Forum · Oral Appliance Question for Dr. Luisi

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[-] NiceSilverBison1316 +1 point · about 2 months ago

I recently went from CPAP mask to oral appliance. I have the TAP 3 Elite. I have been gradually moving my jaw forward with the device to decrease my AHI. My problem has been dry mouth. Since I am a mouth breather, my mouth often opens when I sleep. I have tried all the over the counter dry mouth products to no avail. I have gotten some relief with a chin strap, but it is a balancing act. If the chin strap is too tight it causes sores in my mouth and if too loose allows air into my mouth. I am able to tolerate the TAP 3 without the chin strap fine, but with chin strap, it seems uncomfortably tight. However, without the chin strap, I am getting intolerable dry mouth. Do you have a suggestion for this corundum, besides getting a different oral appliance? I don't think the VA would spring for another one, along with my CPAP equipment.

PS: I have tried nasal, nasal pillows and full face CPAP masks and although they work to some degree, I have never developed an attachment to them (no pun intended).

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[-] KitaKita75 +0 points · about 2 months ago

Hi. My name is Kita. I am also a nurse (LPN) until I was diagnosed with severe sleep apnea, copd asthma and a few other things in 2013 after being in a coma and on a ventilator and feeding tube for almost two weeks for several reasons including severely high co2 levels. By the grace of God I didn't receive the trache my doctors argued over giving me. After 31 days straight of being in the hospital I was discharged on continuous oxygen and a CPAP machine with a setting of 16. I was weaned down from 8Liters of oxygen to 2 Liters. My levels were in the 90s until recently. Now at night my O2 levels​ are between 77 and 80 and that's with my CPap on with oxygen bleeding into it at 3 Liters. If I sleep with just my oxygen on at night my levels are good throughout the night but I have the worst headaches. If I use the CPap machine at night I still wake up with a horrible headache and in both cases i'm tired and sleepy throughout the day. Any advice? Do I need another sleep study? Do my settings need to be adjusted? The headaches sometimes go away on their own after an hour or so but sometimes I have to take Ibuprofen to get rid of them. I'm not sleeping well at night at all. I sleep on my side even though its uncomfortable and before all this I used to sleep on my stomach. When I was on Hospice , they ordered me a hospital bed that was adjustable. I would raise and lower the head of the bed throughout the night as needed and I had no headaches. When they discharged me off hospice, they took the bed and my insurance wouldn't cover the cost for me to keep it and I can't afford the expense so here I am. I always make sure that my full face mask has a good seal on it. I sometimes breathe out my mouth and my breathing is shallow to the point that I have to consciously remind myself to try to breathe deeper throughout the day. Should I use the CPap or the oxygen at night until I figure out what's going on ? Any suggestions, comments or solutions would be greatly appreciated. I am praying for everyone who has commented and are living with sleep apnea. Not being able to breathe is the worse feeling ever and I wouldn't wish it on anyone. But keep the faith and this too shall pass!

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[-] wiredgeorge +0 points · about 2 months ago Sleep Enthusiast

Thanks for checking in Kita. It is hard to make suggestions when the issues are connected and some outside just apnea. Best to post your questions in a separate thread so as not to take away from the original poster's queries. In any case, I can't tell you if you should get a sleep study or continue using the PAP equipment but I can tell you I went onto Craigslist and there are tons of budget-friendly hospital beds there. Of course, I don't have your finances but some of them looked fine and affordable. I am not a hospital bed expert so probably couldn't tell a quality one from one that is junk so you will have to judge this yourself if you go in this direction. Best of luck and I will pray for you as well! God bless you.

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[-] SleepDent +0 points · about 2 months ago

Actually, yes, I do have a solution for you. Airway Management(the makers of the TAPS) are introducing new intra oral mouth shields across the line. These are soft comfortable silicone(I think) shields that attache to the front of the Tap appliances. They seal the mouth from the inside to prevent mouth breathing and to encourage nasal breathing. This usually kills off the dry mouth immediately. Currently, they have a mouth shield that can be fitted to their MyTap product and they are developing shields for the Tap 3 and DreamTap products to be released for sale about November of this year. I can actually cobble together a temporary solution by putting the metal column form a TAP-Pap CS on the front of the Tap 3 and sliding the mouth shield from the MyTap over it. This solution works for most people. Maybe your sleep dentist would be clever enough to do that for you, too. The caveat here is that you have to have enough nasal patency to successfully nose breathe. If you don't, you need to see the ENT doctor to get improved in that respect. I hope that this helps you. Arthur B. Luisi, Jr., D.M.D.

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[-] NiceSilverBison1316 +0 points · about 2 months ago

Thank you for your reply Dr. Luisi. The mouth shield by Airway Management looks like the answer for me. I don't have a problem with nose breathing when I am awake, only when I sleep. I doubt that my sleep dentist would be clever enough for the work around. I will probably have to wait until November for the TAP 3 product. Thanks again for your solution to my problem. I can now see the light at the end of the tunnel.

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[-] SleepDent +0 points · about 2 months ago

You are certainly welcome. I must add that they have changed the release date for the shields several times. I would not consider the present date is set in stone. I have seen and touched a working prototype, so they ARE getting there. If in doubt, you can call them for an update. Phone number on their website. Dr. Luisi

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