UnassumingOrangeRedCormorant9252

You might want to go to www.cpaptalk.com and post your question there. There are some very knowledgeable members who can help you set the right pressure range.

As far as patients changing their own pressure, many people have come to cpaptalk.com and the other apnea board floundering big time because the pressures weren't set correctly by their doctor and were given the right assistance from forum members. Of course, no one should be changing it without totally understanding the data in Sleepyhead, http://sleepyhead.jedimark.net/, which is a free program.

My profuse apologies for not coming back to this thread and thanking everyone for their responses. I am looking for a link to a similar type study that I posted a few years ago on another apnea forum that was from 2011 in which the various AHIs ranges were broken down as to how well the dental appliance had been in getting the AHI to 5 or below.

Dr. Luisi, your point is well taken that someone who doesn't reach an AHI of 5 or below with a dental appliance may still be considered to be successfully treated depending on their situation. Still, I think a study like the updated 2011 would be nice to access. If I remembered where I got it from, I would post the link but unfortunately, I don't,

Dr. Demko, any links you can provide that proves that surgical advances don't hold up long term? And when you say long term, what is your definition of that? Even if someone can't tolerate pap therapy and a dental device but needs treatment, having surgery still might be worth having depending on the situation.

And just so folks know, I have tried repeatedly searching to find what I am looking for to no avail. Perhaps I am not looking in the right place.

I previously asked about whether there was updated research on the effectiveness of dental appliance for sleep apnea and never got a response. Do I take that to mean there isn't anything?

What about sleep apnea surgery such as the UPPP and MMA Jaw advancement surgery?

Many people seem to be under the impression that most alternatives to pap therapy don't work very well. But it seems that unless there is updated research that we can refer to, that no one whether they are or not in support of them, has the monopoly on the truth.

Sleeptech, I understand what you are saying but when someone is out of options and has given pap therapy and a dental device a good tryout, the only remaining options are sleep apnea surgery. By the way, I think what you are describing is the UPPP procedure. From my research, the MMA jaw advancement surgery that sleepsurgeon1 mentioned had a much higher success rate even though it is quite grueling.

To be honest, I wish I had had it done when I had the chance but I chickened out. Unfortunately, for other reasons, it is no longer an option and I am stuck with pap therapy.

Like the OP, I also didn't qualify for the Inspire Procedure due to complete concentric collapse. And I found a Somnodent Herbst dental appliance more intolerable than wearing a mask.

Hmm, no one has any information on this? It seems if this is being promoted as an alternative to pap therapy, that we should be able to tell folks what the data shows on efficiency.

As an FYI, I tried searching myself but couldn't find anything.

Any updated research on the efficiency of dental appliances? I am not looking to switch to one but I was just curious.

Thanks!

Congratulations on your recovery and I am happy to hear that Trazadone works for you. However, I feel it is inaccurate to say it is a nonhabit forming med.

Even though it is used as a sleep medication, it is still technically an antidepressant. Which means that for many people (not all), they will have to carefully taper the med, particularly after long-term use. If they don't, they will suffer severe withdrawal symptoms.

Of course, your mileage will vary and run everything by your doctor.

Dr. Tony,

After greatly struggling with pap therapy, I made the decision to try a dental appliance only to find it was alot more uncomfortable than using my VPAP. What I found even more disconcerting was when I had my usual three hour wakeup and and had the need to take out the appliance yesterday (in spite of little advancement), my jaw already felt like is was greatly out of alignment. I went ahead and did the exercises to get the jaw back in place because I was too concerned about waiting until the morning. Not good for great sleep.

My advice to anyone considering a dental appliance is to buy a cheap appliance like Snore X to get a sense of sleeping with something in your mouth. Not a perfect simulation but definitely better than nothing.

Finally, I hope to god that you understand that just because someone stops snoring doesn't mean their AHI is at an acceptable level. I had a very hard time getting the dental assistant to understand that and found that very frustrating.

One possibility which may or may not be applicable in your case is that your machine could be set to a wide range which is usually from 4 to 20. As a result, at the low pressure, you might feel like you are gasping for air. You also might have a situation in which the machine is taking too long to get to the right pressure to deal with hypopneas/apneas.

To see if your therapy is optimal, I would download sleepyhead, which is free software.

https://sleep.tnet.com/resources/sleepyhead

If you need help in interpreting the data, many folks at cpaptalk.com are very helpful. You can decide if you need to go back to your doctor for further consultation or if this is simply an issue that your minimum pressure needs to be very slowly raised with careful monitoring of the data.

Dan,

Unfortunately, this is happening with the Simplus. An example is at the same pressure, I had a 14 AHI for a 45 minute nap. In limited other uses, I have had the same problem which makes wearing this mask full time impossible because when I increase the pressure, I get massive leaks.

I don't understand why this occurs because with this mask, I am not severely tightening the straps which I thought might be the issue with previous full face masks I used. Any thoughts?