Dental device setbacks?

I had a sleep study done about a year ago. The results said I had severe sleep apnea - 50.9 AHI an hour. I thought how could that be, I hadn’t slept but 49.5 minutes all night. Anyway, the sleep center tech did try a nasal mask on me early in the morning, but I could not breathe through my nose. Next, she tried the full mask and it filled up with saliva. It was a very frustrating night for all.

More time passed and I reached the point that I felt like I was wide awake all night long. I was desperate to sleep . I saw a Sleep Doctor this time and she suggested I see a Sleep Dentist since the CPAP had not been successful. I visited the Sleep Dentist and he talked to me about a dental device. I got the MyTap that very day. I have been extremely happy ever since! I love it. I sleep so well. I still wake up in the night, a few times, but I go right back to sleep. I thought I had stopped snoring! Unfortunately, I read online about the SnoreLab app. So, I set it up and discovered I am snoring with vengeance all night! So, it is good news, bad news. I am sleeping (yeah) but not quietly (boo). Is that Ok? I don’t know if I have as many AHI, I hope not. Can I settle for being happy just to sleep?

I also found that if I move my lower jaw to far forward, I revert back to that horrible wakefulness/insomnia I had prior to having the device. Has anyone had that problem? I need to suggestion. I see my sleep doctor in a week.

I have a dental device also (TAP 3 Elite). You need to have a sleep study done with the oral device to see if it is actually working. When I started mine, I thought it was great, but after having a sleep study with it, I found that my AHI was higher than with my CPAP. My dentist kept having me adjust it forward to lower my AHI. The more I moved my jaw forward the more uncomfortable it became, but I felt it would be worth it if it would lower my AHI. I had a second sleep test after advancing it half way and my AHI was still the same. I finally became discouraged and reverted back to my CPAP. The bottom line was that it felt great when not advanced forward, but wasn't doing me any good. You won't know if it is working until you have another sleep study. Good luck.

It is possible for an oral appliance to resolve the apneas and hypopneas without resolving the snoring. If that is the case, you would be considered successfully treated in a medical sense, although, from a social sense, the people in your household would still be suffering with the noise. There is no way to be sure without having a sleep study(home sleep study or sleep lab study) with the appliance in place.. Feeling better is not sufficient proof in and of itself. There can be a placebo effect. Arthur B. Luisi, Jr. D.M.D.

If you do have another study with your appliance, would you mind letting us know of the results? It would be quite interesting.

You don't need to sleep for 50 minutes to get an AHI of 50. AHI is the number of apnoeas and hypopnoeas you have throughout the whole night divided by the amount of sleep you got. If you have 50 events and 1 hour of sleep, you will have an AHI of 50. If you 50 events and half an hour of sleep you will have an AHI of 100.

It is extremely rare that an oral appliance would correct the sleep apnea and not the snoring (In fact, in 30 years of being a sleep apnea dentist I have never seen it). Oral appliances stop snoring 80% of the time and fully control sleep apnea 37-60% of the time (depending on lots of variable). If you are snoring, you still have sleep related breathing issues.

B. Gail Demko, DMD

Sleep Dentist Consultant to MyApnea.Org

Assoc. Editor of the Journal of Dental Sleep Medicine

Expert Advisor to the FDA on Oral appliance Therapy

Past President of the Academy of Dental Sleep Medicine

American Board of Dental Sleep Medicine