Kool said:

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I could have read that wrong, sorry. Test it out, can you move your lower jaw down and forward without significant jaw joint pain? You could always try a cheap "boil and bite" device you get online and see if it cuts down on your snoring, either with the aid of a fitness tracker or a bed partner measuring the response.

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That's what the sleep doc recommended. I can easily move my jaw forward and create an underbite without pain, but I'd be shocked if I could do that via a device all night without significant pain. I'll buy one of the cheap devices just to test, but don't want to trade problems for problems. I do think I'll do an ENT visit as a next step. I need to go for other issues and and ear cleaning anyways ha

No updates from Cromangum? Maybe he figured it out and has entered a deep weeklong slumber.

Just kidding - hope you worked it out.

GeorgiAg said:

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No updates from Cromangum? Maybe he figured it out and has entered a deep weeklong slumber.

Just kidding - hope you worked it out.

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Been busy with a gigantic landscaping job at the new house so haven't been on here much. Had the sleep docs re-tune my ASV but honestly can't tell a big difference. Once the ramp completes, the device is intolerable. If I fall asleep before then, it's been a lock that I get woken up. I have been at it over a week and have yet to successfully fall asleep or stay asleep at treatment pressure.

Sorry man. I rarely get a full night but i usually get about 4 hours with the CPAP.

I'm going to try the nose cones and nasal sprays discussed above to see if they help. I'm a bad mouth breather due to deviated septum.

Maybe that would help you? I dunno. I may end up getting the surgery but that sounds awful.

GeorgiAg said:

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Sorry man. I rarely get a full night but i usually get about 4 hours with the CPAP.

I'm going to try the nose cones and nasal sprays discussed above to see if they help. I'm a bad mouth breather due to deviated septum.

Maybe that would help you? I dunno. I may end up getting the surgery but that sounds awful.

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You orobabky read my reply earlier….but I had the surgery about 7 weeks ago and is wasn't bad at all.

It took me months to get used to my CPAP; I'd either wake up in the middle of the night or I would throw it off in the middle of the night while sleeping. Eventually, I started to use a strap than went under the chin and over the top of my head to keep me from throwing it off. I want to say it took me 3-4 months to get used to it.

Trying a different face piece on my mask tonight to try to solve the pinching / pulling off issues (going to nose pillows), but still doesn't solve the too much pressure problem. I'm such a light sleeper that any effort by the ASV to "help" me breathe startles me awake.

My issue with the nose pillows was that if you open your mouth, the air goes in the nose and out the mouth. I thought about some kind of chin strap. But I got the full mask to work ok, so I've been going with that.

The nighttime regimen of melatonin 90 mins before bed, then magnesium and L-Theanine before bed has been working great. I also have been doing the flonase, Astropro inhalers or whatever. (Thank you for the recommendations). Garmin sleep scores in the mid-eighties each night since.

If I can keep the CPAP on until 4 am or so, I feel that is a win. I may try the nasal pillows again but may need to get a chin strap. When you switch devices, you need to change the settings on your device - at least for mine.

My current mask is over the nose (but not mouth). It slips off more than it should, and can pinch sometimes. I don't mouth breathe so no need for full mask.

Could not make the ASV work with the over the nose pillows or in the nose pillows due to the large pressure swings the device delivers. They set the pressure (supposedly) lower and said i need to try a full face mask. So I jump through the hoops and try that ***** This mask still delivers way too much pressure whenever the **** it wants to, and is very uncomfortable on top of things.

I'm very close to either throwing the device through the sleep center window and starting a bonfire with it in their lobby. I have had the worst month of sleep in my life with this POS.

I'm sorry to say, but if you have mixed apnea and need an ASV, you're just cooked.

Went in person to the sleep doctor who prescribed my ASV. They thought they could adjust the pulse pressure which is insanely high and wakes me up instantly, but they can't. Their recommendation was "Just keep wearing the mask. Sometimes we have to do things we don't like". Meanwhile I'm falling asleep nearly daily, and sometimes during my commutes. Sleep doctors are ****ing worthless.

Cromagnum said:

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Went in person to the sleep doctor who prescribed my ASV. They thought they could adjust the pulse pressure which is insanely high and wakes me up instantly, but they can't. Their recommendation was "Just keep wearing the mask. Sometimes we have to do things we don't like". Meanwhile I'm falling asleep nearly daily, and sometimes during my commutes. Sleep doctors are ****ing worthless.

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I'm hitting a spell now where I can't stand to wear it. It's not just you. I may go back to the nose pillows.

I'm thinking I may pull the trigger on surgery. I hate going to bed as Darth Vader every night.

I've tried the over the nose pillows, in the nose, full face. Probably over the nose is most tolerable, but if you have an ASV, the pressure surge is a MF to deal with.

Are you not able to tinker with the settings yourself? I played with mine until I found something that I tolerated.

Philip J Fry said:

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Are you not able to tinker with the settings yourself? I played with mine until I found something that I tolerated.

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The normal inhale and exhale pressure yes, but not the inspire setting which is unique to the ASV. You would think you could set the time interval at which it thinks you don't breathe, as well as the pressure on the pulse of air it gives you, but you cant.

What machine do you have again?

Maybe you should try switching to an APAP instead of ASV.

I think it is great that all of the CPAP users are contributing their helpful hints and workarounds. ASV, though, is a totally different animal than CPAP, BiPAP, APAP, etc. It delivers breaths using a calculation of how much the patient SHOULD be breathing over a set period of time. Therefore, it will kick off when the brain fails to send out the signal to breathe (central sleep apnea). Some traditional machines can be set up to have a "backup rate" in the event that a breath is not detected, otherwise you have to go to phrenic nerve pacing or correct the underlying issue (usually cardiac or neurological) causing the central events.

Sounds awful. Surely though, using a less effective treatment is better than not using it at all? Sounds like that's where this is headed if he doesn't get any relief.

Anyone have any tips I need to ween myself off of sleeping pills?

Start doing CBT-I. Go to my post on page 3 of this thread

Long time sleep apnea. Had surgery in 1999- deviated septum, tonsillectomy, uvula removed, etc. Then tried sleep apnea machines after 2 sleep studies twice in the last 25 years. A second nasal surgery about 8 years ago. The last time tried All the different masks, heaters, hoses, settings, etc before giving up. Just could never go to sleep and stay asleep with the mask/ nasal contraption on.

Ready to try again with a new Dr.

Any sleep Dr. Recs in the Woodlands area or even BCS?

Had a consult with my sleep doctor and have confirmed they are just guessing and hoping something eventually works. During my sleep study I fell asleep eventually on bipap out of sheer exhaustion, then for the last hour of the test they swapped me to ASV, and then told me I needed ASV, which is naturally the most expensive option. Two months of fighting with it without even a single hour of sleep to show for it.

Now they are saying "we probably should have gone with bipap, but since you have the ASV we can make it act like a bipap". Thanks *******s. After coughing up $2k out of pocket for the sleep study, and another $1500 for the device that's way overkill for what I probably need.

I just had a Down's teen who isn't tolerating CPAP ask for a Prior auth for a TAP device. I have never heard of such a thing so had to look it up. Not sure if it would help your particular case of OSA but worth looking into.


--------AI snip --------------

A **TAPS device** in the context of medicine and sleep apnea likely refers to a misnomer or confusion with the **TAP device** (Thornton Adjustable Positioner), a mandibular advancement device (MAD) used to treat snoring and obstructive sleep apnea (OSA). The TAP device is a well-established oral appliance designed to reposition the lower jaw and tongue to keep the airway open during sleep. Below is a detailed explanation based on the provided context and relevant information:

### What is a TAP Device?
- **Definition**: The TAP (Thornton Adjustable Positioner) is a two-piece oral appliance consisting of upper (maxillary) and lower (mandibular) components connected by a fixed hinge and pivot point. It holds the lower jaw forward and slightly open, pulling the tongue and soft tissues away from the throat to prevent airway collapse, which causes snoring and OSA.[](https://www.brigliadentalgroup.com/what-is-a-tap-appliance-how-can-it-help-with-sleep-apnea/)[](https://burbankdental.com/products/tap-3/)
- **Function**: By advancing the lower jaw, the TAP device maintains an open airway, reducing or eliminating snoring and apneic episodes. It is FDA-cleared for treating mild to moderate OSA and snoring and is an alternative to continuous positive airway pressure (CPAP) machines.[](https://shop.sleepdoctor.com/products/mytap-oral-appliance)[](https://www.apriadirect.com/mytap-oral-appliance-for-snoring-sleep-apnea)
- **Effectiveness**:
- Studies show TAP devices reduce the Apnea-Hypopnea Index (AHI) by at least 50% and below 10 in many cases, achieving a 90% success rate for snoring and OSA.[](https://newwestlab.com/dental-compass-blog/snoring-and-sleep-apnea-patients-can-benefit-from-this-tool/)[](https://tapintosleep.com/products/tap-custom/)
- It is as effective as CPAP for 87% of patients, with higher patient compliance (up to 90% over 2.5 years) due to comfort and ease of use.[](https://glidewelldental.com/solutions/sleep-dentistry/mandibular-advancement-devices/dreamtap)[](https://tapintosleep.com/why-tap/)
- Over 60 peer-reviewed studies and guidelines from the American Academy of Sleep Medicine (AASM) and American Academy of Dental Sleep Medicine (AADSM) endorse TAP as a leading oral appliance.[](https://tapintosleep.com/why-tap/)
- **Key Features**:
- **Adjustability**: A single-point midline adjustment allows patients or clinicians to fine-tune jaw protrusion (up to 22 mm in mm increments) for comfort and efficacy, preventing irregular bite or jaw discomfort.[](https://tapintosleep.com/products/tap-custom/)[](https://shop.sleepdoctor.com/products/mytap-oral-appliance)
- **Mouth Shield**: A patented accessory (standard with flexTAP, optional for others) promotes nasal breathing, reduces dry mouth, and minimizes excess saliva.[](https://airwaylabs.com/why-tap/)[](https://tapintosleep.com/products/mytap/)
- **AM Aligner**: Included with every TAP device, this morning repositioner helps restore normal bite alignment after use, addressing temporary morning malocclusion.[](https://airwaylabs.com/why-tap/)[](https://tapintosleep.com/)
- **Medicare Approval**: Custom TAP devices meet Medicare requirements (code E0486) for OSA treatment.[](https://tapintosleep.com/products/tap-custom/)[](https://burbankdental.com/products/tap-3/)

### Types of TAP Devices
The TAP Sleep Care system includes several models tailored to patient needs, all developed by Dr. Keith Thornton, who holds over 70 patents for the technology.[](https://airwaylabs.com/why-tap/)[](https://tapintosleep.com/why-tap/)
1. **myTAP**:
- A non-custom, precision-fit device molded in 15 minutes using heat-softened thermoplastic trays.
- Ideal for same-day treatment of mild to moderate OSA and snoring.
- Includes an adjustment dial and Mouth Shield; suitable for travel due to portability.[](https://tapintosleep.com/products/mytap/)[](https://www.apriadirect.com/mytap-oral-appliance-for-snoring-sleep-apnea)
2. **customTAP**:
- Premium, lab-made devices with personalized tray liners and hardware choices for optimal comfort.
- Prescribed by over 15,000 clinicians worldwide; used for snoring and all OSA severities.[](https://tapintosleep.com/products/tap-custom/)[](https://tapintosleep.com/why-tap/)
3. **flexTAP**:
- Features a nasal breathing component (Mouth Shield) and Vertex Technology (45-degree post angulation) for simultaneous vertical and horizontal jaw adjustment, reducing joint strain.[](https://www.dynaflex.com/dental-sleep-laboratory-devices/tap-devices/)[](https://tapintosleep.com/products/tap-3/)
4. **dreamTAP**:
- Made with stronger cobalt-chromium hardware; offers more tongue space and is metal-free in some versions.
- Available in milled trays for accuracy and durability; effective for severe OSA when paired with TAP PAP CS.[](https://glidewelldental.com/solutions/sleep-dentistry/mandibular-advancement-devices/dreamtap)[](https://tapintosleep.com/products/dreamtap/)
5. **TAP PAP CS (or myTAP PAP Nasal Pillow Mask)**:
- A hybrid therapy combining a TAP oral appliance with a nasal pillow CPAP mask, ideal for complex or severe OSA cases.
- Reduces CPAP pressure requirements by opening the airway first; strapless design enhances comfort.[](https://tapintosleep.com/products/)[](https://tapintosleep.com/products/mytap/)[](https://tapintosleep.com/products/tap-3/)

### Benefits for Sleep Apnea
- **Non-Invasive**: Unlike surgery, TAP devices require no invasive procedures and are reversible.[](https://www.cnorthodontics.com/tap-appliance)
- **High Compliance**: Patients prefer TAP over CPAP due to its comfort, portability, and lack of hoses or masks (90% adherence vs. lower CPAP compliance).[](https://newwestlab.com/dental-compass-blog/snoring-and-sleep-apnea-patients-can-benefit-from-this-tool/)[](https://glidewelldental.com/solutions/sleep-dentistry/mandibular-advancement-devices/dreamtap)
- **Health Improvements**:
- Reduces snoring in over 95% of patients and mitigates OSA-related risks like heart disease, stroke, diabetes, and daytime fatigue.[](https://www.brigliadentalgroup.com/what-is-a-tap-appliance-how-can-it-help-with-sleep-apnea/)[](https://burbankdental.com/products/tap-3/)
- Improves REM sleep, cognition (e.g., in dementia patients), and overall quality of life.[](https://www.brigliadentalgroup.com/what-is-a-tap-appliance-how-can-it-help-with-sleep-apnea/)[](https://tapintosleep.com/products/mytap/)
- **Patient Empowerment**: Adjustable at home, allowing patients to fine-tune treatment with clinician guidance.[](https://tapintosleep.com/products/tap-custom/)[](https://tapintosleep.com/why-tap/)
- **Travel-Friendly**: Compact and easy to use without power sources, unlike CPAP machines.[](https://shop.sleepdoctor.com/products/mytap-oral-appliance)[](https://www.apriadirect.com/mytap-oral-appliance-for-snoring-sleep-apnea)

### Limitations and Considerations
- **Not Suitable For**:
- Central sleep apnea (CSA), as it addresses physical airway obstruction, not brain signaling issues.[](https://my.clevelandclinic.org/health/treatments/21129-oral-appliance-therapy-for-sleep-apnea)
- Patients with fewer than eight healthy teeth, removable dentures, braces, recent dental implants, or temporomandibular disorders (TMD).[](https://shop.sleepdoctor.com/products/mytap-oral-appliance)[](https://www.tap-schiene.de/en/the-tapr-splint/overview/)
- Severe OSA without hybrid therapy (e.g., TAP PAP CS), as CPAP may be more effective alone.[](https://my.clevelandclinic.org/health/treatments/21129-oral-appliance-therapy-for-sleep-apnea)
- **Side Effects**:
- Temporary morning bite changes (mitigated by AM Aligner).
- Dry mouth or excess saliva (reduced by Mouth Shield).
- Initial jaw discomfort or tooth soreness, which often resolves with adjustment.[](https://airwaylabs.com/why-tap/)[](https://shop.sleepdoctor.com/products/mytap-oral-appliance)
- **Fitting Process**: Requires a prescription and fitting by a trained dentist or orthodontist (custom models) or self-fitting (myTAP). A sleep study is often needed to confirm OSA diagnosis.[](https://shop.sleepdoctor.com/products/mytap-oral-appliance)[](https://my.clevelandclinic.org/health/treatments/21129-oral-appliance-therapy-for-sleep-apnea)

### Comparison to CPAP
- **Effectiveness**: TAP is nearly as effective as CPAP for mild to moderate OSA (87% comparable AHI reduction) and can be combined with CPAP for severe cases.[](https://tapintosleep.com/why-tap/)[](https://dentalsleeppractice.com/airway-managements-tap-sleep-care-system-continues-revolutionize-sdb/)
- **Adherence**: Oral appliances like TAP have higher patient satisfaction (81% prefer OAT over CPAP in trials) due to comfort and ease of use.[](https://glidewelldental.com/solutions/sleep-dentistry/mandibular-advancement-devices/dreamtap)
- **Use Case**: TAP is ideal for CPAP-intolerant patients, travel, or as a complementary therapy to reduce CPAP pressure.[](https://my.clevelandclinic.org/health/treatments/21129-oral-appliance-therapy-for-sleep-apnea)[](https://tapintosleep.com/products/tap-3/)

### Clarification on "TAPS"
- The term "TAPS device" does not appear in the provided sources or standard medical literature related to sleep apnea. It's likely a typo or misinterpretation of **TAP** (singular or pluralized incorrectly). No distinct "TAPS" device exists in this context.
- If "TAPS" refers to another specific device or acronym (e.g., a new or niche product), please provide additional details, as no such device was identified in the sources or recent posts on X related to sleep apnea treatment.post:0-7

### Recommendation
If you're seeking treatment for sleep apnea or snoring, consult a sleep specialist for a sleep study to confirm OSA and determine severity. A dentist trained in dental sleep medicine can fit a TAP device (e.g., myTAP for immediate use or customTAP for long-term therapy). For severe OSA, discuss hybrid options like TAP PAP CS with your provider. Visit [tapintosleep.com](https://tapintosleep.com) to find a provider or learn more about TAP options.[](https://tapintosleep.com/)[](https://tapintosleep.com/why-tap/)

If you meant a different device or have specific requirements (e.g., cost, insurance, or severe OSA), please clarify, and I can tailor the response further. Would you like me to search for additional information or analyze a specific aspect of TAP devices?

Cromagnum said:

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Had a consult with my sleep doctor and have confirmed they are just guessing and hoping something eventually works. During my sleep study I fell asleep eventually on bipap out of sheer exhaustion, then for the last hour of the test they swapped me to ASV, and then told me I needed ASV, which is naturally the most expensive option. Two months of fighting with it without even a single hour of sleep to show for it.

Now they are saying "we probably should have gone with bipap, but since you have the ASV we can make it act like a bipap". Thanks *******s. After coughing up $2k out of pocket for the sleep study, and another $1500 for the device that's way overkill for what I probably need.

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Oh what do you know...I put my mask on and they didn't change a damn thing with any of the settings. Time to raise hell with these morons tomorrow.

Yeah. You have to be in charge of your own health with this. I know if it was me, I would be accessing the clinical menu myself at this point.

Any progress with them today?

BlueMiles said:

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Any progress with them today?

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Straight to voicemail, no calls returned.

3 months of useless efforts trying to sleep with this ****ing thing. They finally called me back and tried to tell me that now I don't need an ASV, but need a bipap, but can't return the ASV since I've already used it. I told these clowns I'm not buying anything else. I'm $3k in as it is with a device that does jack **** for me. I've spent the last week without using it at all and although my sleep sucks, it's miles better than with this useless device.

So jealous of people that get a device and the **** just works...

Sorry man I hope you find a solution that works for you.

Cromagnum said:

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So jealous of people that get a device and the **** just works...

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I know you've had a tough road, but don't give up. I started with nose pillows and could not get used to them at all. I went with nose only mask and has been good ever since. Long hose helps. My old machine had a humidifier to keep the air moist, but my new machine doesn't seem to need one to be comfortable.

Don't give up. If you have to see someone else to get satisfied, then do it.

Good luck..

If you have an aircurve, I think bi pap is built into it?