Find out about efficacy of the DOME sleep apnea treatment

January 26, 2023 12:29 PM

I'm trying to learn more about Distraction Osteogenesis Maxillary Expansion (DOME) treatment for sleep apnea. Is there any data about efficacy / long term success rate for those who want to stop using a CPAP? How do I get ahold of it and compare it to other treatment methods?

I absolutely despise my CPAP. I use it every night anyway because I get higher quality sleep with it than without, but more than 50% of the time I tear it off in the middle of the night because it feels like a face hugging alien is attacking me.

I tried a custom dental orthotic but could not tolerate it due to jaw pain.

So now I'm looking further down the line for procedures. This one came recommended to me from a couple different sources. My primary care physician hadn't heard of it though. It's scary to contemplate surgery and I really want to know how likely I am to come out of it in a better place if I opt to try it.

My web searches haven't been terribly effective. Seems like most of what I find is sales brochures from dentists.

posted by rouftop to Health & Fitness (7 answers total)

There are a few papers on it, and it appears to have some support for its effectiveness for sleep apnea. They’ve all been about people with narrow jaws though. Does that apply to you?
posted by bluloo at 12:51 PM on January 26, 2023

Sorry to derail, but have you tried nasal pillows instead of a mask? I don't think I'd like to be attacked by a face-hugging alien either, but I've done okay with the pillows. Sizing correctly is crucial for comfort, though. Might be worth a shot before going under the knife.
posted by kate4914 at 1:16 PM on January 26, 2023 [1 favorite]

There are some criteria for being a candidate. Do you have Obstructive Sleep Apnea and do you have a narrow palatal vault? This procedure can't be done in isolation, from what I am reading (I am a dentist and fairly versed in sleep apnea and dental treatments for it, but i've never heard of this procedure) you would have to have ortho as well to establish a workable bite with the wider palate. This is not a minor thing, it's moderately major upper jaw surgery and the expander is in place for up to 8 months, and ortho re-alignment is likely on the order of 24-36 months.
The results for suitable candidates seem promising.
posted by OHenryPacey at 1:55 PM on January 26, 2023 [1 favorite]

Response by poster: I use nasal pillows. Hate hate hate.
I do have Obstructive Sleep Apnea. I have no idea if I have a narrow palatal vault, isn't that a gymnastics event in the olympics? :-P
posted by rouftop at 3:40 PM on January 26, 2023

Best answer: Are you seeing a general practitioner or a sleep specialist? My sleep specialist was able to tell me that I had too many different contributing physical features (and what they were) to have any luck with surgery. (Sigh.)
posted by wintersweet at 4:54 PM on January 26, 2023

Best answer: I'm guessing your CPAP is prescribed by a primary care physician -- I would recommend seeing a sleep medicine specialist and asking to discuss potential procedure options with them. They are probably the person who is making referrals to interventionalists in your area so they will be aware of the options and relative reputations/outcomes of various procedures, as well as the criteria for each.
posted by telegraph at 3:51 AM on January 27, 2023

Response by poster: CPAP was prescribed by a sleep doctor years ago. When I told her about my troubles with it, she suggested I try a tennis ball attached to my back... that was years ago though. I just sent a note to her practice to see what she knows. Thanks.
posted by rouftop at 9:19 AM on January 27, 2023