I am a dentist working in dental sleep medicine. What grinderfrank means is that the lower tray of the device is moving backward and losing protrusion which tends to reclose the airway. Mandibular advancement devices like the Tap3 keep the airway open at night by holding the mandible forward(protruded). This opens up your airway and prevents apneas and hypopneas. The Tap3 has a screw adjustment to bring the mandible forward. The patient adjusts it to the optimal protrusion and then leaves it at this setting. If the screw adjustment device wears or fails, the mandible can drift backward and reclose the airway. The patient starts to get more symptomatic. This is a sign that the device has to be repaired in some way, which, presumably, Airway Management will do. Not unusual, happens with some frequency. Arthur B. Luisi,Jr., D.M.D.. The Naples Center For Dental Sleep Medicine.
I am a dentist working in dental sleep medicine. I would respectfully disagree that it would be impossible to fabricate an oral sleep apnea appliance for a patient who is even a severe gagger. I have done it many times but it does take some creativity. I will give you one example. An appliance called a DreamTap is designed to fit over all the teeth. Obviously, you could not wear that. However, a variant can be created that fits over just the upper and lower six front teeth and I have yet to see a gagger that can't tolerate THAT. Getting the impressions can still be a problem, but digital impressions and some other special techniques can overcome that too. Arthur B. Luisi, Jr.,D.M.D.. The Naples Center For Dental Sleep Medicine.
I am a dentist working in dental sleep medicine. I really hate to say this but, using the alcohol, in addition to the usual addictive potential, is probably causing you SERIOUS medical harm. Alcoholic products relax your muscles and this muscle relaxant effect probably is making your obstructive sleep apnea exponentially worse. You were already at AHI 50, which puts you in clear and present for heart attack and stroke. Now you would be in even more peril. Sorry, but true. Arthur B. Luisi, Jr., D.M.D.. The Naples Center For Dental Sleep Medicine.
Unfortunately, you have it right. In many countries, including my own, the USA, they blew the initial opportunity for containment. Now the toothpaste IS out of the tube. Huge numbers of people are going to get sick and die and we just have to take our licks until they get enough testing done, plus vaccines, and discovering medical treatments. This is going to take serious amounts of time and, meanwhile, the economy will tank and go into recession or depression. Just shows you the price you pay with these things unless you are super sharp. Dr. Luisi
Remember that the exhaust air coming out of the vent ports on the masks is STILL PRESSURIZED. There would clearly still be potential to expel virus particles out of these vent ports for a significant distance. Dr. Luisi
I am a dentist working in dental sleep medicine. Unfortunately, I have some really bad news for the people on this forum. In a post dated 3/22/20 the American Academy of Sleep Medicine states that the use of CPAP by patients with COVID-19 infections does, indeed, pose a significant risk to other family members in the household because it disseminates the virus into the air regardless of what face mask you use. Please check out the FAQs on their web site about this. There is also some risk of spread during the routine cleaning process. Oral sleep apnea appliances are specifically cited as being a safer alternative, as are some other things. Now, I am not suggesting that you dump your CPAPs, but you MUST be absolutely sure that you are totally isolated from other household members and it may make some sense to move some very vulnerable family members(or yourself) to a different location. Arthur B. Luisi, Jr., D.M.D.. The Naples Center For Dental sleep Medicine.
I agree. But even if you can't get the leakage under control, I am going to supply you with one of my accessory intraoral mouth shields at no charge. If you need it, just get in touch with me at www.naplescenterdentalsleepmedicine.com. and I will ship it out. Super easy to install. I will support you any way you need to be supported. Good Luck. Dr. Luisi
I am a dentist working in dental sleep medicine. One of the things that I do in my office is to fit people with the TAP PAP Nasal Pillow CPAP mask when they prefer to have it installed professionally. Many patients find it significantly more comfortable than typical CPAP masks because it is secured on the upper teeth, which eliminates the headgear and straps. It is also more stable and tends not to leak when the patient moves around in bed. It is available on line at all the typical CPAP supply outlets and can be self installed by most patients if they are at all handy. AirWay Management Company enjoys a significant market share with the device and it always surprises me when there is so little mention of it on forums such as this. As with all nasal pillow masks, the patient must be able to breathe fairly well through the nose. Most people naturally close their mouths around the device when they sleep and mouth leakage is not an issue. Again, it won't work for a heavy mouth breather and they must go with a full face mask or an oral sleep apnea appliance. Currently, I am working on a soft, comfortable intraoral mouth shield that attaches as an accessory to the TAP PAP nasal pillow mask to stop mouth leakage. It works well, is available in my office, but not yet in volume production. Arthur B. Luisi, Jr., D.M.D., The Naples Center For Dental Sleep Medicine. Naples, Florida
I agree that putting locks on the older posts is a really BAD idea. By definition, the most recent posts are not going to be the best or the most provocative posts that ever were. It makes the whole experience much less interesting. Dr. Luisi
I am a dentist working in dental sleep medicine. It is so frustrating to hear these endless stories about mask leakage and chin straps when the answer to the problem is sitting right in my office. I have a leak-free nasal pillow mask with an attached soft intraoral mouth shield that seals off the mouth from the inside. It is comfortable and it works. O.K., you say, if it is so good why can't I buy it right now at CPAP.com. Well it is due to a combination of politics and regulatory red tape. Even though every part of my device is made up of F.D.A. approved parts, they are configured in a novel way and the F.D.A. would consider that to be a new usage, thus subject to further review. You CAN get the device directly from me and it is production ready for volume production under an investigational device protocol, but few patients know to do that. So people will continue to suffer unnecessarily as I slog along trying to figure out how to get the necessary approvals. VERY FRUSTRATING. Dr. Luisi