Sleep Apnea/Snoring Mouth Guard Recommendation.

[DawnCt1]

Does anyone have a recommendation for an over the counter sleep apnea/snoring mouth guard. DS#1 has sleep apnea, refuses to even consider a C-pap but is willing to try a mouth guard. thanks

 

[themarquis]

Is there a reason that he refuses a cpap?

A mouth guard is never going to be as effective as a cpap -- at most, it will decrease the number of apneas he has every night by a small amount. It may help a bit if he refuses all other treatment. I would not go the route of using an over the counter guard, but would have one custom-made by a specialist dentist.

Another option for someone who refuses cpap would be surgery, but he may refuse that as well. Is he overweight at all? A small weight loss (even if he is just slightly overweight) would probably be more effective than a mouth guard, because it reduces extra weight on the chin/airway that causes it to close.

I assume as a medical professional, you know that untreated sleep apnea has a number of potentially severe medical consequences, such as significantly raising the rate of all-cause mortality.

Best of luck to you and your son.

 

[DisneyBlonde]

my dh went through all the testing, and was told that the mouth guard helps prevent snoring, but does not help with apnea. fortunately, his apnea is on the less severe side and does not require cpap. the mouthguard he uses is called PureSleep.

 

[MyDizneyBoyz]

DH snores like a freight train and has been through two sleep studies to rule out apnea and other serious issues. In his case, his snoring is caused by a loose palate (I don't remember the medical term - the skin is "flappy") and it could probably be resolved with surgery which he's just not ready to do. So to keep peace (literally!) he got a PureSleep mouthguard last year and it's been working very well for him.

It's not for everyone and is not a substitute for having any sleep issues diagnosed by a doctor, but in our case it's been a great fix.

One way to tell if it might work for your son is to have him make a snoring noise and then have him push his lower jaw out so that his lower teeth are just past his upper teeth and then try and make the snoring sound again. The PureSleep positions your lower jaw slightly in front of your upper teeth so that you sleep with a slight underbite and it's this positioning which alleviates the snoring. From what I can tell, this is what most of them do - it's a matter of finding one that's comfortable for you (or him) and that works in his particular situation.

It's adjustable to either 2 or 3 positions and DH uses the "lowest setting". My biggest concern was that it would affect his teeth position over time but it's been about 8 months of every night use and so far no change. Some nights he doesn't want to wear it and it did take him a week or two to initially get used to it but aside from that it's been okay. He actually brings it with him on business trips as he used to wake himself up when he snored too loud so he sleeps better with it.

 

[DawnCt1]

Is there a reason that he refuses a cpap?

A mouth guard is never going to be as effective as a cpap -- at most, it will decrease the number of apneas he has every night by a small amount. It may help a bit if he refuses all other treatment. I would not go the route of using an over the counter guard, but would have one custom-made by a specialist dentist.

Another option for someone who refuses cpap would be surgery, but he may refuse that as well. Is he overweight at all? A small weight loss (even if he is just slightly overweight) would probably be more effective than a mouth guard, because it reduces extra weight on the chin/airway that causes it to close.

I assume as a medical professional, you know that untreated sleep apnea has a number of potentially severe medical consequences, such as significantly raising the rate of all-cause mortality.

Best of luck to you and your son.

No reasons, just excuses. "I can't get used to a mask" (the sleep clinic has offered to help decondition him and try a variety of masks). "I am claustrophic", etc. Now its "don't even mention a mask". He was diagnosed with severe sleep apnea last year. He knows all of the health implications. He is somewhat overweight, no doubt in part due to his sleep apnea and increased cortisol production due to stress. He actually wrote a very detailed paper for one of his classes and presented it....on sleep apnea Now the shocker?? He is a straight A respiratory therapy student. I am sure you sense my frustration. Sooner or later reality may click. I am done nagging! In fact, I have been done for a while. When he complains that his throat is dry, he is tired, has a headache. I just say, "oh really?"
He would have been very happy to go for the surgical route (get it over and done with)but he is not a candidate and the surgery wouldn't benefit him.

 

[DawnCt1]

my dh went through all the testing, and was told that the mouth guard helps prevent snoring, but does not help with apnea. fortunately, his apnea is on the less severe side and does not require cpap. the mouthguard he uses is called PureSleep.

Thanks.

 

[SC Minnie]

DH has been using the Pure Sleep mouthguard for a couple of months for snoring. It has been great so far. The snoring hasn't completely stopped but it not so loud that I can't sleep. But DH doesn't have sleep apnea issues.

 

[Beth]

Thanks for starting this thread, Dawn...

My DH is fairly certain that I have sleep apnea (my Dad has it, too.)

....But I've been reluctant to do the testing. The idea of the CPAP machine bothers me - something about just being "too young" to have to resort to such a contraption!

But my insurance is changing from an HMO to an HSA on October 1st, so - if I'm going to do it - I probably need to do it NOW!

Let me know how it goes for him, okay?

 

[SC Minnie]

Thanks for starting this thread, Dawn...

My DH is fairly certain that I have sleep apnea (my Dad has it, too.)

....But I've been reluctant to do the testing. The idea of the CPAP machine bothers me - something about just being "too young" to have to resort to such a contraption!

But my insurance is changing from an HMO to an HSA on October 1st, so - if I'm going to do it - I probably need to do it NOW!

Let me know how it goes for him, okay?

If you suspect you have sleep apnea PLEASE do a sleep study. There is no age limit for sleep apnea. DD had it when she was around 6 and used a CPAP then a BPAP machine. She has since had surgery and no longer has sleep apnea.

The dangers that can occur from sleep apnea are very serious. Please, please, please get a sleep study.

 

[Duckfan-in-Chicago]

There are so many different causes of sleep apnea that the mouth guard might not even dent the issue.

From what I've heard about the oral guards they're somewhat effective in people who have mild cases of sleep apnea-people who wouldn't even qualify for a cpap from their insurance company.

 

[mrsmom]

Thanks for starting this thread, Dawn...

My DH is fairly certain that I have sleep apnea (my Dad has it, too.)

....But I've been reluctant to do the testing. The idea of the CPAP machine bothers me - something about just being "too young" to have to resort to such a contraption!

But my insurance is changing from an HMO to an HSA on October 1st, so - if I'm going to do it - I probably need to do it NOW!

Let me know how it goes for him, okay?

My 15 yr old dd had been on a cpap machine since she was 8yrs old, She was born with a small bottom jaw causing sleep apnea , she is having jaw distraction for upper and lower jaw next month and hoping she can get rid of her machine. So your never to young for a cpap machine. LOL.
Kim

 

[themarquis]

No reasons, just excuses. "I can't get used to a mask" (the sleep clinic has offered to help decondition him and try a variety of masks). "I am claustrophic", etc. Now its "don't even mention a mask". He was diagnosed with severe sleep apnea last year. He knows all of the health implications. He is somewhat overweight, no doubt in part due to his sleep apnea and increased cortisol production due to stress. He actually wrote a very detailed paper for one of his classes and presented it....on sleep apnea Now the shocker?? He is a straight A respiratory therapy student. I am sure you sense my frustration. Sooner or later reality may click. I am done nagging! In fact, I have been done for a while. When he complains that his throat is dry, he is tired, has a headache. I just say, "oh really?"
He would have been very happy to go for the surgical route (get it over and done with)but he is not a candidate and the surgery wouldn't benefit him.

Lol that is a shocker. I figured there was more to the story since I couldn't imagine a family headed by medical professionals would let him get away with something like that.

A couple of thoughts. First, this may not go anywhere since it sounds like he refuses to hear any more about cpap stuff!!!! But there is a newer kind of machine on the market called an APAP (auto pap). Basically, it automatically adjusts your pressure throughout the night to give you only what you need and no more or less. A lot of folks say there is little to no adjustment period because you can barely tell you are getting any air pressure through the mask. I think it's something like if you're just lying there awake and your breathing passageways are completely open, it does nothing (or maybe puts out a tiny bit of air)-- it only gives you the pressure later when you're asleep and actually start to have an apnea (something like that.)

My sleep doc is trying to get me one (I have a bipap now) and she claims that she loves the APAP because she can have a newly diagnosed patient, give them an APAP, and they all start using it right away, stay on it all night long, no complaints. (as opposed to regular cpap/bipap which folks hate, causing a lot of problems with compliance). I would say an APAP in combination with a nasal pillow (not a regular mask -- just a light little tube of plastic that sits on your nose -- you can barely feel it) might be the way to go if he is so freaked out about the whole thing.

BUT ... I'm sure he doesn't even want to hear it

Another thought -- has he thought about trying Provigil? This is a medication that is a stimulant only to the sleep center of your brain (does not affect the rest of your brain like regular stimulant medications). It has virtually no side-effects and keeps you awake and peppy all day long . I have residual sleepiness even on bipap, so I started to take it and love it. Now ... Provigil doesn't actually treat apnea, of course, so it wouldn't really help him with his real issue (i.e., him being a big baby ) but if he's tired (or has other symptoms which come out of tiredness, like crankiness, depression, mood swings, etc.) it will help him feel more functional.

It may be worth taking provigil just to decrease some of the risk factors that come with sleep apnea -- i.e., falling asleep or experiencing decreased alertness while driving and doing other dangerous activities. Provigil would likely keep him nice and alert all day and decrease those really scary risks (I think a big part of the all-cause mortality associated with apnea). PM me if you want more info about provigil -- it's great!

 

[Halloweenqueen]

Husband refused to be tested for years, but I finally had him tested a couple of months ago. He has severe sleep apnea. He didn't want the c-pap either and went to another doctor for a second opinion. He wanted the mouth guard but was told by both doctors that it wouldn't help. He even considered surgery, but they told him it wasn't a 100% chance of curing it.

He said he would just go without it. He is in terrific shape and has a BMI of a super model. I insisted he go in for a physical. He has high blood pressure, anemia, and high cholesterol, and other aliments.

I finally convinced him to give the c-pap a try. It was tough at first. He tried a couple of masks and machines to get it right. He is a different man after only 5 weeks of using it.

He has never had so much energy. He goes in to the doctor to get checked in 8 weeks and I bet everything has lowered.

After 12 years of the snoring, the machine noise is a blessing. I really don't hear it at all.

I think your husband needs to give it a try. The results are well worth it.

 

[Pea-n-Me]

Look into the Pillar Implant.

 

[DawnCt1]

Lol that is a shocker. I figured there was more to the story since I couldn't imagine a family headed by medical professionals would let him get away with something like that.

A couple of thoughts. First, this may not go anywhere since it sounds like he refuses to hear any more about cpap stuff!!!! But there is a newer kind of machine on the market called an APAP (auto pap).
Another thought -- has he thought about trying Provigil? This is a medication that is a stimulant only to the sleep center of your brain (does not affect the rest of your brain like regular stimulant medications).:

Yup, there is always more to the story. The best response when he complains of OSA symptoms is, "gee, I wonder what's causing that"? Hopefully, he will do a rotation in the sleep clinic soon and see what new "toys" they have.
We will definitely look into Provigil. I will mention it to DH. As long as it isn't a controlled substance, ie amphetamine, etc, he can order it. If not, DS's primary can order it. Thanks for the suggestion. I just mentioned to DS. He wants to know if its for central sleep apnea or the residual effects of obstructive sleep apnea.

 

[DawnCt1]

There are so many different causes of sleep apnea that the mouth guard might not even dent the issue.

From what I've heard about the oral guards they're somewhat effective in people who have mild cases of sleep apnea-people who wouldn't even qualify for a cpap from their insurance company.

I have no illusions that the mouth guard will help. It will be a "placebo", but I will pick him up one. This thread has been useful, because although he KNOWS all of this "stuff", when he hears it from "real" people, he thinks about it again. I read all the replies to him, including the "Big Baby" comment, which fits in this case. He said, " I am concerned about cardiac enlargement". My response? "Apparently not enough". Maybe someday.

 

[Duckfan-in-Chicago]

A couple of thoughts. First, this may not go anywhere since it sounds like he refuses to hear any more about cpap stuff!!!! But there is a newer kind of machine on the market called an APAP (auto pap). Basically, it automatically adjusts your pressure throughout the night to give you only what you need and no more or less. A lot of folks say there is little to no adjustment period because you can barely tell you are getting any air pressure through the mask. I think it's something like if you're just lying there awake and your breathing passageways are completely open, it does nothing (or maybe puts out a tiny bit of air)-- it only gives you the pressure later when you're asleep and actually start to have an apnea (something like that.)

I've had an auto pap since 2002 (actually 2 different models). I didn't have a problem adjusting to either. But at no point have I ever felt like there no air pressure through the mask. I'd guess like everything else these are all going to be case by case based on the prescriptions of the medical professional and the severity of the apnea. Now in my situation, my nose almost instantly plugs when I lay in a horizontal position. 3 surgeries later and it's a bit better but will plug before the night is over from laying horizontally-just one of my issues. I'd guess this is a reason my machine is set to ramp a little higher at start up, thought I never really asked. It is set to start high out of the gate.

As far as using my auto pap, there were times where I wasn't even 100% sure the machine was on because I adjusted to using it, the sound was so minimal and I had trained myself to breathing through the nose and down the throat, but then I'd open my mouth and the air would come whistling out.

Just a heads up for people....with some insurance companies you are able to get a new cpap after 5 years. I now have the new one and one for travel, so if I'm going on vacation I don't have to hurry home after work and pack the thing, which is wired up behind my bed. PITA to unplug anyway. Your insurance company isn't going to give you much of this information but if you ask they will tell you.

 

[JessicaR]

Another thought -- has he thought about trying Provigil? :

I took Provigil years ago for an extended period of time. Not for the same reason but the benefit was tremendous. I had no side effects whatsoever. I wasn't aware that they approved Provigil for sleep apnea. When I was taking it the majority of filled prescriptions were for off label use. I had a tough time getting it approved. My husband was dx'd with sleep apnea and having a very hard time adjusting to a cpap. I am going to have him read this thread, great info!

Are you familar with Nuvigil?

 

[themarquis]

Yup, there is always more to the story. The best response when he complains of OSA symptoms is, "gee, I wonder what's causing that"? Hopefully, he will do a rotation in the sleep clinic soon and see what new "toys" they have.
We will definitely look into Provigil. I will mention it to DH. As long as it isn't a controlled substance, ie amphetamine, etc, he can order it. If not, DS's primary can order it. Thanks for the suggestion. I just mentioned to DS. He wants to know if its for central sleep apnea or the residual effects of obstructive sleep apnea.

I'm pretty sure it's approved for narcolepsy, shift work disorder, and excessive daytime sleepiness caused by sleep apnea. It could be tht it's a controlled substance, but I'm not sure. I think it is "scheduled" (is that the same as controlled?)

Re: his question, it doesn't treat either central or OSA. It just stimulates the sleep center of your brain. Basically, it would work on anyone (including folks with nothing wrong with them, which is why provigil's a popular performance drug for scientists, doctors, academics, etc.). I think it's mostly intended for folks who are doing CPAP but have residual issues (i.e., not optimally treated OSA and/or coexistent CSA episodes), but I'm sure it would be helpful for someone who is not doing CPAP at all.

 

[themarquis]

I've had an auto pap since 2002 (actually 2 different models). I didn't have a problem adjusting to either. But at no point have I ever felt like there no air pressure through the mask. I'd guess like everything else these are all going to be case by case based on the prescriptions of the medical professional and the severity of the apnea. Now in my situation, my nose almost instantly plugs when I lay in a horizontal position. 3 surgeries later and it's a bit better but will plug before the night is over from laying horizontally-just one of my issues. I'd guess this is a reason my machine is set to ramp a little higher at start up, thought I never really asked. It is set to start high out of the gate.

As far as using my auto pap, there were times where I wasn't even 100% sure the machine was on because I adjusted to using it, the sound was so minimal and I had trained myself to breathing through the nose and down the throat, but then I'd open my mouth and the air would come whistling out.

Just a heads up for people....with some insurance companies you are able to get a new cpap after 5 years. I now have the new one and one for travel, so if I'm going on vacation I don't have to hurry home after work and pack the thing, which is wired up behind my bed. PITA to unplug anyway. Your insurance company isn't going to give you much of this information but if you ask they will tell you.

Well, I haven't gotten an apap yet so maybe I was wrong about it -- I just know what my sleep doc tells me. It does sound, though, like it would be a lot easier to deal with than a CPAP or BIPAP just because you only get the high pressure when you totally need it (and you are probably sound asleep)