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I can’t tolerate a CPAP machine – What alternatives are available?

CPAP machineThe Continuous Positive Airway Pressure (CPAP) machine is considered the “gold standard” when it comes to treating Obstructive Sleep Apnea (OSA). Those who have been prescribed a CPAP machine often describe the experience as uncomfortable, irritating, and cumbersome. Some patients complain of issues keeping their mask securely fastened to their face, a dry stuffy nose, dry throat, and skin irritation.

So what options are available for those who can not tolerate a CPAP? Before moving into alternative treatment options, you may want to first consider the following.

Before giving up…

Check a secure fit

Before exploring CPAP alternatives, it’s a good idea to try to work with your current CPAP set up. Ensure that the mask fits securely and comfortably on to your face. Most masks can be adjusted for a more secure fit. Check the manufacturer’s instructions that were provided with your machine for proper fitting directions. Your doctor can also help you make adjustments if necessary.

Try a different style of mask

nasal pillow

It’s possible that the mask that came with your machine may not be a good fit for you. Several different mask styles are available including the nasal, full face, nasal pillow, nasal prong, hybrid, oral and total face mask so you may want to try out a different type of mask before giving up.

For example, if you find that a full face mask is too irritating or you are feeling claustrophobic, you may want to consider trying out a nasal pillow style mask. Several different styles and sizes are available in a price range that is between $40 and $200. Most insurance providers will provide coverage for select masks.

If you are having difficulty keeping the mask secured to your face, try using the adjustment straps to create a closer fit. Avoid over tightening as this can cause further irritation.

Try a CPAP humidifier

cpap humidifierNasal, mouth, and throat dryness are also another common issues that CPAP users often experience when using a machine for the first time. If dryness and irritation is an issue, you may want to consider switching to a machine that has a humidifier. This lubricates your nasal passages and helps to prevent them from drying out.

Most newer CPAP machines come with a heated moisture adding a feature that can be adjusted to a level of humidity that makes your experience a more comfortable one. If you have an older machine, you may be able to add a heated humidifier to the air stream.

Alternatives to the CPAP for those who can’t tolerate

If you are having difficulty tolerating a CPAP machine after testing out different masks, making adjustments, and adding moisture, you may want to speak with your doctor about testing a Mandibular Advancement Device (MAD) or Tongue Stabilizing Device (also known as a Tongue Retaining Device or TRD). Both have been proven to treat mild to moderate obstructive sleep apnea and are also an effective way to treat snoring.

As mentioned, there are basically two different styles of mouthpiece available, the MAD and the TSD.

Most who have made the switch to a mouthpiece agree that they are less invasive and easier to use. Best of all, you don’t have to carry around a large machine, tubes, and a mask. In addition, no electricity is necessary.

MADs and TSDs that are available by prescription only and can be very expensive because they are usually custom made. The cost of these can exceed $2,500 and are usually fitted by a dentist. Popular brands include Somnowell, Somnofit, SomnoDent, OASYS, Thornton Adjustable Positioner (TAP), AveoTSD as well as several others.

The good news is, less expensive self-fitted options are available. Below are two types that you may want to consider.

Self-fitted MADs

A less expensive alternative to a dentist fitted mouthpiece is the self-fitted MADs which are available from a number of different manufacturers at a fraction of the cost of a professionally fitted product. These self-fitted devices usually cost between $50 to $100 and can be incredibly effective.

Internet ordered MADs are typically made from a thermoplastic material which is heated at home in hot water before being placed inside of your mouth as you bite down and move the lower jaw forward. Your teeth sink down into the soft thermoplastic material and this position is held for a few seconds until the plastic cools. The mouthguard is then removed and placed in cold water to set the shape.

When properly used, these devices hold the jaw forward, which widens the airway and prevents snoring as well as mild to moderate sleep apnea.

The downside to such self-fitted product is that they typically only last for 1-2 years, depending on how well they are cared for. In comparison, a professionally fitted device can last for more than two years.

One-size-fits-all TSD

An alternative to the self-fitted MAD is the one-size-fits-all TSD. There are currently two manufacturers who make a TSD – Good Morning Snore Solution (GMSS) and the AveoTSD. The AveoTSD can only be purchased from your dentist while the GMSS can be purchased online without the need to submit a prescription.

Instead of fitting it inside of the mouth along the teeth, the TSD actually attaches to the tip of your tongue, using suction and holds the tongue and associated muscles forward which has the same effect as the MADs. The advantage of this product is that it’s less invasive and works right out of the box.

Non-prescription products such as the GMSS can only be purchased online and cost around $100.  These tend to last for a year or more before needing a replacement.

A final note on switching from CPAP to a mouthpiece

doctor3Several people have already made the switch from a CPAP to a mouthpiece. Does this mean that you should also make the switch? This is a question that absolutely needs to be discussed with your doctor before making a decision. There are several factors that should be considered such as the severity of your apnea as well as the type of apnea. Changing the type of treatment without first consulting with your doctor can be dangerous to your health so please be sure to discuss this option with your doctor prior to making any changes to your current treatment.

While speaking with your doctor, ask about professionally fitted products as well as the less expensive internet ordered self-fitted alternatives. You can find plenty of in-depth information on self-fitted mouthpieces including several product reviews on the website that you are on right now.


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