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Dental appliance new user here ... is it always so tight?
#1
Dental appliance new user here ... is it always so tight?
Wondering if anyone can share some experience.  I am a bipap user for 3 years now.  Can’t get my treatment right.  I’ve had 5 sleep studies in a lab over 3 years.  Without any treatment, I have an AHI of 25... mostly OA’s.  

When treated on my bipap, My AHI is around 10-12 consistently.... mostly central apneas. Sleep doc thinks bipap is causing central’s.  We have it set at lowest setting (4-8) I think.  

So that’s why I’m trying the dental mouthpiece. The thought from sleep doc is that hopefully the dental appliance can get my OAs down and AHI under 10

I haven’t been able to fall asleep with it.  It’s super tight and uncomfortable.   

I had a tough time adjusting to my bipap initially.  This mouthpiece stirs a lot of anxiety about my poor sleep. 
Any tips or thoughts about the dental mouthpiece are appreciated.
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#2
RE: Dental appliance new user here ... is it always so tight?
How does your doc think he will be able to tell your AHI result with just the dental appliance?

Why were you on a bilevel machine instead of an autopap? Do you have lung issues?

If the device does not fit, if it is causing pain, then it's not working for you. The pain is probably because it is pulling your jaw too far forward for you.

And no, I've never worn one. I'm sorry you're having to.
PaulaO

Take a deep breath and count to zen.




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#3
RE: Dental appliance new user here ... is it always so tight?
I used a dental appliance for years in the '90's. it will do nothing for ca. after 3 years, ca is not treatment emergent, although it might still be pressure induced, but I doubt it. the solution is asv.
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#4
RE: Dental appliance new user here ... is it always so tight?
guess I failed to address your actual questions.

while MADs dental devices may have improved since my experience, I doubt by much. at any rate, my sense is it might have helped with snoring but I would expect much better success with apap & bilevel in dealing with oa.

re tightness, the mad should fit your mouth & teeth comfortably with enough tightness to ensure it stays in place. it shouldn't hurt. otoh, it can make your TMJoint sore, mess up your bite & teeth alignment. if it allows you to mouth breathe, the dryness contributes to tooth decay.
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#5
RE: Dental appliance new user here ... is it always so tight?
Thank you for the responses.

I had to switch to a bilevel from an auto CPAP because we found out I am a sensitive breather.  my obstructive apneas would not come down unless pressures were at around 15.  At that pressure, I was swallowing so much air that I would wake up bloated.  

There were some other issues. The bilevel was a huge improvement. 

Over the last two years, we (doctor) have consistently lowered the pressures as my  Central apneas increased.   

The dental device is an experiment. I have an upcoming sleep test with just the dental device next month.  

I don’t have much trouble with my jaw. I think it is not set forward too much.  The  Discomfort  I have is more of a clamping  Onto the sides of my teeth discomfort.

I put tape over my mouth with the CPAP and with the dental device because I always puff my lips.  The tape isn’t uncomfortable. I’m ok with that. 

I appreciate any thoughts. Thanks.
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#6
RE: Dental appliance new user here ... is it always so tight?
I had an oral appliance made by a speciality sleep dentist last year and it was so tight that just the initial fitting made my teeth hurt for 2 days.  Went back for a follow-up and they filed it down a bit, but then it still took up so much space that I was unable to close my lips around it.  That plus the warnings of having my bite misaligned were simply too many red flags.  

It was a highly disappointing experience and I've never worn the thing once - it just sits in the box with all my masks that don't work.  Then I found Apnea Board, and now a few months later my bilevel machine does what the appliance could not.  Learned along the way that my structural problems are primarily in my nose (deviated septum and enlarged turbinates), so the oral appliance wouldn't have fixed that anyway.  

Hope your experience is a better one.
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#7
RE: Dental appliance new user here ... is it always so tight?
(01-08-2020, 10:14 PM)Zandor435 Wrote: The thought from sleep doc is that hopefully the dental appliance can get my OAs down and AHI under 10

That's strange, even perhaps alarming. The usual route is to switch to a ASV machine.

In addition to higher pressures elevating your OA index, high pressure support (difference between IPAP and EPAP) can also have the same effect.

If you haven't done so yet, post you OSCAR charts so we can have a look at what's going on. We may be able to help you.
Sleepster

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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