I have been diagnosed with mild - moderate obstructive sleep apnea and so far I've tried using a CPAP machine but it didn't work for me so now I have a tongue retaining device. This has given me tons of problems too. It triggers my gag reflex and I have trouble keeping it in while i fall asleep and I have a burning sensation on my tongue. Am I using it wrong? Will I get used to the device or do I need to try something else entirely? Should I look for surgery options?
Doctors Answers (7)
This is a question that needs to be directed to an Ears, Nose and Throat medical doctor and/or an oral maxillofacial surgeon. The side-effects of the TRD are considered "normal". Have you tried an oral appliance that advances the mandible or aids in compressing the tongue down? If you have any symptoms in the jaw joints (called the TMJoints), then a mandibular advancement device type of oral appliance may not be a viable option for you. Who recommended the TRD? Perhaps they are versed in the MAD or a tongue depressive device, rather than retraction. I hope I have helped answer your questions, again as far as the tongue reduction device, please seek advice from one of the two types of clinicians I recommend.
Surgery for sleep apnea treatment does have its uses but there are possible complications and surgery doesn't always work with sleep apnea patients. You need to discuss this with your primary care doctor or sleep medicine doctor. You seem to be experiencing common problems with the tongue retaining device. Again, this is not for everyone with sleep apnea/snoring. At this office, we fabricate oral appliances to re-position the bottom jaw forward while you are sleeping. This opens up the breathing tube (pharynx) behind the soft palate and tongue. You would need to schedule an appointment for an oral evaluation to see if you would be a candidate for this type of sleep apnea treatment.
I have no experience with the tongue retaining devices. An oral device between the teeth that's adjustable may be better with for your apnea. Regarding the question of surgery on the tongue, you should be seen by a specialist in one of the University Sleep Programs that specialize in this type of surgery. They can tell you what surgical options are suitable for your situation. Stanford is one place with this expertise, but other more local places may be just as good.
You may want to consider an oral appliance to treat Obstructive Sleep Apnea. Tongue retaining devices don't work well long term because of pain and other symptoms from the constant biting pressure on the tongue. Tongue reduction surgery may not be successful. Even if the tongue size were to be reduced, if it physically falls back into your airway, the size may not make a difference.
Yes, tongue reduction has helped some individuals with their obstructive sleep apnea. Whether or not you are a candidate for this surgery depends upon a careful examination by an experienced ENT specialist. You may wish to discuss with your physician undergoing a PAP NAP. This service is offered by many sleep centers and often leads to successful CPAP compliance.
Tongue reduction surgery is not a procedure that SomnoDiagnostics, nor Dr. Gibson typically recommend. If you have difficulty tolerating CPAP, then you should consider seeing a Board Certified Sleep Physician and discuss an alternate therapy such as Bilevel PAP therapy.
I would look at surgery on tongue or pharynx only as a last resort. I would instead
look into a Mandibular Advancement Device or MAD made by a dentist trained in Sleep
Dentistry. The Tongue retention Devices can work for some people, but do have
several side effects; of which you are suffering. Your severe gag reflex is because
you feel you are suffocating and are trying to protect your airway. You may need to
be evaluated by an Ear Nose and Throat Specialist to make sure your can adequately
breathe through your nose. No therapy (CPAP, TRD, or MAD) is going to work very
well if you can't breathe through your nose. You may have a deviated septum,
enlarged adenoids, or turbinates that need to be dealt with first.