My CPAP works pretty well, but not great, for me (mild apnea + insomnia), but I travel often and a dental appliance would be so much simpler and may work better (by not awakening me late at night). So I tried a dental appliance.

In short: big, expensive mistake.

• Most “sleep doctors” are CPAP peddlers. It’s all they know. The dental appliance physician has to train the sleep doctor and sleep techs how to sleep-test the product.
• The very experienced and very cooperative sleep techs at my previous sleep lab (I changed labs because that sleep doc is useless) told me they had tested many such appliances, and not one patient had any success with them.
• Most insurers won’t pay for these dental appliances because they don’t work.
• I interviewed a few dentists who sell these appliances, and chose one who specializes in jaw medicine and sells a high-end device called the Somnomed  MAS.
• Against most advice (the studies supporting this concept are very small), I bit the bullet and bought an appliance as a gamble (there are no guarantees). As a lean male with mild apnea, I was a great candidate for this approach.

My Somnomed is very sleek; I barely notice it in my mouth. It grabs all my teeth, not just the front ones, so should not alter my bite. It lets me talk, sip water, yawn, move my jaw, etc., and remains comfortable all night. If any such device is going to work, I figured, this one should, and this dentist is extremely knowledgeable in the physiology of the jaw and throat and the mechanisms of how apnea affects atherosclerosis. He accompanied me to the sleep study to  make sure the sleep doc and techs properly fine-tuned the device to optimize my breathing. The objective is to titrate the jaw extension to maximum apnea prevention by repeatedly advancing the jaw, counting apnea events and pulse oxygen in the next sleep session, and repeating, all night. Analysis of the data should then tell the docs what amount of jaw extension best relieves the apnea.

There were just two problems:
1. It didn’t do squat for my apnea … virtually no effect whatsoever at any jaw extension.
2. My jaw still hurts 20 days after the max-advancement phase of the sleep study, and I haven’t even seen the device since the study. I will call that dentist next week and have him fix my jaw at his expense.

What did my out-of-pocket $2,500 for my dental appliance buy me? A sore jaw and a pair of paperweights.

jwpegram wrote:

Adjustment of the MAS is made in 1/10 millimeter increments, so 10 "adjustments" equals 1 millimeter of movement (you might know that already). ... we decided I'd just do the adjustments myself.

My very knowledgeable (I hope) dentist told me 4 adjustments = 1 mm.

If self-appraisals were accurate, few of us would know we  have a breathing problem while sleeping. "I sleep just fine; I'm just tired all the time" ranks up there with "I"m not an alcoholic".

UGERTH wrote:

jwpegram wrote:

Adjustment of the MAS is made in 1/10 millimeter increments, so 10 "adjustments" equals 1 millimeter of movement (you might know that already). ... we decided I'd just do the adjustments myself.

My very knowledgeable (I hope) dentist told me 4 adjustments = 1 mm.

If self-appraisals were accurate, few of us would know we  have a breathing problem while sleeping. "I sleep just fine; I'm just tired all the time" ranks up there with "I"m not an alcoholic".

Agree, 2 adjustments is about 0.5mm.
 Sorry to hear its not working for you, CPAP had not effect on me and this has worked better than CPAP so far with the Somnomed MAS.

I'm getting a new device in a few months, its said to be much more effective than the existing devices as its self-adjusting, I guess I'll find out then, until then I will do the best I can with the dental device and sleeping a lot.
 Modafinil is having some very unpleasant side-effects but that's another topic.

Silentone - you said you were getting a new device.  What's it called?  Have you gotten it yet and if so, is it working?

dtired, unfortunately I saw the dentist yesterday for the impressions and he said something about the external company had advised him to wait another 3-4 weeks before taking impressions, let alone getting the new splint.

The new splint is not released to the public yet, since I've done another sleep study I have to wait until mid-November for him to confirm I will get new impressions, if the sleep study says things are ok that will change the plan again :(

Thanks

Sorry to hear, silentone.  Hope you get your new splint soon!  How is the Somnomed working for you lately?

Not the best, I've had a septorhinoplasty but the fatigue continues, I'm going to go for a week without the splint to see if that helps or not.

I should mention to keep this in context that the splint did better than the CPAP, but that was all well before surgery, now that I can completely breath through my nose I will see if the splint still makes a noticeable difference.