with positional therapy. The positional device is not as good as CPAP, the dental device is not as good as CPAP, I freely acknowledge. But both together make for something viable IMHO. Perhaps if my OSA were more severe the combination would be insufficient.
Anyway, this is what works for me. AHI before treatment was about 15. I have not had a full fledged in-lab sleep study with the combined dental device and "bumper belt." I don't think medicare would pay for it and I would be reluctant to fund it myself. Also, I am sceptical about the absolute validity of data from any one specific night, let alone in a sleep lab which is nothing like my own bed. Using the pulse oximeter it is clear that not every night is the same. I look for staying in a decent range and my own -- inevitably subjective, of course -- perceived quality of sleep and greatly reduced daytime sleepiness.
My wife has far worse OSA than I do and none of the masks from the DME were at all tolerable to her. She bought a fabric mask through the internet and the first night she tried it felt she could easily live with it. It has been working well ever since. Ironically, when she tried to get a replacement under insurance, she was told "it is not approved." Fabric mask did not work for me because I am a mouth-breather.