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uncleg
Unread post  Post subject: Dental Appliance is it worth the cost  |  Posted: Thu Jan 05, 2017 1:38 pm

Joined: Thu Jan 05, 2017 1:20 pm
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OK I used to have great employer provided insurance, classified as a Cadillac plan, then the government got involved and I now pay more for less coverage,. I just got off phone with my sleep apnea/oral surgeons office, my insurance will not cover a sleep appliance ( my next step) or MMA surgery.

Before I fork out $2500.00 for an appliance...how well do they worK?

I hope it will work, but I don't want to waste the $$ on something that does not. I have already failed miserably with the CPAP, and I don't know how I would ever pay for surgery without loosing my home.

Things just look hopeless right now.


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TheLankyLefty
Unread post  Post subject: Re: Dental Appliance is it worth the cost  |  Posted: Fri Jan 06, 2017 9:33 am
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Joined: Mon Aug 15, 2011 10:22 am
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How well Oral Appliances work REALLY depends on your anatomy (more specifically what it is about your anatomy that is causing the obstruction that is causing your sleep apnea) as well as your rate of breathing ceasation (AHI).

Oral appliances have a higher success rate ("success" defined as decreasing the AHI by 50%) when your AHI is 15 or less. These people have 74% success. Once you get above 15 AHI, the success rate drops to about 50% for moderate sleep apnea and 25% for severe sleep apnea. If you really give this some thought it's an awful option. If you have an AHI of 20 and you have "success", that can mean that you still have an AHI of 10. Doesn't sound so bad until I frame it as "you're going to be woken up by choking only 10 times per hour."

This is only if the oral appliance address the anatomy problem. If it's that your tongue and jaw are falling back into your airway they are very good at resolving that problem. If you have a small airway, large tonsils/adenoids, fatty soft palate, elongated uvula, or a deviated septum, then you're going to be wasting your money.

If you really want to go the oral appliance route you can have an ENT do a procedure where you will be sedated and they scope your airway to see where the obstructions are and what they are.

That said, repeat studies in the sleep lab that use oral appliances almost always fail. I can only remember a few that were successful. These stood out because the success is so rare....true success....not the 50% decrease garbage.

You can always do a proof of concept using an over the counter boil and bite mouth guard and just slightly thrust your lower jaw forward during the molding process.

MMA surgery is a different story. Those are much more successful even in people with more severe apnea. Those repeat studies have come through and are much better. The surgery looks absolutely horrible though.

So, in what way did you fail CPAP?

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jsun1973
Unread post  Post subject: Re: Dental Appliance is it worth the cost  |  Posted: Tue Jan 10, 2017 11:26 am

Joined: Tue Jan 10, 2017 11:22 am
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Thanks for asking this question, uncleg. And thanks for answering, Jason. This helped me decide to go with an APAP rather than a dental appliance if I get diagnosed. I just had a take home test on Friday and am waiting for the results, but it came up while in the dentist's office. He suggested trying it, but after reading this I'll just stick with the APAP if I get diagnosed (I find out today!)


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SleepyHead566
Unread post  Post subject: Re: Dental Appliance is it worth the cost  |  Posted: Sat Mar 10, 2018 3:18 pm

Joined: Sat Feb 24, 2018 11:48 pm
Posts: 54
PAP Mask: Airtouch F20
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TheLankyLefty wrote:
How well Oral Appliances work REALLY depends on your anatomy (more specifically what it is about your anatomy that is causing the obstruction that is causing your sleep apnea) as well as your rate of breathing ceasation (AHI).

Oral appliances have a higher success rate ("success" defined as decreasing the AHI by 50%) when your AHI is 15 or less. These people have 74% success. Once you get above 15 AHI, the success rate drops to about 50% for moderate sleep apnea and 25% for severe sleep apnea. If you really give this some thought it's an awful option. If you have an AHI of 20 and you have "success", that can mean that you still have an AHI of 10. Doesn't sound so bad until I frame it as "you're going to be woken up by choking only 10 times per hour."

This is only if the oral appliance address the anatomy problem. If it's that your tongue and jaw are falling back into your airway they are very good at resolving that problem. If you have a small airway, large tonsils/adenoids, fatty soft palate, elongated uvula, or a deviated septum, then you're going to be wasting your money.

If you really want to go the oral appliance route you can have an ENT do a procedure where you will be sedated and they scope your airway to see where the obstructions are and what they are.

That said, repeat studies in the sleep lab that use oral appliances almost always fail. I can only remember a few that were successful. These stood out because the success is so rare....true success....not the 50% decrease garbage.

You can always do a proof of concept using an over the counter boil and bite mouth guard and just slightly thrust your lower jaw forward during the molding process.

MMA surgery is a different story. Those are much more successful even in people with more severe apnea. Those repeat studies have come through and are much better. The surgery looks absolutely horrible though.

So, in what way did you fail CPAP?


Some people whose anatomy is screwed where they are both a mouth and nose breather and have a jawline that recedes tend to need to use both. I have been on cpap for a while but the trouble is, I can feel as though there is still not enough air flowing through. You could say just to increase pressure. The trouble with that is when you have a rock hard jawline, it makes it more difficult to breath through at an increased pressure. This is why I am looking at both the mouthguard AND CPAP to treat my sleep apnea. It may sound a bit extreme, but I have no other choice other than jaw surgery to fix my receding jawline which will happen.


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MNsleeper
Unread post  Post subject: Re: Dental Appliance is it worth the cost  |  Posted: Sun Jun 03, 2018 6:35 am

Joined: Sat Jun 02, 2018 11:41 am
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PAP Mask: Dreamwear nasal, FFM
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I am wondering about an oral device as well. In my sleep study about 85-95% of my respiratory events happened on my back. I know I am a bit of a mouth breather but mostly breathe through my nose and I have a slightly receded jaw. I had two studies done and in both my O2 was above 90% except for a few seconds in the last one where it went to 87%
I have only been on CPAP for about 2 weeks now but I am not sleeping well with it and would love to find a better solution.


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