Posted by Breezely on June 09, 2009 at 08:47:54:In Reply to: Mandibular Advancement Device posted by MuddyWater on June 05, 2009 at 12:42:15:
In my original sleep study I had 243 apneas in a 6 hour period. That's about one every 90 seconds. The CPAP reduced that to 3-5 apneas a night after lots of fussing with pressures.
I finally realized that my tongue was falling into my throat and that by pushing my jaw forward I could breath much better. I trained myself to sleep on my side and kind of hang my jaw over the edge of the pillow. This reduced the apneas to 3-5 a week.
Later they started developing these positioners. I bought a soft, self-moldable one from a guy in Canada and it almost totally eliminated the apneas. When properly molded to my teeth I would get fewer than one apnea a month. (Always using the CPAP, too, of course.) But they were difficult to mold with just the right jaw extension and being soft plastic they loosen up after a month or two.
I looked around and found the Thornton product (TAP-2 is the current one) and had my dentist fit it. The cost was breathtaking, but the results are excellent. It clips onto the teeth - uppers and lowers are separate - then you connect the top to the bottom with an adjustable hook. So your lower jaw just hangs by a hook, allowing some limited movement so your jaw muscles don't get hurt. Being adjustable I can set it precisely where I want it. Not far enough out and the tongue can still flop into the throat, too far and you hurt the jaw joint.
Now my brother is using the TAP-2. He can use it without CPAP, but I have more floppy tissue in my throat so I do need both. The tongue and the excess throat tissue are really two separate issues.
So I highly recommend the TAP-2 device IF your problem is your tongue falling into your throat. If you do not have that problem, then I doubt it will work.
My suggestion is this. First experiment with taking deep breaths while pushing your jaw forward. If you find a point where breathing becomes much easier, then try one of the self-mold units from that guy in Canada. (I think they were made in Germany so I assume other places have them, but I don't know who.) Buy two of them because you will probably screw one up learning to mold it. Take your time getting all setup and prepared for the molding process because it happens fast and you only get one shot at it. If the self-mold type helps you, the TAP-2 will probably help you a lot and for much longer. Mine start to lose their grip after about two years. At $750 a pop (and no dental insurance) I wish they would last longer, but that's about a dollar a night for really good sleep...I'll pay it.