Hello,

After an unsucessful attempt at CPAP (I just can't tolerate wearing the mask and the noise kept my girlfriend and I awake), I have tried an oral appliance, the Silencer. It pushes my jaw forward and opens my airway. It took me a few nights to get used to it, but I am now adjusted to wearing it and sleeping better than I ever have. Im just wondering how long it typically takes to feel the positive effects, such as an increase in energy. I still wake up in the morning exhausted although the quality of sleep has much improved. I have heard sucess stories about people trying CPAP for the first time and feeling better immediately and am worried that Apnea is not my only problem... Im an otherwise healthy, active 27 year old.

Thanks.

I have never tried the Silencer but do have the TAP 1.  
It takes a while to feel better with the oral appliance because the lower jaw must be advanced very slowly.  It took me about 3 months to reach my optimum setting – pulling my jaw forward about 5.25 mm.  From it’s initial setting of 0 mm I would turn the knob one turn (.25 mm) every few days until I reached 5.25 mm.  Once I was closer to 5 mm my jaw would feel noticeably tighter so  I would turn the knob only once a week.  It’s difficult to figure out what your optimum setting is without a titration study.  I never had one done.  

I felt better and better each day until I reached my sweet spot of 5.25 mm.

I kept a daily journal monitoring how I felt at each setting. I knew my sweet spot because I was dreaming all night and woke up noticeably refreshed – not bounce out your bed refreshed but I no longer had that “angry, anxious" feeling.  I also no longer felt sleepy after lunchtime and could no longer move my lower jaw forward anymore it was very tight at my optimal setting.

There are many old posts on the oral appliance board that discuss how long it takes to feel the benefits of OA - I suggest you research the Silencer etc.

Jaybob81-   I have been using the Somnodent MAS since March of 2008.  My first night using the device was the first time I remember dreaming in a long time.  It was very vivid and I remembered it like it really happened.  My energy levels increased daily using the device.  My morning headaches disappeared within the first two weeks and my day-time sleepiness was totally eliminated by the end of the first month. Like Phoebe368 it took a long time to reach my final adjustment.  My dentist uses the Watch-PAT 100 ambulatory sleep study system to measure the effectiveness of the adjustments.  She also uses sleep partner observations and the Eppy scale.  I have had three Watch-PAT 100 PSG tests and am scheduled for a forth in March.  I adjusted 5.5 mm forward.  I could probably go further forward more but I want to wait and see how my continuing weight loss affects my apnea numbers.  Right now I have "ZERO" problems with my TMJ joint and teeth. My jaw fully recovers in the morning within 30 min.  I do use the bite tabs every morning and slightly push back on my jaw while exercising the jaw muscles.  I wish you  great success in your dental device treatments and welcome you to the dental club.

Thanks for the replies. I am still on the origonal setting that my doctor left it at while I had an 'adjustment period'. I am sleeping better, but it sounds like it will improve as I adjust the appliance further. I do not know how to do it as of yet, but my Dr. will be showing me on my next visit, which I am attempting to schedule asap.

I am experiencing a longer timeframe for my jaw to go back to normal. I stretch in the am, and it usually recovers by lunchtime. I will inquire about 'bite tabs', or just chew gum in the morning.

Im glad that Im getting sleep now and am looking forward to the benefits!

Thanks again for the replies and wishes.

The bite tabs are a definite must.  It is very important to do jaw exercises each morning for at least 15 min until your bite returns to normal.  Otherwise, your bite will be off.  Bite tabs are basically rectangular soft plastic rubber tabs about 2 1/2 in by 1 in.  My dental device (TAP) came with bite tabs but I'm sure you can get some from your dentist or improvise.

I will transcribe my TAP instructions as best I can.
To quote:

Upon waking, place a bite tab between your front teeth and slide your jaw forward. Then slide your jaw backwards, the opposite direction as far as it will go and apply moderate biting pressure until you feel a slight tension up near your ear. This is the proper stretching of the muscle. Continue 15-20 second repititions, testing your bite recovery. Continue these repetitions as needed to normalize the bite.

Repeat the procedure with the two bite tabs located betweem the eye teeth biting with the jaws aligned, attempting to bring the back teeth together. Again they cannot touch. You may find using one tab at a time alternating sides is also effective.

Leaning your chin onto your palm at a table (or office desk) with head facing down, slack-jawed, can also be effective at restoring the bite. Repeat this process later in the day if needed.

Some patients report limited gum chewing can be helpful.

Of course as always, you should have a dentist or doctor supervision...

Thanks Pheobe, I have heeded your advice, and have spent a lot of time this morning stretching. I probably looked like a nut job on my commuter train, but my jaw felt better before even getting to work. I will be keeping it up.

Thanks again.