Does dental appliances get OSA patients out of the water

[allright]

No one needs to be offended by these comments as health is the issue here.

Avoiding the truth does not heal you. The combination of being overweight and sleep deprived is an equation of disaster for the body. Particular if that weight is around the chest and waist. Trouble is most people are like that making it acceptable to dismiss.

I want to try Dental appliances

I have been on CPAP for well over a decade and feel I am getting no where.

An analogy

If OSA is drowning ( suffocating in your sleep with its accompaning sleep deprivation ) then CPAP to me is like a lifejacket that holds my head above the water.

From what I am reading dental appliances seem to pull you out of the water and into the boat. That boat being the land of the awake and full health.

Most not all CPAP sufferers are always struggling with life, sleepy, weight issues etc. Compliance is terrible for them and they live a sub level of life that has lost the quality most people have.

CPAP users are still alive but not living as well as those on dental appliances.

Is this true of dental appliances and that is do they restore full health to OSA patients unlike CPAP therapy where side effects can really disrupt ones life and cause other health conditions eg syndrome X , increase fat tissue around belly etc

I know I am going to get some flak from hoseheads but don't mind them. I have yet to meet a healthy looking person on CPAP therapy.

In my 17 years on CPAP, seminars, waiting rooms in hospitals and at specialists rooms I am always greeted by a fellow OSA patient who is too heavy, large belly and is falling asleep mostly. What I am saying is that 17 years of experience of watching others on CPAP is some scary stuff if you think life is going to get a lot better.

I am sitting there at the hospital the other day saying where have those 17 years gone. Its taking me a awhile to wake up to the fact that no one is going to do much else then push CPAP as a treatment and pat you on the head and say when you complain. But your still alive and without CPAP you would be much worse. Hard to argue but worth debating on an alternative. My weight loss is moving towards a dental appliance so that is why I ask the question.

[ishapira]

CPAP is extremely effective therapy especially for severe sleep apnea. Oral appliances are extremely effective for mild to moderate sleep apnea and may be effective for severe sleep apnea.

The problem with oral appiances is that patients who are morbidly obese frequently can not get effective treatment with oral appliances.

You describe that CPAP prevents drowning I prefer the word suffocating as more accurate
I have treated severe patients with appliance with AHI over 100 and desats into the 50's

This is a very dangerous type of apnea and we ALWAYS start with combination therapy CPAP and appliance and do testing before discontinuing CPAP.

Frequently combining position therapy with an oral appliance is the key but other patients may need CPAP.

Many patients (25%) love their CPAP and are quite healthy "hoseheads" as you call them.

When you say many look unhealthy the problem may be how often they use CPAP and for how long. Most studies show patients utilize CPAP only 4-5 hours a day 4-5 days a week. That treatment well better than none is grossly insufficient for severe obstructive apnea patients. The unhealthy patients you describe may be sub-optimal users of CPAP
Most patients wear oral appliances all night so even when apnea isn't eliminated the overall effect is equal or superior to CPAP.

Patients who weigh three hundred to six hundred pounds are often best served by CPAP. If they refuse CPAP oral appliances may give many of these patients significant if not total relief.

Ira L Shapira DDS
www.ihatecpap.com
www.ihateheadaches.org

[Dickman]

Dr. Shapira,
How can one sleep sideways on your cheek with dental appliance? It perforates your cheek wall and is painful.
Dick

[Perchance Dreamer]

I've used a TAP 3 for years and sleep only on my side. I've never felt it cut into my cheek or had any sensation of pressure from the TAP on my cheek. I use a firm pillow, so you would think if anyone would have the problem, it would be me.

Maybe your device is a different brand?

[ishapira]

"How can one sleep sideways on your cheek with dental appliance? It perforates your cheek wall and is painful.
Dick"

Dick, I am not sure which appliance you have or why it is "perforating" your cheek. I usually prefer appliances with an anterior ramp that opens the posterior to allow more tongue room. This prevents "cheek biting"

Are you trying to use an oral appliance?

I will renew my offer to help in any way I can. I know you have had a long difficult journey with treating your apnea.

Dr Shapira