I have been scheduled through my pulmonologists office for a second sleep study. I have been on CPAP at 13cm for a year and it is suspected that I hypoventilate, or don't breath hard enough to overcome the pressure. At my pulmonary function test, I was evaluated as being an extremely light breather. My blood gas is at 39, and AHI was 18 a year ago.

But the orthodontist that made my dental device would prefer that I was at full adjustment before retesting. I have a large uvula (the ENT's say OMG when they see it) which the orthodontist is moving away from by moving the jaw forward at night.

It has been very difficult to get the second study approved, and the Pulmonologist would like me to go ahead now. There probably isn't a great deal of adjustment left on the device as I've already moved the jaw forward toward the end of the adjustment screws.

Should I go ahead after getting the hard-to-obtain approvals or wait until full adjustment and start over?

Hi ss,

It's good that you are exploring multiple treatment options, it takes a lot of effort, but hopefully will enable you to figure out what option will best treat the condition in your specific case. It's difficult to give opinions/suggestions in this situation, though, as it seems somewhat complicated.

What, in your opinion, is the primary purpose of this next sleep study? In your other post you wrote: "The reason I am going back is to determine whether a CPAP or BIPAP is better in my case". In above post, it seems that the purpose is to check the effectiveness of the dental device.

Can the orthodontist give you an estimate on how much time is needed for the full adjustment to be completed?

What is the allowed time period on the approval for the study? In my case, it takes several weeks to get an appt for a sleep study. I know of people who have to wait up to 6 weeks for their sleep study appt. So the insurance approval must have some time period for which it will remain in effect.

Guest MJ

I went in for the second sleep study, and had it done with the dental appliance, as I was nearly at full adjustment anyway. The purpose to determine if I need Bipap or not, is that I was diagnosed as being an extremely light breather on my Pulmonary Function Test, and have a high PCO2 level at 39. Its believed I can't overcome the 13 cm setting on my CPAP, and I was previously at 11cm on CPAP also. Thus its thought that I inhale the previous exhalation, lowering my oxygen level.

I haven't seen the results, but know my prescribed level will be 15/11 cm on Bipap. I'm not than encouraged as my level was previously 11 cm on CPAP, then 13, so why would 15/11 have a better effect?

I'm beginning to lose confidence in all this, havent been able to work effectively for so long, and am losing my fear of the UPPP surgury which all except the ENT surgeons say is a last resort. I don't have a great deal more to lose. I'll try the Bipap at levels I've already been on, on CPAP, but I think its just a formality now.

I'm not sounding positive, and don't feel positive either. I need to post the situation under the CPAP section too.