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TheLankyLefty
Unread post  Post subject: Re: Oral appliance success rate?  |  Posted: Sun Jan 19, 2014 11:14 am
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kyhrsluvr wrote:
I asked what the actual AHI was and they said it was 3 :o . I hoped for a good number but I didn't expect that good :!:
That is a very nice improvement in AHI.

My main concern with these is that the only number looked at is the AHI. We do quite a few of these Oral Appliance Therapy Split night tests in the lab. The doctors in our area are now better at attempting Oral Appliance Devices on patients that are the most likely to have success, so that's very promising. The problem is that AHI is the only thing looked at typically. Many of these people (I'd estimate about 30-50 percent) still have RERAs that are causing sleep fragmentation. Any follow up testing needs to include (or look only at) the RDI in my opinion. That is really the true measure of sleep consolidation since it includes all respiratory related arousals.

Just something I've been thinking about lately. ;)

kyhrsluvr wrote:
I just wanted to get this posted in case anyone was considering trying an OAD. It can and does work but it's not for everyone.
Absolutely. Just have to be the correct candidate for it.

yesman400 wrote:
Even though my AHI's came down, I don't feel it completely solved the problem.. I think there are other factors related to the oral appliance making my results unpredictable.
Welcome to the forum yesman! I think that the other factors include RERAs that aren't being looked at/for.

yesman400 wrote:
My dentist thinks we still need to find the right setting but he gives no explanation for my results other than my AHIs are reduced
He probably just doesn't know. I have great respect for people who can simply say that they don't know. :)

I'm going to question your name if you don't agree with that! :lol:

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nkonduru
Unread post  Post subject: Re: Oral appliance success rate?  |  Posted: Sun May 11, 2014 12:44 pm

Joined: Sun May 11, 2014 12:35 pm
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It is true that the Oral Appliance has a lower success rate when compared to CPAP. However, CPAP has a very poor compliance rate and most patients discontinue its use after a few nights. The reasons for this is blisters due to the CPAP mask, leakage of air, mask is uncomfortable to wear etc. On the other hand Oral Appliance therapy (OAT) has a very high compliance rate. Although, most patients prefer OAT to treat sleep apnea, it works only on some patients (about 50-60%).
Now there is a great new technology (MATRx system) in the market that can be used to determine whether a patient can successfully be treated with an Oral appliance. Ask your dentist about this and make sure you get this test done if you want to get an oral appliance. This will help you save time (upto several months) in determining whether OAT is working for you. It is a simple overnight test run in the sleep lab and you can find out for sure whether an oral appliance can be used to treat your sleep apnea or not.


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PamVT41
Unread post  Post subject: Re: Oral appliance success rate?  |  Posted: Sun May 11, 2014 2:42 pm

Joined: Sun Feb 02, 2014 12:30 pm
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Location: Vermont
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I used a mandible advancement device for a few months until I got such bad TMJ I had to quit.


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TheLankyLefty
Unread post  Post subject: Re: Oral appliance success rate?  |  Posted: Thu May 15, 2014 12:13 pm
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nkonduru wrote:
The reasons for this is blisters due to the CPAP mask, leakage of air, mask is uncomfortable to wear etc.
This can all be summed up with "poor patient education". Also coupled with poor patient follow up.

nkonduru wrote:
Although, most patients prefer OAT to treat sleep apnea, it works only on some patients (about 50-60%).
Who wouldn't prefer a simple mouth piece to a whole head grabbing apparatus? It only works on a percentage of patients that it's appropriate for. Unfortunately there are some dentists who will gladly make these for patients with AHI's in excess of 15 in which the "success rate" falls to just above nil.

nkonduru wrote:
Now there is a great new technology (MATRx system) in the market that can be used to determine whether a patient can successfully be treated with an Oral appliance.
This is pretty cool. A titration for oral appliances in a lab setting so that it can be done in one night. Even give you the exact number of mm needed for the OAT.

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PamVT41
Unread post  Post subject: Re: Oral appliance success rate?  |  Posted: Thu May 15, 2014 6:13 pm

Joined: Sun Feb 02, 2014 12:30 pm
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Location: Vermont
PAP Mask: AirFit F 10
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I'm glad you got your AHI down to 3. I hope you don't get jaw pain like I did. I have finally really adjusted to my CPAP and my AHI is around 0.0 to 0.5 most nights now.


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dbandas
Unread post  Post subject: Re: Oral appliance success rate?  |  Posted: Thu Jun 05, 2014 12:00 pm

Joined: Sun Feb 03, 2013 6:37 am
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I have just tried out my new Somnomed "Somnodent Flex."

I got good sleep with it. I don't feel quite as good as with a CPAP machine, but nearly as good.

I'm having 12 new crowns on my lower teeth installed in two weeks and we're sending it away to be re-fit. After that, I'll do the home sleep study and get it optimally adjusted.

It may never completely replace my CPAP, but it is a handy item for travelling or for nights when my nose is to stopped up to breathe with my nasal pillows.


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EuroGuy
Unread post  Post subject: Re: Oral appliance success rate?  |  Posted: Mon Jan 04, 2016 3:07 pm

Joined: Thu Dec 17, 2015 12:25 pm
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Location: Europe
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Before CPAP, I tried a mandibular device which was custom made through my dentist. I never had a sleep study while wearing it, but symptomatically, it didn't give me the result I was hoping for.

While I was wearing my device, I found that I wasn't waking up choking like I normally do, but I never felt any better during the day. I wore the device for about 3 weeks and got a sore jaw and tooth pain in return.

Conversely, after about 10 days on CPAP, I noticed a significant improvement in symptoms.

I keep my mandibular device as a sort of back-up. For one or two nights it is better than nothing.


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TheLankyLefty
Unread post  Post subject: Re: Oral appliance success rate?  |  Posted: Mon Jan 04, 2016 6:14 pm
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What was your AHI prior to getting the oral appliance?

Glad that you're getting a great response from CPAP now! :)

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EuroGuy
Unread post  Post subject: Re: Oral appliance success rate?  |  Posted: Sat Jan 09, 2016 7:32 am

Joined: Thu Dec 17, 2015 12:25 pm
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Location: Europe
PAP Mask: Mirage FX
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My AHI was 18, but only 8 when lying on my front. I tried the oral appliance while sleeping on my front.


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TheLankyLefty
Unread post  Post subject: Re: Oral appliance success rate?  |  Posted: Mon Jan 11, 2016 2:11 pm
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Joined: Mon Aug 15, 2011 10:22 am
Posts: 4626
PAP Mask: Practically tried them all.
PAP Machine: Use Phillips Respironics System One APAP with Aflex for mask testing
Humidifier: None
Pressure Setting: When testing, I use APAP with a range of 5-10

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EuroGuy wrote:
My AHI was 18, but only 8 when lying on my front. I tried the oral appliance while sleeping on my front.
This is one of those cases where advancing the mandible isn't fixing the problem causing the apnea. It's great if the mandible is falling back. But if it isn't, then advancing the mandible forward won't fix the problem....as you discovered!

Glad that CPAP is working for you!

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