FatBear

Tried Amazon. They prefer to return search results that they want you to see, not what you asked for. They only actual repositioner that came up in my search was $120 plus it required dental fitting and the same "model" that was used to produce my TAP appliance. My dentist is not seeing patients right now and probably no longer has the "model" so that's not going to work. I did consider using a moldable bite guard as an interim solution. Maybe that's what I should do to get me through the next weeks or months.

I have been using CPAP since 1997 and a TAP appliance along with it since 2005. All is fine with the treatment.

When you use a TAP appliance, you need to use a repositioner in the morning or you will develop TMJ and/or your bite will change. (Have experienced both.) The problem is that mine has self-destructed and I need a new one. My dentist's office is closed and they don't consider this sufficiently important to return my phone call.

The latest repositioner I've been using is a simple heat-fit piece of plastic. It was formed in a few minutes in the dentists chair. Boil it, pop it in your mouth, bite down to form it, wait until cool. I could do it easily myself, but I need to raw piece to start with. I have searched high and low online and cannot find one that is heat formable and available to me to purchase.

So my question is: does anyone know where I can get one?

Thanks

I decided to go with the AirSense. Mostly because the DME company deals almost exclusively with ResMed so I'm likely to get better support on it if necessary. Turns out my insurance will pay 100% and it's already approved, so it matters not to me if it is a little more expensive. Thanks for your help.

Thank you. I'll talk to the DME company and see what they say about getting a Respironics DreamStation. I'm not brand-loyal, but I am more used to Respironics. If they are at least as good as AirSense 10, then I might as well stick with what I know. Especially if it is cheaper. I looked them both up and it looks like ResMed has more style design investment to recoup. I use my machine in the dark, so don't really care about style. :-)

I'll Google putting the AirSense into clinical mode (thanks for the correct term) if I need to. I could probably figure it out for myself as I did when Respironics changed their method, but it's nice to have a backup plan. I don't abuse this and would prefer for everything to go through and be on record with my sleep doctor. But I still have to keep breathing every few seconds of every night and these doctors don't always seem to understand that, or care.

I wouldn't mind reading your rant if it is about the functionality of these modes. My first machine, in 1996, was very basic. The modes were basically on or off. It worked very well and I haven't seen any improvement in my sleep with the more and more complex machines that have replaced it.

Thanks again for your help.

I've read that singing or playing didgeridoo can help firm up those tissues. I tried the didge, but couldn't get the hang of the circular breathing. I no longer commute alone in my car, so singing is out. :-)

Thanks for the mask recommendation. I looked it up and it appears there is some sort of plastic apparatus on the sidees of your face. How does that feel when lying on your side? And where does the air blow out? My current mask blows directly out the front and if the sheets are near it, it hisses and wakes me up.

I work on my health when I can, but I have had a lot of injuries and illnesses in recent years, so it's often one step forward, two steps back.

How long have you been using the CPAP? There are a lot of adjustments to make and I'm sure some are easier or harder for each individual. Mouth closed, don't roll onto your belly (or back for many of us), choosing the right mask, settling into pillow without losing mask seal, not panicking because there's something clamped onto your face!, managing the hose, making sure nose remains clear, etc. I've been using the CPAP since 1996. Some of these things took me months, but eventually it all settles out. You're probably in it for life, so don't fight it, just treat it as another learning/adapting exercise.

My good dentist is retiring soon and my current TAP is about three years old. If they really are that hard to fit, maybe I should have a new one made before it's too late!

I have found that OTC heat adjustable appliances loosen up within just a few months. Are the DreamTaps better than that? If they were built like a TAP, but with a heat-softenable lining, I suppose you could get them molded and fitted to your teeth, but then heat them and let them "settle in" and relieve the various stresses that make them uncomfortable. Otherwise I'd want a money-back guarantee before I paid for one. It really hurt spending $2200 on an unusable TAP during the recession when I only made about $12,000 that whole year. There are no words that I could use publicly to describe my opinion of that dentist.

I have used TAP-II and TAP-III appliances since early 2005 along with my CPAP. TAP-II was definitely better, but apparently more expensive to manufacture or something. You were able to "un-hook" the top and bottom to talk or take a pill or something. TAP-III is still very good, but it locks together before you put it in your mouth and stays locked until you take it out. Both of these clamp to your teeth snugly if made correctly and don't wear out quickly like the mold-in-place ones. They do require a good fitting technician and a good lab or they can be painful. The techs at my dentist's office are excellent. The lab they use is a tiny little mom and pop place in a strip-mall nearby. (I visited them once: a very nice older married couple surrounded by a huge array of molding and plastic manufacturing equipment and clearly very proud of it all.) And the fits have always been excellent. I tried having a TAP-III made once at an orthodontist who specializes in sleep dentistry and ended up throwing away $2200 worth of useless plastic. Either the fit or the (in-house) labwork were terrible. They modded and even made an all-new second attempt and just couldn't do it.

One nice thing about the TAP appliances is that the fitting and the adjustment are separate things. My last one even came with two hooks so you have a huge range of adjustment. And you can start off easy and adjust your jaw out a little at a time so it gets used to the extension gradually. Of course other appliances can do this, too. I'm not necessarily recommending TAP over them, just relating my own very satisfactory experiences. If there's a better one out there, I'd be happy to hear of it!

Hi, I was diagnosed in 1996 and am on my third CPAP machine. I have recently moved to southern CA where there is a huge medical industry, but no "health care" services that I've been able to find. You act like a sheep and do what you are told even if it kills you because the patient does not count down here as far as I can tell. I think it is time for a new CPAP machine and the doctor and DME supplier are completely uninterested in whether I have a good solution or not. The way the tech put it: the doctor issues a prescription for the pressures and the DME supplier issues me a machine based on what the insurance company will pay for. He said I have no input in the selection. I really miss Westside Sleep Center in Oregon... Anyway, they want to issue me a ResMed AirSense 10 auto CPAP machine. I have always used Respironics, so I know nothing about ResMed machines. So I have a few questions to ask of you all.

(Edit: I guess question zero would be "are these decent machines?")

First, it seems that my current machine is effective most of the time, but a few times a week it cannot sense an apnea and then raise the pressure high enough and fast enough to get me breathing again before I wake up with pounding heart and adrenaline. This seems to usually happen in the middle of the night when I am at the starting pressure and I enter deep sleep and need a large increase in pressure. The doctor said that a different machine might react more quickly, but he knows nothing about actual individual makes and models. I asked the technician how the ResMed compares to my old Respironics and he said nobody has ever asked him before and he doesn't have time to research it. I'm supposed to take what I'm offered. He says it's newer than my old one, so it "should" be better. But that means nothing. I want to know it's going to be better, not just guess. The manufacturers won't talk to me, so does anyone out there know this?

Second, it appears that I am not likely to get good service (and forget about "care" entirely) from these humongous California medical businesses, so I want to be able to setup/adjust my own machine if necessary. As I said, I've been sleeping with a CPAP every night since 1996. My early experiences were with a large and well respected hospital in Oregon. They were so bad that I looked over the tech's shoulder and saw how he entered the programming mode and then took over management of my own sleep apnea for about 12 years. I did very well until I moved and started seeing a really good independent sleep doctor. But even since then I have occasionally had to adjust my own machine from time to time. For example, I tried a new sleep doctor shortly after moving down here and she set my machine to a pressure range of 5 to 20, when I had been using it successfully at a range of 12-20. I could not even get to sleep before having an apnea and I do not use the ramp-up feature. I had to adjust my pressure up to 8-20 in order to get to sleep that night! And I fired her and went looking for another doctor.
Also, if I am losing weight, sometimes I'll need to increase the pressure a little as the tissues in my throat become loose. Then as I lose more, I have to lower it down and down to keep air from blowing out of my mouth. There's no point in going to a sleep doctor as long as my weight is changing because all he can do is the same as me: guess at an adjustment with the intention of finalizing it when my weight is stable. So I fiddle with my pressures until my weight is stable and then go in to get the doctor to read the card and recommend a good pressure range. (Unfortunately, then I eventually gain the weight back and have to reverse the process. ) So my very important question #2 is: how do I put the machine into programming mode? On the Respironics, it's a matter of holding down one or two buttons for a few seconds until it beeps into the programming mode. How do you do it with the ResMed AirSense 10? I've heard rumors of passwords than only the Dr. or tech knows. That would rule this model out entirely. And question #3: these things come with all sorts of "modes". The Respironics has C-flex and A-flex and who knows what other flexes now. And they have ramps and all sorts of comfort features and so on. I want to put on the mask, push a button, and have my full starting pressure right from the beginning - no ramp-up. And I want to be able to breathe at my own pace without the machine trying to anticipate when I am going to breathe and raising or lowering the pressure based on its guess. That is very distracting. With my current machine in the legacy mode (C-flex, I think) I lay down and go to sleep almost instantly. With all of these lame "comfort modes", I cannot get to sleep at all until I am just exhausted from fighting the machine. I'm sure some people need them and I'm not putting anyone down for using them. We're all different and I just want to know if the ResMed AirSense 10 can work in a simple auto-cpap mode without ramping up and without comfort modes that anticipate my inhales and exhales.
Thanks to anyone with the tenacity to read this far. :-)