TXLadybug wrote:

How can I find out who in my area makes the Somnodent product?

There's a sticky at the top of this forum's index discussing that, or click here:
http://www.apneasupport.org/viewtopic.php?t=2550

Good Luck!


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Resmed VPAP Adapt SV, Mirage Quattro mask with lots of tape. C5/6 quadriplegic since 1990

Txladybug-
I found my dentist thru Somnomed at this link:
http://www.somnomed.com/Contact_Us.aspx

I am very excited to hear about these oral appliances.  My dentist initally wanted me to go that route, but then my doctor sent me for a sleep study.  The sleep center could only do half of the study (I told them I have bed bugs so they wouldn't do the test at the center.  They sent me home with the equipment telling me I wouldn't infest the equipment.  Turned out that wasn't true.  They refuse to let me come in for the next test and I refuse to take any more equipment home since they admit they don't know how to treat it after it's been in my bed and exposed to bed bugs.  They just keep telling me it isn't a problem, which several pest control professionals have told me is not true.)  

Anyway, I was told my sleep apnea was not severe from the first test (they gave me no scores, just told me by phone.  They don't even want me to come into the sleep center to see the doctor to find out how my test went!)  In the meantime, until I get them to do the next test me without my having to take more equipment home and infesting it, I was thinking of getting the dental advice.

How much does it cost? A broad range will do.

Can you use the device with an orthodontic retainer?  I wear one of them.

Thanks for all the great posts here.

You have every right to see the doctor and go over your test results.  You also have the right to obtain everything that is in your patient file – including your sleep study report.  You need to see your results to determine the severity of your sleep apnea and other important details.  I would contact that sleep study center for this information – they are being paid for a service that is not being performed.  A good FDA mandibular advancement devices start out at least $1500.  Your insurance may cover the costs but you will need the sleep study results.

I will ask the sleep health center for my test results.  I want to make sure that the file does not say I refused to take the next test (titration) that they wanted me to take or simply did not call back to schedule it.  I want the next test but will not take it at home since the equipment will get infested.  They want me use their equipment at home but that shows a lack of knowledge of bed bugs.

Well, I called SomnoMed today and got numbers for 2 dentists in my area.  What I"m afraid of is that if I pursue the dental device, they'll take away the cpap (which the ins. co rents for 10 months, then I own).  My original AHI was 30.7, just over the severe marker, so I wonder if the device would help me enough to not need cpap?  Right now I'm avg 7.4 ahi for past couple of months.


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ResMed Auto Set II w/hi4 Pressure 9 - 20 EPR at 3 SleepWeaver, Mirage Micro, Liberty, FitLlife
Orig AHI 30.4 RDI 36 & RLS/PLMB

TXLadybug- Only a qualified dentist can determine how much you could benefit from an oral appliance.  Just like using Cpap it is a very individual thing.  Everyone that I personally know that uses a oral appliance got enough relief to eliminate CPAP.  I have chatted with some that use both CPAP and a oral appliance.I was the worse at 49.9 AHI.  My co-worker was the lowest at 19 AHI.  I am now at 9 AHI and my friend is at 5.5 AHI.  Both of us average 93% O2 at night.  I could not pass a titration study due to anxiety problems with the mask and pressure.  My friend just hated CPAP and refused to use it.  The Somnodent MAS has given me back my life.  Check into the Somnodent after you own your CPAP.     Good luck to you

hymaneric wrote:

Will let you know when I get the PSG report later this week, but the AHI must be less than 5 because at that  level  they were supposed to wake me up to increase the adjustment on the Somnomed and they did not need to do that.  The technician told me that my results looked very good and showed very little snoring.

My results were 3 respiratory events in 317 minutes of sleep, an AHI of 0.57.

How many adjustments did other users of Somnomed devices have to make?

I've got the newer Somnomed flex device, and get a little teeth pain across the front teeth in the morning, its across all so I think its just how far I have adjusted the device.
 I complete an adjustment as 2 winds on either side, I was told this is 0.5mm (for 2 winds).

I've done this about 6 or 7 times now with minimal or no change in sleep quality, did other users have the same issue?
 I have had the device for approx 5 weeks now and no improvement in sleep apnea, I will see the dentist about further adjustment in a couple of days.
 At one stage I did an adjustment very morning for about 4-5days to see what would happen...nothing really, the pain was similar.

In the mean time I think I'm going back on modafinil as I can't cope with the constant fatigue.

I have mild sleep apnea, it only occurs during REM sleep with no problems with oxygen level, its all hypopnea's, I don't have major issues with falling asleep during the day, its the mood-swings, memory problems, concentration and desire to sleep all the time which are driving me insane.

Also, I do have an overbite, probably a few cm's and the device is not that my lower jaw is equal to my upper jaw....there doesn't appear to be a lot of adjustment left in the device...

I was told that my Somnodent MAS acrylic adjusted 1 mm for every 10 turns (winds).  I went to my dentist every two weeks for a .5 mm adjustment and exam.  I have had no pain in my teeth or jaw.  I was retested for sleep apnea at 3 mm of adjustment and my AHI went from 49 to 29.  I continued the adjustments and I am now adjusted to 5.5 mm.  My last PSG test indicated I now have an AHI of 9.  There seems to be more adjustment but my dentist and Sonomed agreed that adjusting too far makes the device unstable. I would like to adjust out another .5 mm.  It took about three months before I really felt the affects of sleeping better.

Yes, it takes 5 forward clicks on each side to equal 0.5 mm.  My dentist started me at 2.0 mm (15 forward clicks since the device itself begins with 0.5 mm) and I did 5 forward clicks at a time starting 3 days after I was using the device for the full night.  I scheduled a sleep test at 3.7 mm.  I stopped using CPAP 3 nights before the test.  The first day without CPAP I realized that 3.7 mm was not enough as I had much fatigue.  I moved it to 4.2 mm and did not have any fatigue t he next 2 days. That was where I had my repeat PSG and it turned out to be perfect for me at that setting.  I don't have a large face or neck.

Thankyou for the prompt replies, so its only moving 1/5mm each time I adjust, therefore I've only moved it a mm so far.
 It does make a difference to me but no positive side-effects sleep wise, I have a dentist appointment tomorrow so will definitely consider moving it by many more clicks each time...

3 months before you had the full effects? Hmm, that's a while.

What about short term effects?

I really want some kind of short term relief, I'm starting to go insane...at this stage nothing has changed, I've felt no effect so far of the adjustments.

I was diagnosed with OSA over twenty years ago.  Back then all that was available was CPAP or throat surgery.  I have been unable to acclimate to CPAP and didn't find the success rate for surgery appealing.  My adjustment period was longer than most.  I went two to three weeks in between adjustments.  I was worried that adjusting to fast might cause problems with my teeth or jaw.  I was in no hurry and wanted to give my teeth and jaw time to adjust to my dental appliance.
  In the short term my morning headaches disappeared the first week.  My waking up 10 -15 times each night dropped to 1-2 a night.  My daytime sleepiness got better every week.  My fatigue slowly got better and today is alot better.   Since starting to use my Somnodent MAS I have lost 61 pounds, been able to stop my BP and cholesterol medications.  The Sonmdent MAS has given me the energy to excercise daily. This along with a change in lifestyle has given me back my life

Finally saw the dentist, the device is been adjusted to move it 4-5mm forward, and then I can start the winding again if I need more advancement.

I am on the 4th version of my Somnomed mas; the previous versions were not either to my liking or not fitting well.

I upgraded from a TAP3 to the Somnomed last year, but the first version was an acrylic model, with the metal pins to hold it in place, and the interior was rigid plastic. Sure the model was tough, but it could easily break if dropped. I tried it for 2 weeks, but returned to my dentist to show the fitting issues, it was then he showed me his soft interior version. Next I tried the soft version, but by the time it was ready, my tonsillectomy was in a few days. The 2nd version wasnt customized to my current bite, which had changed since the days of my TAP3; my lower jaw had advanced to be equal with my upper teeth. So with this version I had to advance it to the end of the screws, maybe 7-8mm. With the gap so large between the plate and the advancement tabs, there were some rather sharp corners that were cutting into my inner cheeks when it was extended this far. By now my dentist had switched to another lab to make the device.

After my surgery, my teeth moved a little (my dentist said it was from the release of pressure on my teeth from my tongue after the tonsils were removed), so neither the TAP3 or Somnomed would fit well, it was quite painful trying to use either device. And I did not try anything until after my surgery followup which happened 1 month ago. Well, my OSA was still there after my surgery, but a little easier to breath now thankfully. I jumped back on CPAP for the time being till my device was remade/fitted again (I borrowed a APAP, and will purchase one soon as a backup to my MAS's in fact).

Version 3 was made 3 weeks ago, but the advancement was again not based on my current bite registration, and the dentist insisted to add a extension at the front to allow for grinding, but this kept my mouth open and didnt allow for lip seal which I needed to have for my mouth breathing issues. So my dentist made new teeth molds and a bite registration.

I got version 4 this tuesday, and it fit like a glove, and its initial starting position advanced my lower jaw a good 5mm, so i didnt even have to advance it. So far its been great, I might advance it a little in a couple weeks, but I now have a closed mouth with almost potential for lip seal after we removed the "bump".

My TAP3 is being altered to accommodate for my new bite registration, but I found that there was more pressure on my front teeth with this one then the Somnomed MAS, so will keep as a backup also.

My wife woke last night around 3am and heard me "Buzzing" in my sleep, so still working on getting the best advancement, but no headaches and alot more energy now.

The moral is that getting the best fit sometimes takes a while to achieve, and make sure you tell your dentist about ever issue, and be persistent ;) .

good luck to all.