Has anyone tried a mouth guard instead of CPAP?

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Has anyone tried a mouth guard instead of CPAP?

Postby stmcub04 » Sun Mar 01, 2009 3:47 am

I posted a question about problems with keeping my mask on (the title of the forum is "Why can't I keep my CPAP on?" for reference). Being that I have such a hard time keeping my mask on I thought about trying a mouth guard. Has anyone tried a mouth guard designed to help sleep apnea? I see them advertised on TV for opening your airway and was wondering if it'd be worth it to pay the money to try. My doctor has told me I could also see a dental specialist to get a custom mouth guard made for me that shifts my lower jaw forward a little (essentially the same as getting one of an infomercial, just much more expensive).

I've been told mouth guards are more effective for people with mild to moderate sleep apnea or people that have sleep apnea but are not overweight. I am classified as severe OSA, but being that I'm 5'11'' and 185ish, I wonder if the mouth guard may be effective for me. Any insight would be much appreciated.
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Re: Has anyone tried a mouth guard instead of CPAP?

Postby Jan1ce » Sun Mar 01, 2009 10:31 am

My sleep doc said success rates were 60-70% (I think) but a specialist dentist could give you a better idea.

stmcub04 wrote:I posted a question about problems with keeping my mask on (the title of the forum is "Why can't I keep my CPAP on?" for reference). Being that I have such a hard time keeping my mask on I thought about trying a mouth guard. Has anyone tried a mouth guard designed to help sleep apnea? I see them advertised on TV for opening your airway and was wondering if it'd be worth it to pay the money to try. My doctor has told me I could also see a dental specialist to get a custom mouth guard made for me that shifts my lower jaw forward a little (essentially the same as getting one of an infomercial, just much more expensive).

I've been told mouth guards are more effective for people with mild to moderate sleep apnea or people that have sleep apnea but are not overweight. I am classified as severe OSA, but being that I'm 5'11'' and 185ish, I wonder if the mouth guard may be effective for me. Any insight would be much appreciated.
Last edited by Jan1ce on Sat Mar 07, 2009 10:39 am, edited 1 time in total.
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Postby BJH » Sat Mar 07, 2009 1:11 am

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. BJH
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Exception to what people say?

Postby papahemi » Sat Mar 07, 2009 12:53 pm

In March of 2008 after may months of attempting and failing to pass a titration study to obtain a prescription for a CPAP machine I decided to look into dental devices. I at first purchased a "Pure-Sleep" boil and bite device. I got burned gums and a sore jaw for my efforts. Got my money back for that device. I then saw an ad in the local paper for relief of snoring and moderate sleep apnea. They offered free first visit so I had nothing to lose. The dentist specialized in neuromuscular care with training in sleep disorders. I had little faith in the effectiveness of dental devices at this point.

In March of 2008 after a at home PSG test (Watch-PAT 100) I was diagnosed with severe sleep apnea. I had all the symptoms of apnea. I had morning headaches, nocturia, no energy , daytime sleepiness, weight gain, loud snoring and waking up several times at night. I literally drove my spouse out of the bedroom with my snoring and gasping for air.

In March of 2008 I weighed 327 pounds with at a height of 6' 1". ( yea I know morbidly obese).

In March of 2008 I decided to sign up for treatment ( $2200.00 cost) with this neuromuscular dentist for a treatment package using a Somnomed MAS dental device. I also attended a weight loss seminar with the idea of getting a Lap-band weight loss device. I was desperate to feel better. My dentist asked me to hold off on the Lap Band and give the dental device a reasonable chance for results. I agreed to give it six months.

It is now March of 2009 and after one year using the Somnomed MAS I no longer have morning headaches, nocturia, lack of energy, daytime sleepiness, loud snoring or multiple waking during the night. My weight has gone from 327 lbs to 273 lbs. and I am still losing. I have the energy to walk every day 2 miles ( even in the rain, glad I don't have snow). I by no means have been 100% successful in my apnea treatments. My AHI went from 49.7 to 9.9. I am still considering my other options (surgical or another attempt at XPAP).

Are my results typical of some using the Somnomed MAS? I think my success is a combination of Somnomed MAS use, lifestyle change and weight loss.
I do believe that anyone with OSA could possibly benefit from the Somnomed MAS, TAP III or similar device. Just how much is the question. Just as with XPAP or surgical options everyone is different and results can and probably will vary.

Like I always said even some improvement using a dental device is better than no improvement for lack of compliance using XPAP.
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dantal mouth pieces.

Postby mcafton » Tue Oct 19, 2010 2:44 am

Thanks everyone for your advice. While i didn't initially post this thread your responses have helped me.

I have had a CPAP machine for ...probably 3 years. I am sure I haven't given it a proper chance, but I just can't CAN'T wear it. I move a lot in my sleep, and whenever I have worm it I wake up and tear it off in the middle of the night. I have moderate to severe sleep apnea and have also seen the commercials for these devices. My dad also mentioned it to me lately. He prays for me regularly because though I am only 33, a neighbor of his died in his sleep partly due to untreated apnea. I am 5 ft 8 in, and close to 220 pounds. I get a decent amount of exercise, but eat a lot and know i am overweight.

Anyway I have a dentist appointment tomorrow to look into getting one of these fitted devices. I am praying it works, because I hate my CPAP machine. I will try to let you all know how it goes. Being one who has ADHD my sleep patterns are pretty lousy as it is, and I am ALWAYS exhausted. I am hoping this helps.

Thanks again for your posts.

-Chris.
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are you a truck driver or pilot?

Postby truckerdad57 » Tue Oct 26, 2010 12:17 am

If you are someone who needs a medical certification for your job then you need to look into that A LOT before you go with an oral appliance.

I work with truck drivers who need to have a DOT medical certification. Right now you can't get a DOT medical card if you use an oral appliance.
(just a truck driver with sleep apnea)
Co-coordinator Truckers for a Cause Chapter of A. W. A. K. E.
awake.truckersforacause.com
Do not substitute information from here for professional medical advise.
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Re: are you a truck driver or pilot?

Postby wirez666 » Sun Nov 21, 2010 2:59 pm

truckerdad57 wrote:If you are someone who needs a medical certification for your job then you need to look into that A LOT before you go with an oral appliance.

I work with truck drivers who need to have a DOT medical certification. Right now you can't get a DOT medical card if you use an oral appliance.


I am an aircraft pilot, and if I get diagnosed with sleep apnea I feel I may lose my medical. At the moment I feel perfectly fine in the sense that I am not tired during the day and I can function. My girlfriend told me I stop breathing at times in my sleep and I've heard it from my fellow crew when I sleep in the crew rest unit on the aircraft. I fear I do have sleep apnea and want to get it taken care of without the consequences of an official diagnoses. My dentist in this area was going to set me up with the Somnamed without a sleep study since I mentioned it was only for snoring. But now they have reneged on this and want me to go for a sleep study. Are there any solutions I can utilize to attempt to take care of this problem without the consequences? I wish airlines would recognize the CPAP as a sufficent solution; if anyone else here is a pilot and can offer insight I'd appreciate it. I'm sure there are many other pilots with this problem who don't want to come out because their livelihoods are at stake.

Without the ability to fly, I am screwed as I have no other skills.
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not a pilot but.....

Postby truckerdad57 » Sun Nov 21, 2010 4:25 pm

I am not a pilot but a commercial motor vehicle operator (truck driver). We have medical certification requirements similiar to FAA requirements.

DO NOT go with an oral appliance. There is no way you can get a medical card under either FAA or DOT medical guidelines with an oral appliance. I just talked to a former pilot who is using an oral appliance and is in the middle of the formal appeal process attempting to get his FAA medical card back now that he is effectively treated with the oral appliance. He has not been able to get approval with an oral appliance even with the help and backing of his treating sleep doc who is an expert in the use of oral appliances.

CPAP will be the treatment of choice as you will want to make sure you get a CPAP with compliance and efficacy data capabilities (the sleep doc can tell if you are using it.. and if it is working right).

CPAP is a prescription device that no reputable doctor will prescribed unless you have been tested and diagnosed as having sleep apnea.

Talk to an FAA flight surgeon about sleep apnea. As I understand the FAA procedures if you are "under current and effective treatment" you can still get an FAA medical card but you will need to get a regional office review.

The trick bag you DO NOTwant to get into is knowing you have sleep apnea and having any kind of safety incident that might in any way be related to fatigue or sleepiness. NTSB is all over sleep apnea as a causal factor in any transportation related accident.

Get tested.... do you really want to be the next pilot listed in an NTSB incident report for falling asleep in the $!@# and overshooting the airport by 20 minutes? One of the pilots in that incident was diagnosed with sleep apnea....

Many pilots and truck drivers are scared stiff about loosing our jobs over a diagnosis of sleep apnea. If you research and make sure you jump through all the hoops it can be done.

I've been getting my DOT medical cards since 2002 and on a CPAP. The DOT medical requrements for truck drivers are stiffer than pilots. There are two pilots so if one nods off....

Good Luck
(just a truck driver with sleep apnea)
Co-coordinator Truckers for a Cause Chapter of A. W. A. K. E.
awake.truckersforacause.com
Do not substitute information from here for professional medical advise.
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intraoral Devices are not effective in every case!!

Postby noelia » Thu Dec 16, 2010 5:21 am

It's absolutly correct that intraoral devices are an alternative for the CPAP treatment, but this only in cases of mild or moderate sleep apnea. If u suffer severe Sleep Apnea a combination of both treatments would be the best solution.
In every case you get rid of snoring and with over 300 different splints on the market it's hard work to make his choice.

I suggest to follow these steps:
1. A study by a sleep medicine is essential (there are cases in which you suffer SleepApnea without snoring and vice versa
2. After the evaluation of the grade of Sleep Apnea the treatment can start by consulting a specialised dentist (CPAP and/or Appliance)
3. Inform yourself about the different appliances, the dentists are used to their splints (TAP, Herbst, Orthoapnea...)and often patients are better informed about novelties then the dentists themselves
4. It's important that the appliances have proven their efficiency in studies
5. My experiences have shown me that the most important aspect is that the splint garantizes accomodation for being sure to continue the treatment, first i accepted a splint which droped out of the mouth and hurted nonstop, cause i thought that the elimination of the snoring is it worth it. I changed my mind, because i think paying so much for this treatment should mean also a perfect solution, in the end i am very satisfied with my Orthoapnea appliance.
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Postby rlochner » Sat Dec 18, 2010 7:08 am

I currently have a SUAD Device made by a company called Strong Dental. It is a step in between the infomercials and the extremely expensive ones, but still given to me by a D.M.D.

I am a sophomore in college who originally was diagnosed with severe OSA after doing a SNAP study from my doctor in my senior year of high school. I then had my tonsils taken out and my nasal passages cauterized last year. I was given the SUAD device because I couldn't/wouldn't go into my freshman year with a CPAP machine. With the surgery and the SUAD device, I now just have mild OSA. It's hard for me to notice a difference because I am still pretty tired all of the time, but it doesn't help I can't get more than 5-7 hours of sleep because of athletics and academics. However, the mouthpiece significantly reduced my snoring so that is a positive aspect. I rarely had problems with the device, just the occasional sore teeth because the device is molded from your teeth and acts almost like a retainer would.
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Oral appliances don't always work.

Postby rliss » Fri Jan 07, 2011 12:12 am

I have had OSA for about 10 years (I'm now 64). I have never been overweight (5'7" 158 lbs.). I started using a CPAP but after a few years decided I wanted to get off it. I was advised by an ENT doctor that I had an oversized tongue and needed to have bone removed and my lower jaw adjusted slightly, a serious operation. I decided instead to visit a sleep doctor (orthodontist) in my area to get an oral device. The dentist tested me first by having me move my lower jaw forward as much as possible and making various throat sounds as in snoring. He felt that I could get some improvement but I was not convinced it would be enough. I decided to give it a shot anyway, even though it cost me close to $2,000 for the custom device, fittings, adjustments and review visits for up to a year. It ended up that it didn't work for me, so I am back on the CPAP. Be careful when your dentist does initial tests. If it is not very clear to you that jaw movement alone will work do not waste your time or money.
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Oral Appliance

Postby Shu Shu » Thu Jan 20, 2011 11:18 am

I have tried several sleep apnea masks and fall asleep easily but take off the mask in my sleep so in essence get zero relief.
I finally tried the oral device. I was so happy with it as it helped me tremendously, I could cover my mouth and say "Good night, honey!" without
my husband seeing it as compared to how embarrassing it is to use a mask (but understand that my husband would rather me well and probably could care less about how it looks).
The problem is that after wearing this oral device for a year or more, I woke up one day with unbearable jaw pain. And the pain has since not subsided. A year after that, I still have horrible pain as the device completely misaligned my jaw. It has been a nightmare and it seem as if there is no successful treatment.
I would not recommend the mouth device to anyone!! Never use it!!
Does anyone know of a sleep apnea mask that does not have straps across the face? I think that this is m problem. I now use the CPAP pro and it goes into the nostrils and there is a piece that attaches to the upper teeth. It works fine but it still involves my jaw, and I think may be aggravating the situation.
Any ideas?
Also, does anyone know of a great center in Canada who might be able to help with my problem(in addition, I have TMJ)? I am in the US and one of my physicians suggesting checking out what Canada has to offer.
Thank you!!!
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Postby noelia » Thu Jan 20, 2011 11:51 am

The problem you had with your device is that it didn´t allow you sufficient free movement, so that the device caused jaw pain. You could have prevented that with another device that allows much more free movement. There are several on the market. When i started to investigate the different devices i surched in the internet, for me the wear comfort was one of the most important thing that interested me, cause i knew if the device starts to hurt or hinder me i wouldn´t continue the treatment (and again the same horror with CPAP). I´m still very happy with my Orthoapnea device, cause it is the only one that allows lateral movement and the opening of the jaw. I can only recomend to everyone not to pay only attention to the disminuation of the snoring/apnea, but also to the comfort that garanies that we continue using the device.

The only thing i know is that i am so grateful not to use CPAP anymore!!!!
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Mouth Guards

Postby BLH » Thu Jan 27, 2011 3:03 am

I have tried mouth guards because I couldn't keep the mask on and would pull it off during the night, but the mouth guard didn't work because I would take that out during the night as well. They have improved masks a lot, and just recently, 3 weeks ago, got a mask that fits just over my nose and the comfort level was so much improved I was excited to see that I still had the mask on after my first night of using it, and didn't have to take a nap or fall asleep during the day. Since we are not conditioned to have these masks on, I think it just takes a conscious decision to use the machine and stick with it and you will get use to using it, it took me 10 years to reach this point.
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Re: Has anyone tried a mouth guard instead of CPAP?

Postby p3orion » Mon Jun 10, 2013 8:55 am

I've used one for the past seven years. It was custom fitted by a dentist specializing in sleep disorder dentistry, and came in two pieces (one for the upper teeth and one for the lower) which have a loose attachment, allowing some jaw movement. Such mouthpieces work by bringing the lower jaw forward (essentially imposing an underbite) to open the throat. The attachment point between the halves is adjustable to control how far your lower jaw is brought. There was a marked improvement in both my snoring and apnea, but neither were completely cured, even when I adjusted the lower piece to the fullest extension. Moreover, it took several minutes in the morning before I could get my lower jaw to go back to its natural position; until then I couldn't close my mouth properly.

I've recently switched to an over-the-nose CPAP, which my wife says works 100% to stop my snoring, but which I find annoying and hard to sleep with.
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