Hi,

I had a difficult time with a CPAP and found that an oral appliance worked for me.
However, in my sleep study to determine the success of the oral appliance, I
still only went to Levels 1 and 2 of sleep (no deep levels, 3, 4 or  REM).  I also
continue to have problems with low oxygen. This was not resolved by the oral
appliance.

I recall after 3 or 4 months of using the CPAP that people began to tell me how
much better I looked. And I felt better.  I have not that experience with the oral
appliance.  And worst of all, I continue to have severe fatigue during the day -
I am diagnosed with Chronic Fatigue.

There was something benefical about the air blowing into my nose and mouth
that I think improved my overall sense of feeling better.  Perhaps I don't breathe
deeply enough.

I was thinking of perhaps trying to use the CPAP and the oral appliance together.
If it would cure my chronic fatigue, I would work hard to find a CPAP that fits without
all the side effects I had.  Has  anyone tried both?  Were there additional benefits?
Any advice is welcomed.  Thank you, St. Remy


_________________
St. Remy
Night/Day Sleep Study Gtwn.Univ.
29 apneas/hour; no REM; no deep.
Oxygen desat 90-84%
14 cm H2O pressure
Failed CPAP use
TAT oral appliance 8/13/07

Yes, I know of many that use both.  The oral appliance will usually allow someone to use CPAP at a lower pressure than would be prescribed without the oral appliance.  In addition, it will help with bruxism if that is also an issue.  

You would need a titration with the oral appliance in place, in order to determine the optimal pressure while wearing the oral appliance.

Best of luck!

I have been TRYING to use my TAP III with CPAP.  It solves the problems of leakage with CPAP, and allows me to reduce the pressure a few mm (still experimenting, but so far 11 down to 8 or 9 seems to work.  

It does cause increased dry mouth/throat and puts additional force on my jaw and mouthpiece.  I have had a few problems with the top piece of the TAP just popping off in the middle of the night.  This is mainly due, however, to my lip-flutter countermeasure of wrapping an ACE bandage tightly around my mouth.  So if you don't have that issue, it COULD be the perfect solution.

Ryan

I have severe OSA.    I have had 3 sleep studies in the last 12 years.   I wore the SilentNite oral device for the first 12 years with moderate sucess.   It worked pretty good when it was new.   I just got the SomnoMed MAS and am truely surprised and pleased with how well it works.   At night, my wife was reaching over to touch me to see if I was in bed because I was breathing so quitly she couldnt even hear me.   This is a well designed oral appliance.   I tried the CPAP in the sleep study and it was horrible.   The SomnoMed is much better.   BJH

I personally like using both.  I think for some people, cpap covers all the problems,
but for others they may need one to complement the other.  For me, the oral appliance
is pulling my tongue forward and keeping it out of the way. It seems to make a difference.

I have also been trying to use my TAP in conjunction with CPAP but find myself waking up several times due to dry throat/mouth.  I will try using Biotene moisturizing oral gel tonight as well as an oral moisturizing spray.

There are different types of oral appliances, and I've found that because mine has
the bottom and top attached, and I can't open my mouth very wide, it forces my
mouth to stay somewhat closed and has eliminated my dry mouth.

TerriG1221,

What type of appliance are you using?

Well, I'm using the Silent Nite but it's just because I couldn't afford the more expensive ones.
But I was reading a post yesterday and I think someone was saying there was one type
that you could open your mouth and drink water and another type that keeps your mouth
more closed.  If you read the posts by Papahemi you could probably find it.  

That got me to thinking that I would rather have the type that keeps your mouth more
closed than the one that keeps your mouth more open.  If I had the time I'd look up
the post but I thought it said that Somnodent was the one that kept your mouth more
open and TAP kept your mouth more closed.

However, this Silent nite has a hook (for lack of better word) that holds the upper
and lower teeth together.  I can't open my mouth wide like I used to - even if I wanted to.

I wouldn't recommend the Silent Nite because it hasn't helped me as much as I hoped it would.
I'm moving on to Plan B for me which is to lose some weight.

Hi everybody-  The Somnodent MAS is two separate pieces independent from each other.  The adjustment pieces are attached to the both sides of the upper mouth piece near the back molars.  The lower mouth piece has fin shaped protrusions on both sides that contact the adjustment ramps on the upper mouthpiece when the mouth is closed.  I found it beneficial during the adjustment process to be able to open and sort of workout muscle cramping I experienced after an adjustment.  It was great to be able to move my lower jaw during the night up and down and side to side.  I normally sleep with my mouth closed but drooled quite a bit in the early stages.  Not to much drooling now though.  I have never used another oral device other than a boil and bite that was horrible so I can't address the advantages or disadvantages of other oral devices.  I am sure others will chime in with their experiences good and bad.

Now I've changed my mind because the Silent Nite I have keeps my mouth closed to some degree but I woke
up really tired today.  Maybe I do need for my mouth to be open while I sleep.  Yes, I didn't wake up with a dry
throat but, I'm tired.  

I tried the chin strap one night, and it seemed like my throat wasn't as dry as usual.  I'm going to try it again
though.  Yes, you can still open your mouth and breathe with the chin strap on, but you don't open your mouth
as much.

If I have to choose between a dry throat and having more energy, I'll do that rather than my throat feeling
great in the morning, but really tired.  I guess I need to have my deviated septum fixed so that I will breathe
through my nose, but I'm just not up to the surgery right now.

Good luck, Phoebe.

Thanks, Papahemi.

TerriG1221- You might want to give a product called "Sinus Cones" a try until you have the deviated septum fixed.  They work great for me. The cost is minimal.  They stent the nasal opening open to improve air flow.  JMHO

Can you use the sinus cones together with CPAP?

Hi St. Remy!,

I know you have been around awile and I am sorry to see you are still having problems.  Did they give you an oral appliance soley to correct your OSA?  Exactly what problems are you having using a CPAP?  Since you are still feeling fatigued, did they do a sleep study/look at a data card to check your AHI?  Did they rule out other sleep disorders such as Periodic Limb Movement Disorder?

If they gave you an oral appliance because you have a jaw disorder/bruxism another option is to use a device that is both an oral appliance and CPAP interface.  You will need to see a dentist whose specialty is sleep medicine if you are not already.  See their accreditation info. and how to locate them in the above sticky.

A friend of mine has OSA and bruxism.  His sleep dentist made him an oral appliance for his OSA and bruxism which has nasal pillows on it.  It is the first interface he ever used for his OSA, loves it and has never had problems with either since he started.

Vicki


_________________
Being defeated is often a temporary condition. Giving up is what makes it permanent.
Marilyn Vos Savant

That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

hymaneric wrote:

Can you use the sinus cones together with CPAP?

I don't see why not.  I don't use CPAP.  But for $20.00 its worth a try.  I use the white ones with the nose side clip.