Anti snoring mouthpieces?

[ratski]

Dental Insurance will NOT cover sleep apnea treatment. This is in the medical field, so medical insurance is filed. Again, you have to work with someone that knows how to do this, it is NOT the same as Dental insurance and there are lots of hoops to jump through especially for a dental office filing medical insurance.

No one is trying to sell you on a CPAP. You either need treatment or you don't. If you need treatment, you get to elect to be treated or not treated.

A medical benefits check through an office that routinely deals with medical insurance and knows the appropriate codes is usually pretty simple.

Looks like you are close to Tulsa.

Angie Nauman is up there and one of the best. http://www.glistendental.com/

There are other places to check credentials:

The American Academy of Dental Sleep Medicine website is: http://www.aadsm.org/

The American Sleep and Breathing Academy website is: http://americansleepandbreathingacademy.com/

Having a dentist that is a member of one of these two academies shows you that they take this stuff seriously.

Finding a dentist that is a Diplomate of either of these academies shows you that they not only take it seriously, but have taken the extra steps of testing and education that are needed for that level of recognition.

Angie is a Diplomate of the AADSM. I think that she might also be a Diplomate of the ASBA

I have taken the tests for the ASBA and am just dinking around before submitting my final cases for Diplomate status.


You could also Google Dentist, Sleep Apnea and see who and what comes up.

Dave

 

[_CY_]

So how do you tell if your dentist knows what he's doing as far as apnea is concerned? I want to do the appliance, but he said that insurance may not cover it. I damned sure am not paying what I'll have to pay for a sleep study; my deductible is $1500, and since I go to the doc but never, that ends up being a nasty bite out of my budget. Then they'd no doubt try to sell me on the rotten CPAP - which I really have no desire to mess with. My apnea is enough that it's hard for me to sleep on my back, though my wife says I do from time to time. I usually "choke" as soon as I fall asleep and it jars me awake, but I guess sometimes I get away with it. Sleeping on my sides is no problem, but I'd like the option..... Would be nice if there was some referral reference for dentists that are experts in this field, so those of us who want to go the appliance route don't have to gamble with time, money, and pain in the ass testing.

sorry but there are no substitutes for trying out different possible solutions. you could go to the most qualified dentist for an oral appliance and/or sleep doctor for a cpap or bipap (bilevel) machine .. then find out you cannot tolerate the oral appliance and/or cpap machine.

this is why there are soooo many used $2,500 cpap/bipap machines for sale on Craigslist. perhaps that person actually cannot tolerate said device, but more likely that person didn't receive the after support needed to get into compliance. perhaps a different mask was needed, different pressures, a different machine and/or all of the above.

the good news is technology is marching on .. with each generation of cpap machines getting smarter and smarter with auto titrating machines that will set intake and expiration pressures on the fly. free sophisticated tracking software like Sleepyhead with loads of data points to help dial in your settings and most importantly give feedback that your treatment is actually working or not, so you can take steps to fix.

your first stop really should be a sleep doctor at a sleep lab. although a trend is for insurance companies to send home an auto titrating machine to see if you are able to stay in compliance. meaning one is able to use auto cpap machine for a set number of hours (4 hours?)

that auto cpap machine will track all sorts of data like number of events per hour, intake pressures, expiration pressures, AHI (apnea-hypohnea index) central apnea index, etc.

 

[cjjtulsa]

I've heard Angie Nauman's spots on the radio, and did visit her website earlier today. I might contact them in the future, as I'd like to get something done about it. If not, I'll roll the dice and remain a side-sleeper.

 

[druryj]

I sleep with a CPAP and have for years. I had no idea how bad my sleep apnea was until I got the sleep study done. I was having like an average of 37 "events" (an event is when you stop breathing) per hour and getting zero stage 4 sleep. I woke up every day tired and cranky. Now I just wake up cranky. Life is MUCH better now, I put that mask on, dial 'er in, push the GO button and it's off to la-la land I go. It's amazing how much better you function when you get real sleep. The CPAP has device saved my life, of that I am almost certain. If you snore, wake up a lot, gasp for air in your sleep, don't dream...do yourself a favor and get a sleep study. You might live a better life and have a few more years to enjoy it too.

 

[John6185]

I have been wakened since a teenager at 145 lbs gasping and coughing. I slept on my stomach most of my life but due to arthritis of the neck finally couldn't stomach sleep. Then I slept on my side and back and that's when I received the diagnosis of severe sleep apnea. Had it all along thru the years and didn't know.
I've been to various Sleep Specialsts and sent for. "Titration" test and the doc said, "I didn't qualify." The VA sent me some a sleep study Titrate and the doc who said I dint qualify read the report and said I had severe sleep apnea. They aren't all looking out for the patients best interests so the patient has to try and manage their own health.
And Dave, I respect what you have said and appreciate that you don't resort to calling people names-you must be a Republican! :>)

 

[Mos Eisley]

The VA took care of my sleep study and CPAP machine at zero cost to me. They provide all devices like new hoses, headset, nasal pillows, filters, etc every six months or so and I never see a single dime billed to me. They also make me come in at least once a year and pull the memory chip from the machine to ensure that it is operating correctly and providing the benefit it should. Absolutely no complaints about the VA when it comes to this.

As far as not wanting a CPAP because it seems like it would be a pain, or you feel you're too young...you have no clue what you're missing. Your family might some day when you're dead or have a stroke. The hoses aren't much of an issue for me. I don't really notice them except for that once every six months or so when I stretch to the far side of the bed, roll over and yank the machine off the nightstand. That's a big pain in the arse with water everywhere and up in the hose. Fortunately, that's rare. It is no different than carrying a laptop when it comes to traveling with it. You just need to buy distilled water whenever you get to where you are going. Overall, the comfort I feel when I'm using it is definitely one of the things that puts me to sleep every day.

 

[ratski]

I have been wakened since a teenager at 145 lbs gasping and coughing. I slept on my stomach most of my life but due to arthritis of the neck finally couldn't stomach sleep. Then I slept on my side and back and that's when I received the diagnosis of severe sleep apnea. Had it all along thru the years and didn't know.
I've been to various Sleep Specialsts and sent for. "Titration" test and the doc said, "I didn't qualify." The VA sent me some a sleep study Titrate and the doc who said I dint qualify read the report and said I had severe sleep apnea. They aren't all looking out for the patients best interests so the patient has to try and manage their own health.
And Dave, I respect what you have said and appreciate that you don't resort to calling people names-you must be a Republican! :>)

Don't feel bad about having this stuff since you were a teenager. Not sure how old you are, but the first CPAP machine didn't roll off the line until ( I think) 1982.

Sleep apnea is something that wasn't taught in general medical school until the mid 90s.
I know a lot of MDs that tell me "I just don't know anything about this". And I can tell you that is a HUGE statement for an MD to make.

Dental treatment of sleep apnea is not widely taught in most dental schools. I talk with some of the guys on staff at various schools and cringe at some of the comments I hear. I talk to my contemporaries and really cringe at some of their comments and 'treatments".

I had a sleep study done in the 90s and there was "Severe Snoring" but no mention of sleep apnea.

Mine is severe enough that I wear both the CPAP and the Oral Device at the same time.

The VA is good for CPAPs and Uncle Sam is good for CPAPs and Surgery, but they are slow to accept the Oral Devices even though the evidence of effectiveness is mountainous and the American Academy of Sleep Medicine now recommends them as front line treatment.

This is an area that we will see more and more of over the next several years as the number of people affected by it are staggering. Medical insurance is already dropping their re-reimbursement levels in a lot of areas. Same for Medicare.

BTW, I'm registered as a Democrat (Heaven forbid!!), think like an Old School Republican, Act like a Libertarian, and really wish I could be an Independent!!!

Dave



Dave

 

[_CY_]

the dirty little secret for sleep apnea treatment is compliance .. or more accurately the lack of it. compliance being defined as using your cpap appliance more than 4 hours a night.

the gold standard for apnea treatment is cpap or a form of, which according to studies can be more than twice as effective vs oral appliances.
of the flip side oral appliances has a higher compliance percentage with studies showing about 30% of patients not responding vs studies showing cpap compliance rate of about 50% with some studies indicating compliance low as 30%.

there's ton of data out there if one cares to dive in ... zzzzz ...
below is an abstract that gives a brief summery of linked paper imediately above to full pdf.

Oral Appliance Treatment for Obstructive Sleep Apnea: An Update
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899326/

Long-term compliance with continuous positive airway pressure in patients with obstructive sleep apnea
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2679572/

Interventions to Improve Compliance in Sleep Apnea Patients Previously Non-Compliant with Continuous Positive Airway Pressure
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556913/


Adherence to Continuous Positive Airway Pressure Treatment for Obstructive Sleep Apnea: Implications for Future Interventions
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2972705/

Abstract
Adherence to continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) is a critical problem with adherence rates ranging from 30–60%. Poor adherence to CPAP is widely recognized as a significant limiting factor in treating OSA, reducing the overall effectiveness of the treatment and leaving many OSA patients at heightened risk for comorbid conditions, impaired function and quality of life. The extant literature examining adherence to CPAP provides critical insight to measuring adherence outcomes, defining optimal adherence levels, and predicting CPAP adherence. This research has revealed salient factors that are associated with or predict CPAP adherence and may guide the development of interventions to promote CPAP adherence. Over the past 10 years, intervention studies to promote CPAP adherence have incorporated a multitude of strategies including education, support, cognitive behavioral approaches, and mixed strategies. This review of the current state of science of CPAP adherence will (1) synthesize the extant literature with regard to measuring, defining, and predicting CPAP adherence, (2) review published intervention studies aimed at promoting CPAP adherence, and (3) suggest directions for future empiric study of adherence to CPAP that will have implications for translational science. Our current understanding of CPAP adherence suggests that adherence is a multi-factorial, complex clinical problem that requires similarly designed approaches to effectively address poor CPAP adherence in the OSA population.

 

[John6185]

I have the VA issued CPAP and have worn one out and I use it every night but still cannot obtain a quality sleep. I awake in the AM and I'm sleepy and stay that way the rest of the day unless I take a nap. I can't begin to tell you how excited I was when I first received the CPAP, I thought that I would fall asleep and be refreshed in the AM but it never happened.
I had a very erratic childhood and maybe that's haunting me psychologically? Beats me.

 

[_CY_]

I have the VA issued CPAP and have worn one out and I use it every night but still cannot obtain a quality sleep. I awake in the AM and I'm sleepy and stay that way the rest of the day unless I take a nap. I can't begin to tell you how excited I was when I first received the CPAP, I thought that I would fall asleep and be refreshed in the AM but it never happened.
I had a very erratic childhood and maybe that's haunting me psychologically? Beats me.

what you need to do is see a sleep doctor for an updated sleep study. but he is only going to be able to give so much support.
visit http://www.apneaboard.com/forums/index.php ..
post your problems with exact machine used, pressures and any other data you are aware of.

most likely folks at apneaboard will dive in and find a solution.
they will help find the manual that allows you to change pressure settings, etc.

if your cpap machine is close to worn out, most insurance will pay for a new machine after 5 years. please consider getting a data capable auto titrating machine. with sleephead software capable machines you can post up data at apneaboard .. those folks are very helpful especially when given enough data points to work with.