“Now what?”

 

Bloat the blowfish, to his fellow sea creatures after they escape the dentist’s aquarium for the sea only to now have to escape their sealed plastic bags.

Finding Nemo (2003)

In last week’s post, I described how decades of dysfunctional breathing led me to first repair a deviated septum, then get diagnosed with sleep apnea.

Among the first things I learned was that my “mild” case meant I didn’t need a continuous positive air pressure (CPAP) machine. The device forces air into your airway while you sleep.

With that ruled out, I looked into practical options.

Mouth guards

I tried a couple of store-bought mouth guards to keep my airway clear during sleep. You boil and bite the guard to customize its fit, so the fits were good given the several-dollar price point.

Unfortunately, I got what I paid for because the results were awful. I suspected I needed a custom fit to bring relief. I discovered there’s more to it than the custom fit, which I’ll clarify soon.

With some investigation, I learned of another device with an incredible track record.

Sleep appliance

A sleep appliance looks like a mouth guard and reminds me of the retainer I wore in my teens once I had my braces removed.

Insurance coverage

Because a sleep appliance goes in your mouth, you might think you’re dealing with your dental insurance to arrange coverage. If your insurance coverage works like mine, the medical necessity for the appliance meant getting preauthorization from my health insurance company.

My sleep study’s neurologist had to certify its medical necessity so the insurance company could grant an out-of-network coverage authorization for the dentist to build the appliance.

Finding a provider

Some dentist make sleep appliances, and many don’t. No dentist near me was in-network, so I had to contact my insurance company for an exception to secure in-network coverage for an out-of-network dentist.

Sleep appliance measurements

“It’s your professionalism that I respect.”

 

Masochistic Arthur Denton, while undergoing a tortuous root canal from a sadistic dentist
Little Shop Of Horrors (1986)

Getting measured for the sleep device was a twenty-first century experience: The dentist inserted a wand in my mouth, running it over my teeth while a digital display rendered my jaw in almost real time.

When I saw “wand,” it wasn’t thin like a magician’s wand. It was about the circumference of a milk frother’s base.

I found it too bulky to comfortably capturing the angles they needed of the teeth in the back of my mouth, but I got through it. I felt like Jim Carrey contorting in the chair.

They completed the measurements in minutes.

It takes 3-6 weeks for the lab to design the device.

Sleep appliance fitting

“And I… am… Iron Man.”

 

A breathless Tony Stark, just before harnessing the Infinity Stones’ power to vanquish Thanos and his minions
Avengers: Endgame (2019)

I returned to the dentist for my appliance. I slid it into my mouth, noting its fit. The appliance is about twice the size of the post-braces retainer, so it took me a couple of weeks to adapt to it.

I spoke earlier of there being more to a sleep appliance than the custom fit. The other key factor is how the sleep appliance works.

To help maintain a clear airway, the appliance keeps the upper jaw back while holding the lower jaw forward. We’re talking about fractions of an inch here, nothing medieval. You use a small metal key to increase or decrease how far forward to position your lower jaw. You experiment until you find your sweet spot.

Sweet, sweet snoring relief

Such a monumental difference pre- and post-appliance. I went from habitual snoring to rarely snoring.

Even with the significant improvement, I learned I could do more to improve my nighttime breathing and sleep.

Mouth taping

I was a mouth breather until I came across research that delved into the benefits of nasal breathing.

Much like with snoring, I never had reason to explore anything other than mouth. I’d imagine the demands my deviated septum placed on my breathing apparatus made my mouth-breathing preference the most logical choice.

Once I read about the benefits of nasal breathing, I wanted to reinforce the habit during sleep. I bought a lightweight medical tape that’s easy to remove, and I tape the middle part of my mouth shut. It keeps my lips closed and forces my breathing through my nostrils.

Snoring is a rare event for me, and a gentle nudge puts from my wife an end to it. She says it’s barely audible, and she wouldn’t hear it if she was asleep. She just doesn’t want to see me struggle.

Cost versus benefits

Though the sleep appliance costs about $3,000, I view it as an investment in my and my wife’s overall health, wellness, and quality of life.

I no longer experience the persistent fatigue, dry mouth, upper respiratory bugs, and conditioning challenges that were routine. If I had to do this again, I’d do it much sooner.

I had my first sleep appliance for five years before the bars malfunctioned. I had to adjust it each day to ensure it’d properly position my lower jaw that night.

The neurologist re-certified my appliance’s medical necessity so I could repeat the out-of-network authorization process. Good times.

Make the call today

“Remember the steps, mate!”

 

Sharks Anchor and Chum, pleading with shark Bruce to resist eating Marlin and Dory once he gets a whiff of Dory’s blood

Finding Nemo (2003)

If you’re snoring, or if you’re experiencing any of its symptoms, talk to your doctor about a referral to a neurologist.

Schedule a sleep study. Get diagnosed.

Treat what’s treatable and prevent what’s preventable.

You and your loved ones deserve it, and too many people don’t even know it’s an option.

What’s your sleep apnea success story? I’ll share your response in a future newsletter.