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Sleep Apnea

1,924 Views | 23 Replies | Last: 6 yr ago by 94DallasAG
Cancelled
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AG
Anyone here with it? I was diagnosed in December and about a month ago finally got my dental device.

I have struggled with moderately high BP for years - it would range from 140/90 to even a bit higher. The doctors suspected that it might be due to sleep apnea. I don't know if this is a success story and it may just be an aberration, but my BP this morning was in normal ranges. I feel a bit more refreshed and I'm not snoring nearly as much now. However, I still need to adjust the device to be a bit more aggressive.

I'm not a doctor, but I'd suggest anyone struggling with sleep apnea to consider talking to their doc about the dental device over the cpap.

Has anyone else, either on cpap or otherwise, noticed a decrease in BP after treating sleep apnea? I know that sleep apnea has a direct correlation on blood pressure.
Na Zdraví 87
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AG
I was diagnosed with it years ago and finally lost some weight this year. My face and neck are much thinner now. I no longer need the cpap. Wife and I both sleep much better.
I've always had moderate to high BP. It runs in my dad's side of the family. Been on BP meds for 20+ years and always will be.
The_Thinker
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Treating sleep apnea will absolutely reduce blood pressure in some people. It also has many other benefits; sleep apnea is a large cause of atrial fib later in life and proper treatment can help prevent this .

Do you mind saying how you were diagnosed?
OasisMan
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AG
i used to work with a sleep doc
she was against dental devices because they can ultimately alter your oral structure

a vast majority, not all, of those with OSA would benefit from weight loss, some to the point of getting rid of their OSA
lazuras_dc
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AG
Snapped a photo of this slide at a conference I attended a month ago that touched on OSA

lazuras_dc
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AG
Some tooth movement from oral appliance is minimal in the grand scheme of things in comparison to breathing lol.

Some people can't or won't tolerate a cpap and oral appliance is the next best thing.
Cancelled
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AG
Sleep study.

Yes, you do have to wear a device in the morning to get stuff back in line.
Kool
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AG
Every apnea event is followed by a "tachy/brady" event, and a small shot of adrenaline entering your bloodstream. Over time, add up your AHI by about 7 hours of sleep to know how many times your heart is being raced and your arteries are being squeezed if you have apnea. That's why untreated apnea, over the long term, results in increased risk of hypertension, stroke, heart attack, persistent A-fib, etc. If that's not bad enough, there are mood and concentration issues with the disease, as well as diabetes, fatal car accidents, and even the dreaded ED!!!!!
I always tell my apnea patients that CPAP should be numbers one, two, and three in terms of their treatment options. And I do not make a dime off of that therapy. Oral appliances and surgeries should be considered numbers 4 and 5, or vice versa. That being said, nearly half of all people diagnosed with sleep apnea cannot tolerate CPAP. I am glad OP is experiencing some tangible results with CPAP, but I would encourage anyone using an oral appliance to get a Home Sleep Test with the device in place to make sure that it is working. And, yes, I have had one patient I treated with an oral appliance have a very significant shift in her teeth. Of course, she was a nurse I used to work with. Ugh.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Spore Ag
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Take the above scenario and think about having apnea as a child. Magnify the effects of adrenalin compounding with progressive learning difficulties. Important to get your children evaluated.
Work with your practitioner as if it is not comfortable one will not wear it. My Mom tapes her mouth which has provided proper tongue position, stopped snoring and sleeps better now.
Na Zdraví 87
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AG
Good point on afib.
Also forgot to mention that my afib has stopped now too. Knock on wood.
Haven't had an afib event since losing the weight.
lazuras_dc
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AG
Quote:

but I would encourage anyone using an oral appliance to get a Home Sleep Test with the device in place to make sure that it is working. And, yes, I have had one patient I treated with an oral appliance have a very significant shift in her teeth. Of course, she was a nurse I used to work with. Ugh.





Yep , Just like you would have a followup titration study with a CPAP, it is the same recommendation for an Oral Appliance.

So just like the research shows, you said half of the patients can't tolerate a cpap, so what then? Why then would that be plan 1 2 AND 3... oral appliances are definitely effective and a great option 2 if cpap cannot be tolerated.

I'm curious, did you make the oral appliance for your nurse? Which appliance was it? Was she compliant w/ her AM aligner therapy after using the oral appliance? Any periodontal or TMJ problems prior to treatment? All these can affect whether you have "shifting" of your teeth. This one case is very anecdotal so if we are sticking with that- I've had several patients have no issue at all that start with healthy teeth/periodontium and are compliant with AM aligner.
Titration can be tricky because I am not in the study with them. But for cases where the OA is titrated correctly and patient tolerates it well, think about how much more convenient that is, esp for traveling, and not sleeping with hoses connected to you.
Kool
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AG
lazuras_dc said:

Quote:

but I would encourage anyone using an oral appliance to get a Home Sleep Test with the device in place to make sure that it is working. And, yes, I have had one patient I treated with an oral appliance have a very significant shift in her teeth. Of course, she was a nurse I used to work with. Ugh.





Yep , Just like you would have a followup titration study with a CPAP, it is the same recommendation for an Oral Appliance.

So just like the research shows, you said half of the patients can't tolerate a cpap, so what then? Why then would that be plan 1 2 AND 3... oral appliances are definitely effective and a great option 2 if cpap cannot be tolerated.

I'm curious, did you make the oral appliance for your nurse? Which appliance was it? Was she compliant w/ her AM aligner therapy after using the oral appliance? Any periodontal or TMJ problems prior to treatment? All these can affect whether you have "shifting" of your teeth. This one case is very anecdotal so if we are sticking with that- I've had several patients have no issue at all that start with healthy teeth/periodontium and are compliant with AM aligner.
Titration can be tricky because I am not in the study with them. But for cases where the OA is titrated correctly and patient tolerates it well, think about how much more convenient that is, esp for traveling, and not sleeping with hoses connected to you.
If you are on auto-titration CPAP, or follow your CPAP compliance reports carefully, you shouldn't really need to do follow-up studies unless you aren't doing well, weight changes by 10%. etc. My point is that CPAP is far superior to almost every other form of therapy. The one patient I had with a shifting of her teeth was under the care of her dentist and had no significant periodontal issues pre-treatment, but the literature indeed shows that shifting of the teeth is a recognized complication of oral appliances.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Know Your Enemy
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AG
I was diagnosed a long time ago. I use a CPAP but I'm really hoping that when I lose all this weight I will be able to ditch it. Can't really sleep without it now, though.
Spore Ag
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With out question c-pap is the gold standard but alternatives needed to be developed. You cannot have a soldier storming the beach lugging a c-pap device. There was a need to an alternative treatment.
Swarely
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Had an oral appliance for about a year. My sleep improved, but I fought the appliance every night in my sleep. My jaw muscles actually became noticeably bigger in that year. Got to the point that one day I yawned and felt something pop in my jaw. Couldn't chew for days. Shortly after that one morning my teeth would not realign no matter how long I left the bite thing in.

Long story short, had my tonsils and uvula removed. Also had my nose roto rooted. That was about a month ago and I can breath and get a good nights sleep for the first time in my life. Recovery from surgery was one of the worst things I have ever gone through.
malenurse
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AG
I used an oral device for years with minimal success, and it definitely altered my bite. Have been using a C-Pap since May and it has changed my life!!!!!!!!!!!

I use the nasal pillows and they are far more comfortable than the oral device.
ellebee
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Can you use the oral device if you have tmj?
Kool
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AG
ellebee said:

Can you use the oral device if you have tmj?

It'll make it worse, likely
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Cancelled
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AG
Kool said:

ellebee said:

Can you use the oral device if you have tmj?

It'll make it worse, likely


I asked my dentist the same thing. I paraphrase, but he said that Tamu can be caused by bruxism (grinding), which is directly caused by sleep apnea. He said the device will treat the apnea which in turn treats the grinding.
Kool
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AG
An oral appliance has to bring your mandible down and forward in order to treat apnea.
A TMJ device, in contrast, holds your teeth in a more relaxed, normal position while also preventing grinding them down.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
JonSnow
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Swarely said:

Had an oral appliance for about a year. My sleep improved, but I fought the appliance every night in my sleep. My jaw muscles actually became noticeably bigger in that year. Got to the point that one day I yawned and felt something pop in my jaw. Couldn't chew for days. Shortly after that one morning my teeth would not realign no matter how long I left the bite thing in.

Long story short, had my tonsils and uvula removed. Also had my nose roto rooted. That was about a month ago and I can breath and get a good nights sleep for the first time in my life. Recovery from surgery was one of the worst things I have ever gone through.
Facing a decision about that exact same surgery. Hate, hate, hate my CPAP. Just can's sleep with it. My wife is about to throw me out of the house. But dreading the surgery. How long were you miserable for?
ellebee
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I don't feel like I got any relief with the cpap and I hated it too so I just gave up.
Spore Ag
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Had one of my best friends pass away in his sleep two months ago. Classic symptoms. Died about 3-4 in the morning, overweight, over 17 inch neck size, high stress from work, small nares, bagged eyes, crowded teeth and interrupted snoring. All my lectures went on deaf ears and feel I could have done more.
Apnea is real and there really is not a silver bullit.
I have seen relapse from surgery and it is tough. Have an ENT ck for nasal obstruction first. As stated above try a custom mask with the nasal pillows. Loose weight! Lower stress.
By the way my friend was class of 78 and was a real wake up to all of his friends and associates.
AggieChemist
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AG
Have worn a CPAP for over 14 years, and can't sleep without it.

Still have severe apnea, even after losing 70 lbs.

Still love my CPAP.

Wish my dad would go get one. His apnea will kill him one day. He had a mild heart attack and 2 new stents last week. Borrowed time.
94DallasAG
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AG
JonSnow said:

Swarely said:

Had an oral appliance for about a year. My sleep improved, but I fought the appliance every night in my sleep. My jaw muscles actually became noticeably bigger in that year. Got to the point that one day I yawned and felt something pop in my jaw. Couldn't chew for days. Shortly after that one morning my teeth would not realign no matter how long I left the bite thing in.

Long story short, had my tonsils and uvula removed. Also had my nose roto rooted. That was about a month ago and I can breath and get a good nights sleep for the first time in my life. Recovery from surgery was one of the worst things I have ever gone through.
Facing a decision about that exact same surgery. Hate, hate, hate my CPAP. Just can's sleep with it. My wife is about to throw me out of the house. But dreading the surgery. How long were you miserable for?

Had the surgery done in 2009, same as swarley. The tonsils were the worst part, a few weeks of hell (I was given liquid hydrocodone - watch out with that stuff). The roto rooter, LOL, of the nose was actually not that bad although they recommend you don't blow hard for about 4-6 months.

It was a life changer for me. Yes the recovery is tough but I have slept like a baby for the past 8 years and no snoring, ever, at all. I was miserable for years sleep was hard to come by. Nowadays I lay down to sleep and sometimes wake up in the exact same position, fully rested, without an alarm, ready to go (and I get up at 4am every day to go to the gym).
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