I'm a happy Tap PAP user, with a bit of an odyssey getting to PAP therapy.
In retrospect, my wife is convinced that I've been having sleep issues since my late thirties. And primarily due to a family predisposition (my sister has been recently diagnosed with severe sleep apnea, and my brother is currently considered borderline... My father would shake the house with his snoring.
). My wife's basis for believing I've had sleep issues for 20+ years revolve around my restless leg syndrome, which goes away when all is well.
So, pressed by my wife and my dentist [he sells custom-fitted upper-lower oral mouthpiece to control snoring) four years ago I finally went for a sleep study, that confirmed only mild apnea but severe snoring. [Wife's response is unprintable]. Oh, and a lot of restless leg syndrome also.
Got fitted with appliance, which basically moves your jaw forward as you close your mouth. And blessed silence descended.
Fast forward 2+ years, and better half reports some snoring has returned, plus restless leg. Time for another sleep study, this time using oral appliance. In a mind-bending result, appliance works... to control snoring, more or less. But apnea numbers, oxygen saturation levels, leg movement etc. are all bad. Basically, I've turned into a silent apnea sufferer. Dentist is VERY surprised, but wanting to ensure my health, coordinates with my primary-care doctor for an immediate referral to an ENT specialist... who takes a look at the file, sleep studies, and immediately prescribes use of a PAP device. Time for another study, this time with a PAP...
Understand one key factor: I have a full face beard & mustache, which immediately rules out a full mask, and during the study, we ruled out a nasal mask also due to leaks past the 'stache. The lab had a fairly simple nasal pillow setup, which worked fairly well, except that I couldn't get a balance between good seal and tightness against nose. Bottom line, I had to use nasal pillow[s] in future. And as someone who is primarily a side sleeper (either), it had to be a mask where the hose goes up and over the head. Sleep study confirmed that a downward-directed hose got tangled in bedding.
While my insurance company rumbled into action, enter Apnea Board... I found this place, and started reading like mad. Went to other sites too, but always circled back to here. Armed with extensive reading coupled with relatively low pressures determined during sleep study, I was able to convince my ENT to support use of an APAP, and as an IT geek, the ResMed line appealed to me the most... So the prescription got amended.
I can't remember where I heard about TAP PAP, but the fact that it incorporated a mouthpiece was NOT an issue - Due to my history with an oral appliance, just the opposite. It's also designed to go up and over head... check.
Got all of the equipment, and during the first night, the "wife checking to see whether I had died because I was so still and quiet" experience happened also
- she was reassured when she realized that a) I was OK and b) life insurance check HAD cleared...
Anyway... I quickly found that I needed the headgear, for two main reasons:
1) headgear (using Velcro) keeps the hose going up and over your head.
2) headgear shifts the emphasis from the whole mouthpiece acting as the main means of holding your mask in place to just the front of the mouthpiece, where it ends up (counter-braced by the headgear straps) resting against your teeth. This allows the nasal pillow pressure to be eased up, and your jaw can relax a bit (still with your mouth closed). I ended up redoing the fit on the mouthpiece to be quite loose - no need to have it grip my molars like a vise...
To summarize: Those of you who have had issues with the Tap Pap may have a completely different experience with use of the headgear.
With the Tap Pap nasal pillow contact pressure readjusted downward with the use of headgear straps, I found that I was able to drop my pressures (Rescan tells me that I'm typically averaging 8.5 vs 12 when I started) and the blow-by effect at the back of your throat that can occur with higher pressures is basically gone. The only time I've had the chipmunk syndrome was during a cold...
Hope this helps with past, present and future Tap PAP users.