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Newly diagnosed. Dr. Recommending oral appliance instead of CPAP
#31
(07-26-2014, 01:47 PM)danf183 Wrote: Hi all-

After 3 in lab sleep studies, and 2 home studies, I finally have a diagnosis. My most recent in lab study showed an AHI of 9.4 during NREM, and 16.9 during REM sleep.

I understand that this is moderate sleep apnea. My doctor recommended trying the oral appliance first before a CPAP machine. After searching through this board, it seems like most people opt for CPAP. Is there any reason I shouldn't try the oral appliance first and go straight for a machine?

Any input would be greatly appreciated.

Thanks,
Dan

Three lab studies? Someone is after your wallet. The efficacy of an oral device can only be demonstrated by another lab study. I suspect it actually might get your overall AHI near or below 5.0, so success, at least in the short term. However a simple $600 auto CPAP will not only give you better results, it will report your AHI every night at no additional cost.
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#32
(07-26-2014, 01:47 PM)danf183 Wrote: My doctor recommended trying the oral appliance first before a CPAP machine. After searching through this board, it seems like most people opt for CPAP. Is there any reason I shouldn't try the oral appliance first and go straight for a machine?

It gave my wife TMJ and a lisp and loose teeth and didn't fix the apnea.

There's a reason for you. 8-)


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#33
(12-16-2015, 10:14 PM)Terry Wrote:
(07-26-2014, 01:47 PM)danf183 Wrote: My doctor recommended trying the oral appliance first before a CPAP machine. After searching through this board, it seems like most people opt for CPAP. Is there any reason I shouldn't try the oral appliance first and go straight for a machine?

It gave my wife TMJ and a lisp and loose teeth and didn't fix the apnea.

There's a reason for you. 8-)
Following is a repeat of my post to another thread:
I abandoned my cpap 31/2 months ago in favor of a mandibular advancement splint. Although it was not verified by a full sleep study, the splint seemed effective as demonstrated by an overnight oximetry test.
However...I have developed a painful temporal mandibular disorder (TMD) which makes eating a painful experience. My jaw has moved forward and to the left resulting in misaligned teeth and pain in the jaw hinge. I visited another dentist today and was told that if I continue using the splint, I may permanently misalign my jaw. He also told me that opening the airway by advancing the jaw will allow the soft tissue which is blocking the airway to grow in size making it necessary to increase the advancement.
So...in my case, the advancement splint is not an effective approach. I am returning to my trusty cpap tonight.

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#34
(12-17-2015, 08:08 AM)JimZZZ Wrote:
(12-16-2015, 10:14 PM)Terry Wrote:
(07-26-2014, 01:47 PM)danf183 Wrote: My doctor recommended trying the oral appliance first before a CPAP machine. After searching through this board, it seems like most people opt for CPAP. Is there any reason I shouldn't try the oral appliance first and go straight for a machine?

It gave my wife TMJ and a lisp and loose teeth and didn't fix the apnea.

There's a reason for you. 8-)
Following is a repeat of my post to another thread:
I abandoned my cpap 31/2 months ago in favor of a mandibular advancement splint. Although it was not verified by a full sleep study, the splint seemed effective as demonstrated by an overnight oximetry test.
However...I have developed a painful temporal mandibular disorder (TMD) which makes eating a painful experience. My jaw has moved forward and to the left resulting in misaligned teeth and pain in the jaw hinge. I visited another dentist today and was told that if I continue using the splint, I may permanently misalign my jaw. He also told me that opening the airway by advancing the jaw will allow the soft tissue which is blocking the airway to grow in size making it necessary to increase the advancement.
So...in my case, the advancement splint is not an effective approach. I am returning to my trusty cpap tonight.

Good news...After only three nights back on CPAP, my misaligned jaw has returned to a normal lateral position, i.e., when I close my mouth, my teeth are in alignment. I continue to find when my left molars are in contact, there is space between my right molars and it is painful to force them closed. Hopefully, in time my jaw will close completely.

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#35
Had the discussion about the device vs CPAP with my sleep doc and he gave me the why do you want to do that look. His experience is they don't work and can cause other issues especially with bite and jaw alignment. He also mentioned that from experience most of the insurers consider them more of a dental device instead of a medical device. I know with my dental insurance it wouldn't be covered for the SA but would be if it was designed for TMJ. (asked my dentist about that one). Still, CPAP is a lot cheaper and you get instant results as to whether it works or not.

Homer
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