Replacement OAT for AHI 40

OAT successfully reduced my AHI 40 to below 5. Not overweight at 5 ft 6, 143 lb. HIstory of bruxism and TMJ, allergies, and sinus surgery. ALso have disturbed sleep and daytime fatigue from chronic neck and shoulder pain under treatment. Previously used Somnomed Mas and TAP3. Somnomed MAS: found it reasonably comfortable (except for salivation) and very good durability, but keeping it wet was inconvenient with travel. TAP3: found it significantly less comfortable and durability was poor. TIme for replacement device. Need to decide between the various Somnomed models and Narval, oasis, or micro2. Choice will affect which sleep dentist I can go to. What are the pros and cons for me of these possible choices?

Hi! I am a dentist working in dental sleep medicine. Were you efficacy tested by HST or polysomnogram for each appliance you wore and, if not, which appliances were tested? Of the appliances that you mentioned, the TAP 3 is the most universally effective. This is because the TAP 3 holds the mouth closed, which has been shown to best control OAS. The fact that it does hold the mouth closed also makes it significantly less comfortable for many people. Being able to open and close the mouth at will with the appliance in place is a comfort plus for many people. The key here is to find out if this comfort feature will reduce the effectiveness of the appliance for the patient. In some cases it will, in some cases it won't. If you have had good results with the Somnomed MAS, this shows that you can get away with an appliance that lets your mouth fall open. I have used the Oasis in the past and, in the main, patients have found it to be pretty bulky and uncomfortable. Actually, I no longer use it in my practice for that reason. The Narval is thin and comfortable, but the adjustment struts can be problematic. If you have done well with the Somnomed MAS, I think that the Micro2 could possibly be a better choice for you. It is made with new CAD/CAM technology which makes it strong, thin, light, and very comfortable. It also has a simplified tray system which eliminates the need for adjustment tools. Arthur B. Luisi, D.M.D.