I Can’t Tolerate a CPAP Machine – What Alternatives Are Available?

cpap-machineMany people who suffer from Obstructive Sleep Apnea (OSA) will be familiar with and use a Continuous Positive Airway Pressure (CPAP) machine. These machines are the “creme de la creme” of devices that treat OSA. That said, many people who use the device, find it highly intrusive on their face and difficult to sleep with it on.

Particular issues experienced by patients that use the CPAP mask are:

  • Getting a blocked or stuffy nose.
  • Getting a dry throat due to the air.
  • Getting irritation to their skin or pressure sores.
  • They feel claustrophobic.

If you’re a sufferer of OSA and you use a CPAP machine but suffer from some of the problems above, it can feel very isolating and leave you at a loss as to what to do. This machine is supposed to be the best solution out there and if it’s not working, what do you do? Well before giving up, there are some things you can do to see if you can make the CPAP machine work better for you.

Alter The Mask Type

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Click to enlarge

CPAP masks come in all shapes and sizes. Some cover both your nose and mouth and have straps that stretch around your head via your cheeks and forehead.

Many people find that these masks make them feel claustrophobic. The straps irritate other people. This mask is very effective however, for people who move around a lot in their sleep as it allows them to keep the mask securely fastened to their face.

Another type of mask you can try is the nasal pillow mask. This mask is more compact and allows more visual freedom, this mask would be more suited to people who feel claustrophobic with other masks.

Another thing to note about CPAP masks is that the sizes change with the different type. Just because you are one size with one particular mask, doesn’t mean you are the same size in a different one. Luckily, most masks are adjustable so you can ensure the mask fits nice and snug through adjustment.

Try Wearing The Mask During The Day

Wearing the mask during the day can help with many issues that users face. The first being that by wearing the mask for some time during the day you can become accustomed to it.

This can be done while watching TV or simply while sitting down and reading a book. This will help people who are having trouble getting used to the machine.

Another aspect of wearing the mask during the day is that it can help people that are feeling claustrophobic. In this case they should first practice by holding the mask up to their face without any other parts like the straps or the hose.

When they are used to this they can start to try to use the straps. Eventually when used to the straps they can attach the hose and set the machine at a low-pressure setting. Finally, after some time they can become ready to try the mask turned on with all bells and whistles attached, while awake.

Following this, using it while sleeping will feel more normal to the user. If the claustrophobia persists, it might be advisable to consult a doctor.

Try Using a CPAP Humidifier

cpap-humidifierCommon problems associated with CPAP machines are dry, stuffy nose and dry mouth. This dryness often leads to irritation of those areas. Most recently built CPAP machines come complete with a humidifier in order to lubricate these areas and prevent them from drying out.

That said, a lot of the old machines don’t come with them so it would be beneficial for someone suffering from dryness to add a humidifier to the air stream.

If you breathe through your mouth while you sleep, with your mouth open, CPAP machines can worsen dry mouth. This can be rectified with the use of a chin strap. This will help to keep the mouth closed while reducing the air leakage from the CPAP machine.

Alternatives to CPAP Devices

After trying all the steps mentioned above, if you are still having difficulty with the CPAP machine or just cannot tolerate it, it may be time to talk to your doctor about trying a Mandibular Advancement Device (MAD) or a Tongue Stabilizing Device (TSD). These have been known to help individuals who suffer from obstructive sleep apnea (OSA). They are both mouthpieces that are far less intrusive than the CPAP machines.

The benefits that people have found from switching from a CPAP machine to a mouthpiece are as follows:

  • Physically, they are much more handy to bring with you if you are travelling. The CPAP machine is a big clunky machine that needs its own power source. The mouthpieces can fit in your pocket or a small bag.
  • They are far less invasive on your head/face.
  • Less likely to fall off while you sleep.

MAD and TSD devices come in two types. There are ones that are custom made and available only by prescription and the kind that are self-fitted. What’s the difference?

Being custom made, they are designed specifically based off a mold from your mouth while the self-fitted ones are a molded using a boil and bite solution. Another huge difference is the price. The cost of the custom-made oral appliances can exceed $1500. Luckily the self-fitted devices can be around $100.

So, let’s assume that you don’t have $1500 to spend on one of these devices (if you do, consult a doctor and seek a prescription) and that you want to go with the self-fitted option.

The first question you have to ask yourself is whether you wish to go with the MAD or the TSD type mouthpiece.

Mandibular Advancement Devices (MADs)

somnoguard-apThe self-fitted MADs are far less expensive than the custom made ones. Not only are they less expensive but also they can be extremely effective.

If you’ve never seen a MAD before, picture a sports mouth guard with the difference being that the MAD devices cover both the top and bottom sets of teeth.

They come in various types from one-piece to hinged, and from the bite and boil custom fit to one-size-fits-all. The price range for these devices is $40-$150.

The boil and bite technique involves putting the mouthpiece into a cup of boiling water until the plastic softens. Then the device is placed into the mouth and bitten down upon and the lower jaw pushed forward slightly.

This is because these devices operate on the principle of advancing the lower jaw slightly forward in order to tighten the muscles at the back of the throat to clear the airway.

A product that I found particularly effective and comfortable was the ZQuiet.

The ZQuiet mouthpiece is a MAD oral appliance. The benefits to the device were that it was:

  • Ready to use straight out of the box. There was no boil and bite required to fit the mouthpiece.
  • It didn’t smother my teeth. A lot of boil and bite MAD devices fit so tight on the teeth that it can irritate the gums. This isn’t the case with the ZQuiet.
  • It was less clunky than a lot of the alternatives. Due to the hinge at the back between the top and bottom pieces, I was able to close my mouth properly with it in. It felt smaller in my mouth than standard MAD devices.

Read a full review of the ZQuiet here

Tongue Stabilizing Devices (TSDs)

gmss2-215Another alternative is the TSD. It operates on an entirely different principal to the MAD mouthpieces.

It holds the tongue at the front of the mouth to make sure that the tongue doesn’t fall to the back of the mouth. This ensures that the soft tissue at the back of the tongue doesn’t block the airways.

A TSD is one-size-fits-all so no need to worry about self-fitting.

The TSD type oral appliance comes in at around $100 so is a fraction of the price of the custom fitted mouthpieces.

My favorite TSD product is the Good Morning Snore Solution (GMSS). The simplicity, level of comfort and effectiveness of it is why I like it so much.

The benefits to the GMSS are:

  • The fact that it’s one-size-fits-all. This means no worrying about whether it will fit or not,
  • Does not pull the jaw forward so it is very comfortable to wear.
  • Can be worn with or without dentures.

Read a full review of the GMSS here

Before Switching

exclamationSwitching from a CPAP machine to a mouthpiece is definitely something that can be the right choice for some people. Having said that, if you suffer from sleep apnea, it is a serious medical condition and you should treat it that way.

For this reason it is very important that you consult your doctor on your options for switching and whether it’s the right move for you, personally.

Making that decision without a doctor’s advice can be dangerous and can put your health at risk so please don’t take our word for it, consult your doctor on what is best for you.

Which Product Should I Choose?

questionEvery person has a unique mouth and needs, so one that is perfect for one person may not be the best option for another.

There are well over 100 products on the market, so making a decision can be quite daunting.

You will find a lot of helpful information in the comparison chart, and I have written reviews of several products.

If you would rather not spend a lot of time reading reviews, please consult my article titled “My Mouthpiece Recommendation”. I have compiled a list of three products that I believe are the best options, based on my experience.