Sleep Apnea non-CPAP solutions
I'm losing my mind in the weeds on this so I'm desperate for advice. I was diagnosed with moderate sleep apnea this spring after many years of high blood pressure that isn't fully managed w/ meds. I'm not sure I've EVER felt refreshed when I wake up in the morning in my life. I always thought it was for other reasons (motherhood, stress, perimenopause, hot flashes, migraines, the list is endless).
A CPAP is a non-starter for me. My reasons are excellent but too personal to share publicly. And nothing like Inspire - I don't want anything implanted in my chest.
I have Kaiser HMO and have been thru the sleep study and have spoken w/ a sleep doctor. He gave me a MyTap boil & bite device which allegedly will work "enough" to allow me to pass the 2nd sleep study which is required to give me a referral for a dentist who will make a custom oral appliance. The disclosures on this temporary device are making my head spin with the risks to my bite and my jaw and my teeth. My insurance will definitely pay in full for a custom device - the DME is great and doesn't seem to have any conditions on it aside from a referral.
I haven't had a drug induced endoscopy yet, thought am wondering if I should to know the true reason for my apnea. I have a deviated septum, which is only tangentially related, but I understand fixing it won't address the apnea. I've tried breathe right strips and flonase, but that's only making nasal breathing more comfortable (which is good, true), not changing the apnea episodes.
I would love a permanent solution to this rather than a lifetime of any number of devices. I do not think I'm willing to go as far as full jaw surgery or palate/tongue surgery. I understand that Stanford is better at solutions for this than Kaiser and that other countries are better at this than the US is, but how to engage with them as a Kaiser patient? I've read James Nestor's Breath book and there were a few ideas there too. The one orthodontist I spoke with said that I'm too old (52) for a palette expander. Am I?
Has anyone - especially someone with Kaiser insurance - figured out the least obtrusive way to solve this? Any recs for professionals in the Bay Area?
I'm all over the place trying to figure out how to move forward, so if you have any ideas or anecdotes, I'm all ears! Thanks!
Parent Replies
Hello;
I hear you. My partner has moderate sleep apnea and wears a CPAP which he hates tremendously but it does work.
Our kid was following on the same track, and we did 9 months of Myofunctional Therapy with Virginia Downing. It's a HUGE commitment (time and financial, and Kaiser wouldn't cover any of it of course), but she got our kid using his tongue differently through a series of daily exercises. He did have a frenuloplasty (his tongue was fairly tethered to the bottom of his mouth) which, combined with the exercises, has made a huge difference. She's intense, it's a real commitment, but you could even just do a consultation with her and see what she thinks. Here's her info--
https://orofacialintegrity.com/breathing/
Best wishes to you.
First of all, I'm so sorry to hear about your distress. Sleep is so essential and poor sleep is a huge deal. I totally feel for you. I would encourage you to go all the way with the diagnosis to understand exactly what is going on that is causing the poor sleep. I say this because I think that's the only way to really understand what options will (and won't) work for you, since there are lots of treatments out there, but none of them work for everyone as there can be many causes of OSA. I'll just share that personally I am in a very similar place as you (50 something peri mom, etc) and my sleep started to take a turn during the pandemic. I had an at-home study where they said 'congrats, you don't have SA" even though I do stop breathing a certain number of times per hour (below the threshold for mild). I tried to try to figure out what may have changed. I had been singing in a choir for years and stopped during the pandemic. Guess what? The muscles I had been using were basically weakening, causing an increase in sleep related apneas. I purchased a CD "Singing for Snorers" and started the exercises, and things improved a lot. Not to say this is a path for you, but understanding what was happening helped me figure out how to make things better. I'm also interested in this new device eXciteOSA Clinically Proven Daytime Therapy for Mild OSA and Snoring - eXciteOSA. At any rate, there are SO many people suffering from OSA and there seem to be new treatments being developed all the time. I hope you can get to the root cause and work your way out of it from there. Best to you!
I have experience as a Kaiser patient who was recently diagnosed with severe sleep apnea. I did get a CPAP. You said you don't want that, but maybe my experience will be helpful. It took me a couple of months to fine-tune the fit so it was comfortable. I do not use the full mask, just the little "cushion" that sits under the nostrils and delivers the pressure that keeps your airway open. For the first few months I felt very resentful about having to wear that stupid thing and I cursed it every night. But a year later, the CPAP is my friend. I sleep all night long. It is comfortable to wear now that I've figured out the logistics, and I would even say it is soothing. It's also completely quiet - it's hard to tell when it's on. I am also completely quiet now - no more snoring - which my husband appreciates. I've taken it on a dozen trips - it's very portable. I know you said you don't want the CPAP, but the other options you listed sound worse than a CPAP. Maybe you could give it a try for a couple of months. If you don't like it, you've lost nothing and you can move on to a different option. I'd be happy to answer any questions.