A reader writes:
I started with the mouth piece your reader described. I don't know what it's called, but I got it from this guy. (I lost it, and just recently found it five years later.) Anyway, now I use a new thing called ProVent, which I love. They are basically valves you stick over your nose. You can breathe in fine, but breathing out is slower. This increases the air pressure in the windpipe even if you breathe through your mouth.
I guess they are fairly new. My doc said he was reluctant about trying them, but he kept hearing about good results with them. He tried them with me because CPAP filled my stomach with air. My lab results using them were good. Downside is that if you make a mistake putting them on you have to put on another pair (they are disposable, one-time-use), and sometimes they come off. Otherwise they work great.
I discovered I had apnea when I met my current partner and he refused to let me move in until I got tested and CPAP'd. I felt like I woke up out of hazy dream afterwards. Try this headgear. It does not touch your face except your nostrils.
My wife noticed the apnea.
I went and had the sleep test/super-tentacle thing done and sure enough: moderate sleep apnea. Got the CPAP, tried the nasal pillows, the face mask, the full (hockey mask) face mask ... no dice. For some reason I start to yawn as I fall asleep and the pressure of the CPAP makes it hard to yawn and wakes me up because I feel like I am choking.
So back to the pulmonary doc. He suggests talking to an E/N/T. Talked to the E/N/T and he said surgery was a possible option, but maybe I should try an occlusal mouth guard. Gives me a prescription for one. I go to my dentist, they make the mouthcast, and a week later I have my mouthguard ... I LOVE IT! It's uncomfortable for the first few weeks, but I don't snore anymore and my wife says I'm not having the episodes of 'choking' while I'm sleeping.
Here's the mouthguard info. I don't know anything about brands or who's better or worse or anything like that. This is just what they got me, and what I'm happy with.
After failed experiments with CPAP and a not particularly successful bout of surgery, an oral surgeon recommended this mouth-guard type device. I got quoted $2000 for a fitting that, having been laid off and now having lousy health insurance, has been a real mental battle as to whether it's worth that much for another gamble at a normal life. There are apparently a couple of different firms offering devices like this.
Like you and one of your readers, I had the wired-up study and was found to be having 80 apneas an hour. I had been tired since high school (I was 43) and thrilled to finally have an explanation. Like another reader, I had trouble using the mask. I usually fell asleep, but wearing the mask sucked the peaceful joy I feel laying my exhausted head on a pillow. The seal problem was huge because the pressure I need is very low and a busted seal renders the thing useless (so does a loose set screw, or a few kitty-claw punctures). I could only bring myself to use it 3-4 nights a week. My life improved a lot but tiredness remained.
Sleep apnea accessories must be real moneymakers because they are continually improving. My first mask looked just like the one you are wearing. I am now on the third generation and the current mask (Swift LT) works enormously better - I can even sleep on my stomach with it. There is a single nasal pillow with two outlets and the seal is really good once you get the nasal angle right. My Giant Schnauzer has discovered the nasal pillows are delicious to eat and when that happens I have to go back to an older model. There is no comparison; it's awful compared to the LT.
For the past 6 months I have made a special effort to use it religiously every single night. After 10 years of using a CPAP I'm still getting improvements in my energy level and alertness. I bet the technology will improve to the point that we will just be able to get implants.
Andrew, the dental device your reader mentioned is generally called a mandibular advancement device. My understanding is that the most state-of-the-art brand of these devices is called the SomnoMed. Since you're in DC, I can tell you that by all accounts, the number one doctor in the area for this is Dr. Sylvan Mintz in Bethesda. (I have no affiliation; I'm just a sleep apnea sufferer who just started trying this device myself.)
By the way, thank you for all your accounts of sleep apnea. It has been very inspiring for me to read about such productive and well-known people as yourself who have worked through this problem successfully. The frustration of sleep apnea is nearly unbearable otherwise.
(Photo by Flickrite mia3mom. The caption reads: "Love is sleeping after your daughters crawl into bed. Love is wearing your CPAP every night.")