How many were given other options than CPAP

[RickRed]

To All,
First I want to thank everyone who helped me to adjust to CPAP. It was the most difficult adjustment I had to go through it my life. Though I had mild apnea, the effects on my life were NOT mild. I felt fatigue all the time, I would fall alseep at red lights even if I was only minutes away from home. Once I got home from work, all I wanted to do was sit on the couch. Often I'd fall alseep there.

Anyway, my Sleep Dr told me CPAP was the only option for me and that I'd need that treatment for the rest of my life.

Not once did he suggest there were alternative treatments, such as using a dental appliance. But I knew I could not comply with CPAP so I had a pillar, a nasal somnoplasty and was fitted for a dental appliance. My sleep study confirmed this combination successfully treated my apnea and I no longer use CPAP.
After 8 months withI CPAP, and I never felt very good, now I have energy and my life back. With CPAP I never slept more than 2 consecutive hours, now I can sleep through the night.

To all those who hate CPAP and are tired of trying to find the right mask or the right machine:
1. Have you been told there are other treatment options?
2. Have you checked out the dental forum?

The list of former CPAP users who are using dental appliances, then having sleep studies confirm our success is growing every month.
Rick- A former CPAP user

[Toth]

CPAP is the first intervention to be attempted.

For those who have difficulty, they have thier own threshholds for frustration and their own resources for further testing and experimentation.

When the decision is made to seek an alternative intervention, then others can be considered, but cpap is the first choice at all times. I see no need for anyone to get a pamphlet explaining a UPPP if it turns out that cpap works great for them their very first night on it.

[Sleepy Stoboy]

Yes, it is the first intervention to be attempted in almost all cases.

But it does beg the question "why"?

A major part of the reason is that sleep doctors rarely if ever prescribe a dental device as a first option. This would require a referral and follow up consultations with the dentist and not the sleep doctor, costing them hundreds if not thousands of dollars. In addition, if there are any kickbacks to the doctor from the DME and/or CPAP manufacturer, there are more dollars lost.

Dental devices are far less expensive than CPAP, both short term and long term, provide significantly higher compliance rates among their patients, and are found to be far more comfortable and portable.

There are enough clinical studies out there that prove that these devices are effective. Some of the studies have even shown side by side comparisons to CPAP.

But unlike the CPAP manufacturers, the dental devices lack the power of a few very large manufacturers. And they have no hope of getting their foot in the door with the sleep doctor community.

The best hope is that the dental community begins to see the financial gain behind advertising and promoting dental devices as an option. It would probably require sleep doctors and sleep dentists working out of the same office to allow the proper diagnosis and proper fitting of a device to be handled through one clinic.

Most people are led to believe that they have only two courses of action after they're diagnosed: CPAP or a surgical route. And the surgical route represents little hope for most patients unless they choose a MMA, which most patients are simply not going to sign up for.

Often these discussions meet with strong reaction from a CPAP community that has worked hard on their own compliance and actively works to see others reach the same level of compliance and benefit. But the real outcome for many of us on the dental forum is to see dental devices offered up as an equally viable option for anyone diagnosed with sleep apnea. Many are also scared away due to TMJ or dental concerns, but a qualified sleep dentist can certainly answer if these will be valid concerns after a consultation.

This board has been wonderful at creating the dialogue to let patients know their is a very effective alternative to CPAP. Unfortunately, many never know about this option as it is never presented to them. My hat is off to Rick and others like him who care enough to keep this topic alive.

[RickRed]

Toth,
You said:

[powersnore]

This is an issue I feel very strongly about.

The doctor that did my initial sleep study (a pulminologist) basically sat me down and said, CPAP clearly eliminates your apnea according to the test, so CPAP it is. Then they hand you over to the DME, who could give a damn less (nor should they) as they only fit your mask and bring you a machine.

I distinctly recall calling the pulminologist months later ( I can NEVER get him on the phone) and telling his receptionist that I needed to speak with him b/c I could not comply with the treatment and kept ripping my mask off at night. Her response...... "Why do you think that is?"

Hmmmmmmm, I skipped medical school, so I was kinda hoping TO ASK THE DOCTOR.

Point being, I think there is a disconnect going from the sleep study, to the method of treatment. Just b/c a treatment is effective, doesn't necessarily mean it should be the first option. Money has EVERYTHING to do with this as was mentioned above. Kickbacks from the dme, and continued visits to the doctor keep the gravy train moving.

To those that CPAP works for, god bless you, I wish it worked for me, but it doesn't. If i didn't have this board as a resource, I would never know about TAP and quite honestly, I'm excited to look into it.

I have a consult with my pulminologist on Tuesday to discuss my scheduling of surgery. I will definitely report back with the notes from that conversation.

[RickRed]

Powersnore,
After my first few days with CPAP, I thought this was a treatment from hell. I couldn't decide which was worse the treatment or the disease. When Paul first posted about the Pillar and dental appliance it was for me like finding water in a desert. I went for the Pillar hoping it would cure both my snoring AND my apnea. However, I didn't even bother going for a sleep study after the Pillar because 3 months later I was still waking myself multiple times with snoring so that even if my apnea was cured, my own snoring was a major source of sleep disturbance to ME, as well as to my wife.

I was VERY reluctant to go for a dental device, after all, if these things worked I thought my Sleep Dr would have discussed this option with me. But desperation drove me to the point of willing to try anything. So I met with a dentist and got an adjustable dental appliance. After 2 adjustments, my snoring stopped and I could sleep well. I began to feel so good, I knew I didn't need CPAP any more.

However I also knew that if I was going to be a credible source of information to other apnea patients I'd have to have my results confirmed by a sleep study. So went for my study in June. The study confirmed what I already knew, I have no problems with apnea while using the dental device.
I'm free of CPAP. Thanks to Paul and Stoboy who shared their experience. Now I want to return the favor and give hope to those who hate CPAP, so every now and then I post this topic to generate discussion and to reach those like yourself who want their apnea treated without CPAP. Keep going in your search, there are other options.
Rick

[Sara]

CPAP was the only treatment offered. After much frustration I quit CPAP, I called the sleep doctor and was given no help. Because I do not want to use CPAP I guess I am not worthy of their time!

I called my dentist, he is so in the dark. He told me to do the research and he would make whatever I wanted. Again I am on my own. So I do some research and realize it would help to know where the blockage is. I go to an ENT he wants me to have a UPPP along with four other surgeries. The only exam he did was look at my throat with a tongue depresser.

I am totally on my own in a small town with no idea what to do next. Medical care is somewhat limited here. Should I just start calling every dentist in the yellow pages?

I am so close to giving up.

[rested gal]

I'm quite content with autopap treatment - mask and machine are comfortable enough for me and quite effective.

However, I feel almost as strongly as you folks do about how important it is for people to be given information about dental devices (plus Pillar) as a treatment option. It's unfortunate that UPPP is what probably jumps to most doctors' minds when they are asked, "Is there anything I could try besides a machine?"

It will take time and a lot of educating. Stoboy pointed out some of the financial reasons that most sleep doctors would have for not getting up to speed on what's really going on in dental sleep medicine. Many sleep doctors are ENT's. Cutting and carving are the alternatives they'd think of, unfortunately.

As Stoboy said, it will take more dentists focusing on "sleep". With cardiologists becoming more aware of the effects of OSA on the heart, and with the media putting more attention on "sleep apnea", internet conscious baby boomers aging their way full blown symptoms of OSA may be the ones who alert the dental profession to the cash cow "sleep" sideline that other doctors have already discovered.

It will take a lot of advertising on the part of dentists. Slowly but surely the word will get out. Alternatives that are effective, as TAP combined with Pillar are proving to be, will help prevent people from dropping through the crack of not being able to "comply" with cpap treatment no matter how hard they try.

It's looking more and more as if T & P can provide an effective first line treatment choice alongside "cpap". Either method (T & P or cpap) being easily reversible or abandoned in favor of trying the other...or something else.

[Swordz]

To Sara:

Check out www.quietsleep.com for explainations and visuals on all the dental devices. Also check out www.dentalsleepmed.org to find dentists in your area that make dental devices.

IT FRUSTRATES ME SO BAD, THAT WE, THE PATIENT HAVE TO TAKE OUR HEALTH INTO OUR HANDS JUST TO FIND THE ANSWERS WE NEED. But we have resources, such as this site and cpaptalk.com, to help in finding those answers. I just want to bring all doctors together and beat them with the "Sleep apnea info" bat.

Maybe then they'll see the answers... Or just some black and blue.

[RickRed]

Sara,
I'm so very glad you posted. I know how frustrating your experience is. Please check the links you were given and also ask lots of questions on the dental forum. If you live in a small town you may have to travel a few hundred miles in order to find dentist who can help you, but trust me it will be worth the trip. Apnea is too serious to ignore and there are other treatment options. However you will get little if any support from a Sleep Dr for your efforts to treat apnea without CPAP.

Please don't give up on yourself. This is too important to your future and your health.
Rick

[Sara]

Dear Swordz and Rick Red

Thank you so much for the links, the advice and the support. I am feeling a little overwhelmed and really appreciate being able to talk about it.

I found a dentist about a hundred miles away on the dental link. Does being a member of the academy of dental sleep medicine give the dentist the expertise to chose which appliance would be right for each patient or do I have to chose beforehand? I believe they a expensive and I am not sure about my insurance, I want to be sure that I don't make a mistake.

Thank you again
Sara

[RickRed]

Sara,

[Sleepy-In-CA]

RickRed,
My consultation with my sleep specialist (before I was even tested for sleep apnea) included a lengthy discussion on "options". He covered everything....including dental devices and the various surgeries. He also made sure I understood and was available for questions. After the sleep study, the first suggestion was CPAP. I said no. We agreed to a Bilevel machine because of my difficulty exhaling to the same pressures as I was inhaling. So...I started out with a Bilevel and am not sorry I did. My compliance rate is 100% and the first mask I was offered by the DME also turned out to be a winner. I think all sleep docs should cover all options with their patients. It should be standard protocol.

[RickRed]

Sleepy in California

[Guest]

I am just curious here, is there more female compliance with CPAP then Male? It seems, on this board anyway, that most of the girl sounding names have had great success with CPAP therapy, while most of the male sounding names have fought it from day one. I am wondering if there is something to be said about how males and females handle situations, and if the therapy could be adjusted for that.
For example, and I am using very broad strokes here, please dont take anything personally, etc. But Women as a whole tend to want to solve a problem, and will try and try to make things work. women want to "Comply" or make things better. Men as a whole are Problem Solution oriented. IF it doesn't work right away, there must be another way. Think about other male female relationship dynamics and you will see this is part of their genetic code. Women carry babies for 9 whole months thru much problems and aggrevations, Men, one shot and they are done with the actual making of a child.
Women are put on hormones, and told to get counciling for "female troubles" and Men are given surgery or pain pills and move on with their lives.
Now I am not saying that the men with this problem should "act like a woman and deal with it", or that the women should demand surgeries and dental appliances to Fix this problem, I am just saying, there has to be a happy medium, a way to treat all Apnea sufferers without having them give up to soon, or try every radical thing out there when perhaps they just haven't given the first couple of solutions a good college try.

Anyway, this thought occured to me after reading the posts on this board for the last 3 months. I am also in school right now studying sociology and other things and am most likely looking way too deeply into all this