HI! I am a dentist working in dental sleep medicine. The Dream Tap is one of the most effective oral appliances out there, but is not for everyone. It does hold the mouth closed. However, there is breathing space built into the anterior part of the appliance, so that you can get air exchange if you mouth breathe. If you find it insufficient, there are ways for your dentist to increase the air space. You also mention anxiety. Although most people actually sleep with their mouth pretty closed, the fact that you can not open may be giving you a feeling of claustrophobia. In that case, you may want to discuss going to another appliance design like the Micro2 IA that allows your mouth to open fully when you sleep. That might help. However, be aware that losing the feature that keeps the mouth closed may compromise the efficacy of the appliance to some extent. More often than not the loss of efficacy is minor and can be tolerated, but sometimes it can be significant. If your breathing has worsened over time, it may also be that you have over-protruded the appliance past your most effective "sweet spot" and may have to work with your dentist to essentially start over again with the titration to relocate it. You should get some useful feed-back from you upcoming sleep test with oral appliance in place. Arthur B. Luisi, Jr., D.M.D.
Thank you so much fro your reply. I actually slept without the TAP last night and ironically slept so much better not waking up at the same god awful hour of 5:30AM! I do hate the fact that my mouth is forced to stay closed with just that small opening - the mouthpiece has popped off several times throughout the night from me inadvertently trying to open my mouth. With the TAP, we started at 16 turns then went to 20 and then went to 22 turns because he said I would need that much protrusion. I wasn't experiencing this issue at 16 turns so maybe I will speak to my dentist about going back to the beginning. I have a sleep study tonight that I have to do with the device. I have spoken to him about trying another oral appliance but he is hesitant because I was diagnosed with moderate Apnea and says the other devices aren't as effective (not sure if that is true or not). I really just want to feel better and I just seem to be feeling worse. I have been so worried that something is wrong with my heart or lungs due to this suffocating feeling of not getting enough oxygen that I've gone for several tests; an EKG, an Echo, a stress test, 3 pulmonary tests to see if I suffer from asthma....all passed with flying colors. I am actively trying to lose weight I am 48lbs overweight, all the doctors say that might cure my apnea. With the added issue of anxiety and depression that I suffer from my life has become one big nervous mess.
Well, I actually agree with your dentist that the other devices are not as effective as the TAP. That is my personal feeling based on the testing data that I have seen and my personal anecdotal experience in my office. However, you may not necessarily need THE most effective device to get adequate treatment. I have had the same talk with my own patients many times over. It is not unusual for people with high levels of anxiety and a degree of claustrophobia to be uncomfortable with their mouths held shut. I would do the sleep test and work with your dentist in good faith to see if you can get used to the TAP. What I happen to be doing for my own patients right now with this problem is to switch them to a Micro2 AI appliance which is very thin and comfortable and allows you to open and close the mouth at will. If people can get used to ANY OA, it would be this one. Test data on the Micro2 is much more limited than the TAP, but what I have seen is reasonably good. I would look at it this way: if you can wear an appliance like Micro2 and it works well enough-- fine. If it doesn't work well enough, OAs may not be for you. Again, I have not had the benefit of examining you and this information is given to suggest possible avenues of conversation between you and your health care providers and is not to be used as a substitute for in person medical attention. Arthur B. Luisi, Jr., D.M.D.