Sleep apnea and mouth guards

[Mr._Graybeard]

What prompted you to have a sleep studies done? If it was because you are sleepy during the day, then I would take the apnea seriously and get the CPAP. My doctor said my case was mild too, but I got the CPAP anyway and while it took me time to get used to, I sleep much better.

I did the study at DW's urging. She said I'd stop breathing for five or six seconds during each episode, and (of course) I snore. The home study found my O2 level dropped to 83% for about 40 minutes over the course of the night. The CPAP bumped that up to 90%.

 

[Teacher Terry]

Your oxygen level dropping means you need cpap and not just a mouth guard.

 

[swakyaby]

The home study found my O2 level dropped to 83% for about 40 minutes over the course of the night. The CPAP bumped that up to 90%.

Those results sound consistent with mild to moderate sleep apnea. I’m surprised the CPAP didn’t improve it better than 90% which is fairly borderline.

 

[RetMD21]

The $129 device sounds like it would be worth a try

 

[swakyaby]

The $129 device sounds like it would be worth a try

My thoughts as well.

 

[RetMD21]

For $100 you can get a device on Amazon to monitor oxygen overnight. Has anybody tried one of those?

 

[blueskyk]

I’ll be trying this soon on DH - looks like it’s a pulse oximeter with an app

 

[explanade]

Can you even use CPAP if you almost always sleep on your side?

 

[Aerides]

DH did a sleep study (lifelong snorer, no matter his fitness or weight). I wasn't convinced as he never seemed to stop breathing, but the studies showed lots of issues.

He's on the kind that just has a nose breathing thingy, not the mouth or whole face. His actual sleep data is far improved. It's very quiet, just the sound of air, no machine noise. And it provides a lot of data, how long he's getting quality sleep, etc.

The dangers of letting apnea go untreated are quiet startling, so I wouldn't mess around much with other stuff for too long, and be sure you have a partner who can tell you how you appear to be sleeping.

 

[Winemaker]

Can you even use CPAP if you almost always sleep on your side?

Yes, I can. There are several different types of masks, I find this one works the best for me.



https://www.thecpapshop.com/respironics-dreamwear-nasal-cpap-mask


This website price is much higher that what I have previously paid. I actuall broke mine once on vacation, and bought it on Amazon for about $50.

 

[explanade]

Yes, I can. There are several different types of masks, I find this one works the best for me.



https://www.thecpapshop.com/respironics-dreamwear-nasal-cpap-mask


This website price is much higher that what I have previously paid. I actuall broke mine once on vacation, and bought it on Amazon for about $50.

You have to connect that to some kind of pump right?

 

[Teacher Terry]

Can you even use CPAP if you almost always sleep on your side?

I had to learn to be a side sleeper when I was diagnosed with sleep apnea. I was a stomach sleeper. I can’t sleep on my back because of back pain. I have to wear a full face mask because I am a mouth breather. I tried the nose piece and strapping my mouth shut which didn’t work.

 

[Winemaker]

You have to connect that to some kind of pump right?

Yes, they hook up to my CPAP machine, I have no issues sleeping on my side or back. I never did sleep on my belly.

 

[Emerson11]

Anecdotally, in my social circle, nearly al of the men and many of the women use a cpap. Additionally, I've not heard of a single person who's gone through a sleep study and was not subsequently diagnosed as needing a cpap. It's interesting that humans have so quickly evolved to require an apparatus to sleep safely. (I jest.)

 

[Montclairbobbyb]

I was a hold-out...

I actually cursed at the doctor who read me the results of my sleep study,.saying "there's no F'ing way I will wear a.CPAP mask... AIN'T goin down that road!!!."

When he very calmly explained to me the daily effects apnea will likely have on my body, and how it REALLY CAN shorten my life, I agreed to try it out for 30 days.

Admittedly I struggled.to get used to the CPAP mask and machine, and I felt like I couldn't breathe. My doctor's office wasn't helpful (DO MAKE SURE TO CHOOSE A GOOD DOCTOR who will help you make adjustments and get over the initial struggles... IT IS WORTH STICKING TO IT. I was ready to call it quits, when my brother (God bless him) convinced me it was worth sticking to it, and to try different masks and settings...and that I WOULD eventually get it to work for ME. He was right.

I've been wearing a nose mask nightly now for roughly 2 years and after finding the right air pressure, I really look forward to sleeping at night. CPAP WORKS!!!

 

[Tessie]

I am a female, normal weight, side sleeper and I snore unbelievably loud. I used to use an oral appliance called Silent Night which I got from my dentist. I primarily used it when I was sharing a room for travel, etc. I think it was $400-$500 10 years ago. It worked pretty well but could be a bit uncomfortable. I’m actually in the market for a new one as this one degraded over the years and I will be sharing a room on an upcoming trip. I have no intention of spending thousands of dollars on one. I’m sure the expensive one your dentist recommended is better made than the Silent Night. I did eventually have a sleep study and have mild to moderate sleep apnea but even my doctor was surprised at how loud my snoring is. I have a cpap now and have tried several different masks and comfort accessories but I just can’t get comfortable with the cpap. Plus it’s unrealistic to travel with one. So I have given up on the cpap and just sleep in my own room now. I am hoping to get an over the counter one that will work but have no idea which ones are effective and tolerable.

 

[Tessie]

I have moderate obstructive sleep apnea and use a nasal CPAP. It works really well, although sometimes I find myself taking it off in the early morning so I can curl up in more natural sleeping positions. But I have also used the over-the-counter mandibular advancement devices that you make a moldable impression of your jaw first. It was because sometimes I had to spend the night in various places where I didn’t want to bring a CPAP machine, but didn’t want people to hear my loud snoring. Or dry camping where plugging in a machine is a problem, but didn’t want to bother DH with my snores. It works enough to lessen the snores, but I’m pretty certain the CPAP machine does a better job keeping my oxygen levels up and carbon dioxide level normal.

For mild to moderate sleep apnea such as the OP, it would be reasonable to try the over-the-counter mandible device, I think. An actual CPAP would be the next choice. The overpriced dental device from the dentist would be last choice.

Which OTC oral appliances worked well for you?

 

[isisdave]

DW had a sleep eval six years ago and had a mild problem, but never did anything about it. I asked her to do it because at 5-6am, she'd stop breathing for 40 seconds once in a while. No gasping or sounds of obstruction-- just finished one breath and waited a scary time to start the next one.

This summer we both had one; she had 16 events per hour, and I had -- gulp -- 58. We both got ResMed Airsense 11 in July after waiting 5 months.

Two months later, my resting heart rate and blood pressure are down -- I may get to discontinue meds -- and I don't fall asleep in front of the TV (much) any more. I don't sleep less (I'm 73) or feel much different. We go back for the 90-day review soon. It took me about 15 minutes to get used to the CPAP nasal pillow delivery system.

DW is less impressed, as her number wasn't nearly as bad, and she seems to feel better sleeping without it.

Medicare covers it all but the list price for the device is under $1500 and there are many less expensive. They are available for resale all the time for the obvious reason. Ours are kinda big for travel, so we may look for a more portable one later.

 

[bq1993]

If you decide to go the CPAP route, compare insurance price vs buying it outright. I've read on a few apnea forums and reddit of folks who found it was just as cheap to buy a machine and supplies without insurance.

I've had my APAP for almost 4 years and haven't missed a night and never plan to. My sleep is so much better than before.

 

[troutnut1]

Sleep apnea is a serious condition that negatively affects your entire body and mind. CPAP is the gold standard for treatment. It is mostly covered by medicare and most other insurances. Unlike the alternatives, it provides evidence of its efficacy as it works via cell to your doctor, and on an SD card. It tracks every minute of use. Pressures can be changed as things get better or worse. It works almost silently. It generally resolves the problem simply with some pressurized air that keeps your airway open while you sleep. Yes, it takes a little getting used to, and yes, there is a learning curve to find the right equipment combinations. But it works great and it’s not snake oil like most of the alternatives are. Lots of people will take your money and make wonderful promises with silly things and silly theories. Cpap works and can really improve quality of life for decades. I travel easily with mine. Airlines can’t even count it as a bag. It even goes in my RV to wilderness campouts. And best of all, my wife’s sleep was dramatically improved as well because I’m not snoring on her all night. It also greatly reduces my night bathroom trips. Before I was up 4-5 times a night. Now its maybe once and most nights not at all. Turns out this bodily function is suspended when we are sleeping well. I’ve been doing it about 8 years and it is one of the biggest life improving things I ever did for myself. Go with Cpap first. Then try the snake oil if it doesn’t work for you for some reason.

 

[JBeez]

Diagnosed with a severe case of apnea in late 90’s and been on CPAP ever since. I struggled with it early on, but between advancements in machines and better masks, its somewhat better. However, I sometimes still have issues keeping it on.

About 15 years ago I tried the mouthpiece made by a dentist. The cost was around $1500, and I also had to sign a waiver acknowledging it could cause TMJ and the dentist would not be liable. I wore it for about 3 weeks before I started feeling discomfort in my jaws. That was it, back to CPAP. Again, my apnea is very severe, so it might work for you since yours is mild. Good luck.

 

[explanade]

Does anyone use only a small mask, like the nose mask linked earlier?

As opposed to a full mask that seems to be what most people think of when they think of CPAP?

OK read up on it, guess there are nasal pillows, nasal masks and full face masks.

Complications are dry mouth or nose bleeds depending on type of mask and type of breathers.

Do you have to have forced air or can some people get by with a device to mostly prevent obstruction of airways?

 

[swakyaby]

Does anyone use only a small mask, like the nose mask linked earlier?

As opposed to a full mask

Do you have to have forced air or can some people get by with a device to mostly prevent obstruction of airways?

From what I understand, most issues with airway obstruction during sleep seem to occur when inhaling, since the soft tissues of the upper soft palate and back of the tongue relax and cause partial or full obstruction. A CPAP relieves this obstruction by providing a measured amount of positive pressure airflow. If you sleep with your mouth closed, often a nasal mask will work for you. But if you find your mouth opens when you sleep, then you'll need a full face mask.

People with mild obstruction who are concerned about loud snoring can sometimes get by with OTC or dental prescribed mandibular advancement devices, if their jaw can tolerate this. I'm not an expert, this is what I understand.

 

[Montclairbobbyb]

Nose vs Face Mask vs non-CPAP

I actually tried the airstrips that help to open up your nasal passages, and these partially worked, although not nearly well enough. Like you explained, the soft tissue near your uvula relaxes during sleep and naturally closes your airway, contributing to snoring and apnea. No nasal strip or mouth guard is going to fix this, in my opinion. I believe the added air pressure of a CPAP device is instrumental in opening up your breathing airway.

After trying several nose and full face masks, I settled on using the RedMed Nasal Pillow nose mask, and it works very well for me. Your experience may be totally different, but I think you owe it to yourself to explore the CPAP option and determine what kind of mask works best for YOU. If you asked me prior to using CPAP, I would describe myself as a mouth-breather with difficulty breathing through my nose... I tried the full-faced mask and found it way too cumbersome. The nasal mask changed all that, and now I find I have even learned to breathe naturally through my nose much better, even without a CPAP device. I never thought I'd say this, but the CPAP has been a game-changer for me.

 

[Mr._Graybeard]

OP here. I've looked into one of the ~$100 OTC mouthpieces and found it to be too clunky, triggering my gag reflex. There's a ~$500 version that creates fixtures like a dentist would, with the device created using latex impressions. But I'm wary of blowing that kind of money on something that may or may not be effective.

I'm having better results with the chin strap approach, like this. DW says my snoring has stopped with my jaw strapped shut. Since I no longer keep her awake, she can't tell whether my breathing interruptions are still occurring. I'm sure she'll advise me on that over time.