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External Mandibular Advancement Device

for those people uncomfortable with having hoses attached to their faces or items in their mouths while sleeping.
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(+1, -4)
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Hello. My name is [contracts] and I have obstructive sleep apnea (OSA). I use a device called a constant positive air pressure (CPAP) machine to help me sleep at night [link 1]. It has been the most effective product that I've tried, but there are also mandibular advancement devices (MADs) [link 2] available that serve to push the lower jaw forward clearing the obstruction and allowing safe sleep. A major problem with the MADs is that they go inside your mouth. A lot of people with sleep apnea are very uncomfortable with this notion, especially considering they already have a proclivity to suffocation in the night.

A simple solution would be an external MAD that straps on to the forehead and pushes the mandibular joints forward from the outside (from just in front of the earlobes.) A soft cloth/neoprene forehead strap with small bars running downward to soft rubber pads would exert gentle pressure on the backs of the mandibles and have tensioning controlled by straps that cross up from the base of the bar to the center of the forehead.

This would dispel concerns of suffocation as well as removing the difficulties associated with having a hose come out of your face (CPAP Machine, [Link 1]) or having a large foreign object in your mouth.

(Illustration in url below. You might have to click it and then after Yahoo! gives you a "huh?" click in the address bar and hit enter. That's the only way it works for me.)

contracts, Jun 28 2004

CPAP Machines http://www.circleci...leepdesk/apnoea.php
Imagine trying to sleep with that crap on. [contracts, Oct 06 2004]

MADs http://www.quietsle...ralapp_descript.htm
Again, creepy to have in mouth while sleeping. [contracts, Oct 06 2004]

(?) EMADs http://www.geocitie...me_matthew/Emad.jpg
External Mandibular Enhancement Device Illustration [contracts, Oct 06 2004]

Pickwickian Syndrome http://www.healthat...ckian_syndrome.html
For [DrCurry]: Similar to the problem some have with outgrowing their bladders, this signifies one who's outgrown her lungs. There are, naturally, other causes for sleep apnea. [dpsyplc, Oct 06 2004]

Aspen Collar http://www.aspencol...cervicalcollar.html
Thx [robinism] [dpsyplc, Oct 06 2004]


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Annotation:







       Hi Contracts! and a question. Does this problem with excess tissue only occur in mouth breathing?
dentworth, Jun 28 2004
  

       [cliff_dood] it certainly would make halloween costumers a no-brainer.   

       [dentworth] it affects mouthbreathers in the same way as nose breathers. In my instance, when I sleep my jaw muscles relax and the weight of my jaw on my neck causes my throat to close. I then stop breathing until the oxygen difficiency triggers a twitch or what have you and jar myself awake with a gasp (shock of which returns muscle tone to throat and jaw.) The actual breathing obstruction takes place in the neck, so the airway would be cut off regardless of the source (mouth or nose). My problem is irrelated to excess tissue - - the doc was actually shocked that I had it because I'm rather lithe. The entirety of the obstruction comes from my jaw (which isn't abnormal in any respects.) The most common form of obstruction is in people who are obese (as I'm told by the docs), who do indeed have a significant excess tissue.
contracts, Jun 28 2004
  

       I had a friend who had an operation to open things up internally. My doctor offered me the same option, but I chose the "lose fifteen pounds" route.
DrCurry, Jun 28 2004
  

       I wish I had that option! I don't have much to spare but I'd rather have to worry about fainting in public due to malnutrition than get my throat slit or not be able to sleep with the machine that's supposed to help me sleep . . . I know they offer tracheostomy which is punching a hole in your neck; I don't know how they would go about scraping the inside of the throat. I wouldn't be too fond of that, either.
contracts, Jun 28 2004
  

       while i think your idea is certainly worth a shot, i would think that any problem that can be corrected by repositioning of the jaw would be better (and permanently) corrected with surgery (osteodistraction of the jaws ((an orthodontic like movement of the jaws to open the airway during sleep))). but then it's not my body.   

       i've heard that cpap is very uncomfortable, so kudos for thinking up options for yourself. (+)
xclamp, Jun 28 2004
  

       [contracts] pastry for this. I understand the internal devices also move teeth over time, similar to orthodontics. Have you considered a bungy cord attached to the ceiling over the bed, with a strong clamp attached to some sort of jaw support (it sounds like you are sleeping on your back)?
ConsulFlaminicus, Jun 28 2004
  

       Worthy of exploration. Although you'd have to take precaution to not disturb the veins situated right behind the mandible bone.   

       Both dad and step-dad have to deal with sleeping with 'the alien' attached to their faces at night.
RayfordSteele, Jun 28 2004
  

       [xclamp], I think the only way to make it work would be if you torque down the jaw muscles so much that if they were completely relaxed your mouth wouldn't open (which presents difficulties.)
[Consul], you want me to hang myself from my face?!? (Yes, I'm a back sleeper, which is the main problem . . . can't do it any other way, for some reason)
[Rayford], I thought about that. Very few things hurt as much as localized high pressure in that area - - when drafting the idea I thought about the application of lower grade pressure over time. My notional solution was a sort of "L" bracket so that it doesn't hook or sink in, it just "cradles" the bone.
I think I'm going to go try to patent this sucker.
contracts, Jun 29 2004
  

       Good stuff. Sounds minimally invasive. It occurs to be that sleeping on your stomach with your face through one of those massage pillows would accomplish a similar end - but it would be gravity pulling the jaw forward. You would need a bucket, to collect the nights worth of drool, but with good old gravity you could do without devices altogether.
bungston, Jun 29 2004
  

       Have you considered the "plaintiff's necktie", orthopaedic neck brace, coupled with rubber door chocks?
dpsyplc, Jun 29 2004
  

       [dpsyplc] is right. I wear one of those for my neck, and it has the side effect of holding my jaw forward when I sleep on my back. It should be the kind meant to limit neck movement, like an "Aspen Collar."
robinism, Jun 29 2004
  

       I can't get the illo link to work, [contracts]. If you could embed the image in an html page, it'd probably work - free hosts don't like direct linking of images.
calum, Jun 30 2004
  

       [robinism], [dpsyplc], I hadn't thought of that . . . my concern would be the whole claustrophobia thing. I think one of my goals here is to provide the most "free" feeling - - the Aspen collar doesn't look too uncomfortable and it also has the benefit of staying off of the forehead and out of the way of the face. The neck would be immobilized, however . . . this is a sticky wicket.
contracts, Jun 30 2004
  

       Well, use of your thinking cap and a hacksaw (shudders at the whole visual) could result in some freedom for your neck. Aspen Collars were designed to stabilize a neck -- you want a unique application of that molded chin support.
dpsyplc, Jun 30 2004
  


 

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