Trying oral appliance but keep waking up

I just finished my 4th month straight with a Resmed Air 10 and using a F30 mask. I’m a mouth breather, so I tape my mouth and also use a night guard (teeth grinder, too). I made a silk pillowcase for my down pillow but still struggled with mask leaks. I’m sure I’m not alone in saying that I don’t like using a CPAP. My scores was always in the 90’s except when the leaks pushed to the 80’s and AHI 5-9.
So last week I woke up in the night with my abdomen painfully tight with air - the pressure unchanged - and I just hit a wall. So I started using my oral appliance instead. I had done a home study with it and it went well, but the next day I was EXHAUSTED, so went back to the machine, thinking I would just use the oral device when camping and on overnight trips. Last week I had an appointment and my doc cleared me to switch to the oral device, so I am. I find that I wake up frequently and suddenly need to use the bathroom most nights. My sleep tech said that is usually because you’ve been awakened by an event. I know I should ask my doc (or a tech) but honestly, I really value this brain trust almost more. Should I go back to the machine, or am I just being anxious, which is interrupting my sleep? I am back to catnaps in the afternoon. I don’t want to case damage to myself. What do you think?

I can't help you with the oral appliance, but there are a couple of dentists that check in that probably can. What kind is it?

The CPAP, if you can learn to live with it, will probably control the apnea the best. I understand you are using the F30? What kind of pressures are you using? Have you considered a nasal mask like the AirFit P10? If you are OK with mouth taping, it could work for you. When the tape is not inside the mask it can take the moisture a lot better. 2" 3M Micropore tape (white) should work well. What is your ratios of OA events to CA events? I'm wondering if there is any opportunity to get the pressure down. Pressure is the main cause of swallowing air.

It really sounds like your body is telling you to be on CPAP, my RT told me to avoid tucking your chin to help keep air from your stomach a store bought cervical collar might help. Also don’t be afraid to adjust the pressure, the machine I use is very smart and only uses just enough to eliminate my apnea’s but in your case a bit less pressure may allow you to tolerate it and still eliminate most of them. If it is that or nothing than anything helps

I am a dentist working in dental sleep medicine. Obviously, if your baseline AHI is in the 80's to 90's, you have heavy duty OSA. As a general rule, CPAP does better against very severe OSA than do oral appliances. Having said that, I have successfully treated some people with OSA as severe as yours with oral sleep apnea appliances. The first thing that you have to do is to get your oral appliance well sleep tested to see just how effective it is. A quality home sleep study like Alice Night One by Phillips would be sufficient. If your appliance comes up short, be aware that there are a few oral appliances that do notably better than average against severe OSA. The best appears to be the O2 Oasys, which has tested extremely well(90+% effective i.e. AHI reduced to below 5 with complete abolition of symptoms) against severe OSA. However, only the model with the optional tongue buttons and the optional nasal dilators does this well. The plain, standard one does not. In second place would be the Tap3 or DreamTap which would get the AHI below 5 about 30% of the time, AHI below 10 with complete abolition of symptoms about 50% of the time, or reduce AHI by 50% to less that 20 with complete abolition of symptoms about 69% of the time. Be advised that I am doing this from memory and that my percentages may be off by a few percent here and there. Arthur B. Luisi, Jr., D.M.D., The Naples Center For Dental Sleep Medicine.