We've updated our privacy policy.

FatBear

FatBear
Joined Dec 2017
FatBear
Joined Dec 2017

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. :-)