Excess Deaths at Night - Obstructive Sleep Apnea Explained Clearly 

Go to www.medcram.com/courses/sleep-apnea-explained-clearly for the full course on obstructive sleep apnea

I’m a 53yr old woman and I’ve recently been diagnosed with severe sleep apnea (112 per hr), and just received myCPAP/APAP machine and I absolutely hate it!!! I’m obese, my BMI is 34.7 and should be 25 I blame this condition on my weight. I’m on a mission to take off this weight and praying that it rectifies this health problem. This has been a huge wake up call for me, other than extreme fatigue and excess snoring, my blood pressure has been fine and had no clue I was at this point. Wish me luck 🙏🏼

I’m 51 years old,been on CPAP for 6 months.The best thing I’ve ever done to help my sleep apnea.I feel better now than I did when I was 25.I wake up feeling great,no headaches.

22 years on CPAP and I'm pretty sure it saved my life. I was a mess. Slept all the time but felt awful. Has acid reflux at night due to my chest heaving to get air. Morning headaches. My first night with CPAP I dreamed in color, woke up like I had never felt in years. I score 95-100 points every night with really low events/hr. These newer CPAPs are fantastic.

My dad died in his sleep in 2010. He had sleep apnea. Now I have sleep apnea. This video helps me understand exactly what it is and treatment options. Thank you 🙏

My CPAP is my best friend. Took an entire month till we worked together well. Watched videos on my specific machine to learn how to adjust heat, humidity, build up of airflow and resistance to breathing against the pressure. I practiced while watching TV. I did have periods of feeling suffocation/claustrophobia. I had to calm my breathing to restart. A lot of it was mental. You have to decide you don't want to die.

I was diagnosed at 35, female, no health problems, no weight problems. The doctor was surprised when I asked for the sleep study. Luckily I knew what it was and it was caught early before it caused serious health issues.

Both of my parents had untreated obstructive sleep apnea and died early in the morning. I now have OSA as well and recently started on CPAP and cannot believe how much better I feel. I was going through the days exhausted and thought it was just because of aging but I now have energy to spare. As an unexpected positive side effect my acid reflux has also greatly improved which proves to me that GERD and OSA are related. If you even think you might have OSA then get tested and on CPAP if you do as it is a life changer.

I only got a sleep test because of my wife complaining about my snoring. The very first time I used it, I noticed a difference in my mental state. I had no idea I wasn’t sleeping well! I no longer have mid-afternoon crashes, which is huge.

I would fall asleep at red lights and roll into the person in front of me not realizing it. I thought it was them rolling back into me. I was also getting dizzy spells while standing so I had my heart checked out ok. Then I did a sleep study and found out I was having micro sleeps. I got a cpap and lost 15lbs. Completely changed my life, sleep better, more awake then ever and my blood pressure dropped to normal level. I recommend getting checked out.

I have Sleep Apnea. I found out after my Colonoscopy. The doctor said I stopped breathing several times during my procedure. I got a CPAP and it way LIFE CHANGING!

I've had obstructive sleep apnea since 2016 but it took some time to diagnose. I shared a cabin once with a friend and noticed irregular breathing from where she was sleeping, so stood there listening and I knew something was horribly wrong. Told her to get help from her doctor and the following year she thanked me for saving her life. It turns out she had been walking around with severe OSA and had no idea until I pointed out her breathing pattern and urged her to seek medical attention for it. She's doing much better now.

My brother died at 37 yo in his sleep. Has sleep apnea, never used a CPAP. He is overweight. I wish we paid more attention to his condition 😢

I was diagnosed with sleep apnea when I was in my twenties, 20 years ago, in a lab. I received a CPAP machine, started getting restful sleep, and lost 20lbs as a result because I wasn't exhausted anymore. Then I moved to a different state, and it has been a real struggle to convince my new doctors that I had sleep apnea. Home tests didn't show that I had it, so I insisted on sleep lab studies. The sleep lab studies showed mild sleep apnea, that was borderline normal. But I know the difference in my health in sleeping with a CPAP machine and without, so I kept insisting that I needed a CPAP. I recently learned that a friend of mine was diagnosed with an Uppper Airway Resistance Syndrome in California, and started looking into it. From what she told me, this syndrome is harder to diagnose because it doesn't show up as constant sleep-wake up cycle, rather the brain doesn't allow the body to fall into deep sleep because the patient's throat is so narrow. I suspect that I might have this, because I notice that without my CPAP my sleep is not deep. It's such a light "surface" sleep, I remain aware of my surroundings. I wish more attention was paid to patients like me, women who are not overweight, and who don't manifest as "classic" sleep apnea patients. Interestingly enough, I didn't seem to get much push back from my insurance company. It's the doctor's offices and their sleep technicians who fight, argue, and gaslight like their life depends on it. I am disturbed by the fact that without my vigorous and aggressive insistence, I would not get the care that I need.

My life was transformed several years ago when I was treated for sleep apnea. In my case, I had Severe Central Sleep Apnea (60+ an hour), with some Obstructive Sleep Apnea. Treating with a CPAP worked great for me, now I'm down to around 2 apneas an hour, and I actually feel rested when I wake up!

A friend of mine passed away years ago due to sleep apnea. It was so bad for him he could only sleep for a few minutes at a time and because of his exhaustion he would fall asleep during conversation or game play. I lost a friend because we couldn't afford to get him help 😔 If you or a love one is suffering from sleep apnea, don't let it kill you or the one you love. Take my word for it, you think they will be there tomorrow and then they are gone before you can say goodbye 😢

I was a very loud snorer and my GP suspected sleep apnea, he had me go to a sleep clinic. I turned out that my problem was in my nose, due to a deviated septum. I had surgery to correct the septum, my post surgery recovery took about ten days, the first week of which was very sore and painful. After that it was a massive improvement, I slept better and did not get so tired in the day.

I'm a bit overweight but a muscular, very active and physically fit 60 year old with perfect metabolic and lipid panels, however I didn't feel great. Much to my surprise I was diagnosed with OSA earlier this year and my OSA was made much worse when I consumed alcohol. Since starting CPAP in April and dramatically cutting back on alcohol it has been life changing. I feel way better, sleeping way better, blood pressure is perfect now and my heart rate is low and beats very quietly. I love my CPAP... is that a bad thing to love a machine? :)

About 12 years ago I started to notice that I was a little tired during the day. The tired increased until I would sleep my entire weekends away. I thought that I may have chronic fatigue syndrome. Eight years ago I had a heart attack. Lately, I noticed that I have been getting tired during the off and my blood pressure has been out of control. My doctor asked if I snore and sent my to be checked for sleep apnea. Was just tested positive and look forward to having this treated so I can have more energy, better health,and going for long walks and losing weight. I'm 65 and just started my semi retirement. Thank for the information.

Physician education is important. I had undiagnosed sleep apnea that was impacting my memory to the point where I couldn’t function at work. I saw my Kaiser doc several times on this issue and even brought my husband to also say what he was seeing with me. The doc ran through the same questions to see if I had beginnings of dementia/Alzheimer’s. I had to count backwards from 100 by 7’s etc. When I passed the test he pronounced I had no memory problems at all. He diagnosed me with stress. I lost the job due to my inability to track info and my memory function. I found another job. Got new health insurance. I went to a UC Davis doc. That doc sent me to neurologist. In his exam, he asked one simple critical question, “Do you feel rested when you wake up?” I said, “never.” That got the ball rolling for sleep study. Yeah- sure enough, severe sleep apnea. CPAP has made such a huge improvement in my daily living. I wish my Kaiser doc had asked that simple question and was educated on different presentations of sleep deprivation. You can’t lay down new memories if you’re not sleeping.

I wanted to note that sometimes the at home sleep test misses mild sleep apnea, so it's good to get a lab test too if the the at home test is negative. My at home test was negative and my lab test was positive. Now I have a dental device and am doing so much better :)

6:34 yes! 100 % true. I work in a hospital and most of our Code Blues happen between 0300 and 0500h. I was recently talking to my co workers about it. Again, I studied that our heart is greatly affected by the Circadian rhythm. So for people with heart disease, then adding a disorder such as OSA and you have the perfect combination for high mortality risk.

No where in this video does it talk about keeping your head elevated. I have a mild case of sleep apnea and the best way I know is to sleep on your side and elevate your head with 2 pillows. I find when I sleep on my back, that is when I stop breathing.

Learning to park my tongue on the roof of my mouth stopped the sleep apnea and help deter the TMJ pain.

This is hands down one of the most informative videos I’ve seen on sleep apnea - have received fly been diagnosed and struggling badly with using the CPAP machine 7 weeks on and I’m yet to sleep through the night with the mask on - glad to see there are other treatments available

Thank you for this! I’m 61, 155, 6’1 and was waking up with massive “hangover” headaches and waking up gasping, not breathing. Been on cpap for two years. It’s been a difficult journey but getting better. I tried all the mask designs and settled on a full mask, swapped to a longer hose so I wasn’t yanking the machine and adjusted the humidity and pressure until I was naturally breathing in and out with the assist.

Was diagnosed age 33. Normal/low bmi, female. Doctor was shocked I had it because I was not middle age, overweight, male. Everyone should get tested who wakes up unrested. I have had it my whole life. And I feel so much better with treatment.

I don’t think I’ve ever had such an emotional reaction to such a straight forward informative video as I did with this. I was diagnosed at 36 and I’m now 40. The difference from morning one after first use of the cpap machine was transformative. I was about to have the energy I use to have and managed to start turning my health around again in a serious way. This apnea is no joke. I was teaching parenting classes at the time and shared my story as part of the taking care of yourself to be able to handle parenting better part of the classes I did. I think I helped a good amount of people get checked and diagnosed. It was going great until my mental health started going south for a smattering of reasons in the middle of the pandemic. I sometimes don’t make it to my cpap in time before the apnea gets me. Sometimes I wake up with the mask my hand never having put it in when I got to it. Along with physical health and using the cpap it seems to me that mental health is just as important of a factor. Each of these factors need to be in place to properly fight against the apnea. If one fails it seems to have a compounding effect and causes the other factors to crumble as well. Thank you for this video

I’m a hospital based internist and I’ve been diagnosing OSA for the better part of my 18yr career - significant treatment protocols are impacted by poor sleep that result in acute on chronic cardiopulmonary disease states that is resistant to treatment or results in frequent readmissions, including resistant HTN, afib, allodynia/hyoeralgesia, resistant DM, Sz disorders and intractable migraines, resistant depression, anxiety, Parkinson’s and dementia, behavioral disturbances, and delirium. The list goes on and on, even in the acute setting and it’s critical to recognize. Also, respiratory mechanics impacted by musculoskeletal issues and constipation all result in reduced diaphragmatic excursion which is even more critical in patients with OSA. As a healthcare system in the US, we are way behind in addressing these foundational aspects of health and disease. Let’s keep diagnosing and treating the body the way it deserves to be helped. Everyday.

I've trained myself to sleep on my side with my head tilted back. Works very, very well.

A surgery last summer was postphoned for me due to need for a sleep study during pre-op clearance. Then getting CPAP equipment took over 50 days with that Phillips recall. I was upset about the postphoned surgery, but after learning more about sleep apnea, heart, post anesthesia, in recovery room and the thought of discharge to home without CPAP equipment was not recommended. This is a subject that needs much more coverage in preemptive medical care!!!!

Thank you! I learned so much in just 15 minutes. I am an RN working in a Med/Surg Trauma Unit.

My OSA had been progressing over the last decade without me knowing. I was getting to the point that I couldn't sleep at all because I felt like I was suffocating. Then I started developing really bad panic attacks. After going through this for six months or so, I finally got on APAP and most of the problems went way. The valve issue they detected in my heart before I started treatment went away afterwards.

Thanks for the information and clear explanation. Got a dental guard from my dentist (I grind my teeth a lot) and it greatly improved my sleep apnea as well!

Thank you very much Dr. Roger Seheult, Your teaching is so clear and easy to understand.

Great apnea overview. Thanks. I'm on a machine and it has improved my sleep quality considerably. I pressed for this approach since my Dad died in his sleep and he was a very loud snorer with long pauses in his night breathing.

I am the youngest of 7, and I am ancient at 60 years old, lol. Several of my siblings and I went on a vacation and I shared a room with an older sister (who in a previous life was a respiratory therapist). She kindly barked my name to get me to wake up, she was startled and was getting ready to do a precordial thump on my chest! I learned the next day that 5 of my siblings suffer from moderate to severe sleep apnea and all use CPAP machines. I will be getting this addressed in the coming days. Thank you, this video was extremely well done and incredibly helpful!

I definitely came here for a difference discussion. There has been some discussion about excess deaths showing up in the data since 2021 and no one seems to have a good explanation for why we're seeing this particular timing, across many Western countries, and across all age groups. I don't think we're seeing a pandemic of sleep apnea =) Anyway, excellent presentation on sleep apnea. Clear and concise as usual. Thank you!

OSA one of the biggest problems in America. Easy to treat and often missed. Ty for talking about this.

Thank you for the help you give. May God continue to bless you and be a blessing to others

Excellent job explaining in an easy to understand manner. 10/10 😉

Diagnosed with severe central sleep apnea with 65+ issues/hour. Had an mri to rule out issues in my brain and wore heart monitor to discover the reason my heart was skipping a beat. I’m on a bi-pap st machine and I’m convinced it saved my life. Nothing showed up on the mri and my heart issues were because of untreated sleep apnea. When I read others say how much they hate their machines just makes me sad. I am finally getting back on top of my health and would not be if I didn’t have this machine.

Thank you so much for this clear brief invaluable explanation

Ha- should have watched full episode. As always, superb work in your explanation and illustration!

Dr Seheult...I woke at 5am last month with spasms up and down my legs from my calves to my hips, only way to describe them is they felt like labour contractions. For some reason I wasn’t too alarmed and carried on dozing till it was time to get up and do the school run. I felt rough and had a migraine like forehead headache but made it the 15 minutes walk to school well it took another 10 mins, my legs moved so slowly. I then had to walk home and it took 30 mins! They felt like parts of the muscles especially quads and glutes were empty....dead! I walked so slowly and had to tackle a very steep hill home 😔I almost called my partner (who was poorly at home with Covid) for a lift home as every little step caused a huge hit of lactic acid. My legs were not my own over night. Made it home. Almost 2 months on my muscles no longer have the tolerance to go up hills or walk fast or they get heavy again. My suspicion Is hypoxia from undiagnosed sleep apnea? I tested positive the morning I made it home, for Covid. The two events are connected surely? No doc or specialist cares about this detail...both conditions can cause hypoxia? And how do I recover from here 😢

Excellent video. Thank you

Thank you for your knowledge and encouragement.

I haven't slept on my back for years . After falling asleep I would let out a large snore or a gasp of breath which would wake me up . I have been sleeping on my left or right side with my knees slightly up and pulling the pillow under my neck to level my head , or sometimes lay on my front and these positions are working great for me . Sometimes I'll fall asleep in the chair, but my body position is nearly up straight which i don't have a problem with .

I had sleep apnea near the end of my pregnancy, I was retaining a lot of fluid because of pre-eclampsia. Thankful it resolved after I gave birth

I was recently diagnosed after a sleep study at the VA Hospital. They say that I have severe obstructive sleep apnea and I stopped breathing over 60 times per hour. They say that I am a candidate for the Inspire implant device.. Praying that they'll expediate the process for the implant. I also have an obstructed jawline. Thank you for your videos

Extremely enlightening! Thanks!

Like you say at the beginning, a very low-hanging fruit for those who want to optimize their health. I had to push the concept through my cardiologist, who had little interest. After a few months I was finally on a CPAP. A definite improvement, although not perfect, the wide-ranging benefits are well worth it. Wish all my problems were this easy.

Very informative video Doc! My wife is Asthmatic and also has sleep apnea. I keep trying to get her to go for an evaluation but she continues to resist. You are so right about it affecting ones sleep and not only hers but mine as well. It's like a never ending cycle. Hope that you and your family are doing well.

Thank you so much for this informative video.

Awesome video that helped a regular guy like me. Thank you very much.

I’m 70 and I have sleep apnea, diagnosed over 30 years ago. Never did anything about it. Still healthy as a horse.😊

I'm a reformed sinner - fitted for a CPAP about five years ago. About 3 days after I first used it I was driving on a highway (my job called for a lot of it) one morning and realized I could keep track of the cars around me. Ten years earlier I was on the same highway and noticed a highway patrol car gradually overtaking me on the left, A moment later an RV appeared on the roadside so I checked my side mirror (but not the wide angle part) and changed lanes to give it room. The officer pulled me over and ticketed me, as he should have. That ticket stung, of course, but it was part of the process that eventually got me on a CPAP. Today I don't even nap without it. I wonder how much of the excess mortality is the result of traffic accidents.

Just received my CPAP from the VA 2 days ago. Can't wait to try it out.

Useful info! Thanks.

Good presentation. You should discuss the link between sleep apnea and floppy lid syndrome, lash ptosis and normal pressure glaucoma.

My story: I felt I was a good sleeper. No complaints. No snoring or other symptoms. I developed polycythemia (18.2 gram hemoglobin) with no known cause. My wife though she saw subtle breathing pauses but she wasn’t sure and had trouble counting the respiratory rate and pauses. An at home sleep study showed an AHI score of 38 (severe). Turns out I’ve got central sleep apnea. Subtle symptoms. Rats.

❤thank you for the splanation. Very useful.

Very clearly explained, thanks so much.

I have this. I’m so tired all day plus I have bad headache due to this. 😢

Now I understand what my CPAP is doing. For some reason I can't get most doctors to go into technicality and it's frustrating. So next step, how do we convince the manufacturers to give end users access to their own raw data. Those summary numbers that my app outputs are nothing more than "feel-good" numbers. See numbers that change slightly over time? Then it must be doing something. There are those of us competent enough to digest raw data. Blocking us from it is just not right.

This is so good! Thank you!

Excellent video! Thank you

I record 100 to 200 apneas per 8 hours of sleep with my breathing monitor. These apneas are mostly in the range of 10-20 seconds in length. However, I once recorded a 1 minute no breathing event. I clearly recall me dreaming of swimming and playing with a whale. The whale loved playing with me and did not realize that I could not stay as long as he could under water, he accidently drown me and that is when I woke up. This is another way to discover if you have this disease. Think of your dreams. Sometimes I dream that I laugh so much that I can not breath, then I wake up. These are all sleep apnea related dreams. I can list many more. I just wanted to give the doc and people a heads up on this as another sign of sleep apnea. All of the best to you all and I hope you beat the disease.

Thank You! You left out The most Common reason: sept deviation în The nasal cavity ! Should be mentioned as most Common în both men and women! ❤

Great morning I've been using my CPAP machine for almost 4years now and it's a blessing...great video y'all stay encouraged,stay healthy and have a blessed day....

Really interesting, cool to provide a course for doctors all over the world. How about consciously trying during the day to keep your tip of the tongue to the upper front almost touching the teeth, then during the night there's a good change you will do this too, even though you are unconscious. And i understand correctly, keeping your tongue up front would mitigate this issue.

I’ve just been diagnosed with osa with a score of 28. I was wondering how the cpap machine helps, this video explained to me how it helps that it pushes the tongue away so air can enter. Thanks for this informative video.

It was discovered that I had sleep apnea when I spent two nights in the hospital after a TAVR procedure. My oxygen level would drop to 82! I then had a sleep study done and learned I have severe sleep apnea....30 apneas per hour. It has been over six months now since my cardiologist has tried to get me a CPAP machine. Impossible to do. I have now developed AFib and am on 2 meds to keep my blood pressure under control. I sleep as little as two hours per night.....absolutely no energy....learned that inflammation of the back of the throat adds to my issues so I have stopped all dairy products and sugar, which causes inflammation. I have also ordered the tongue device, which I should be getting within the next week. I am now looking into mouth exercises for sleep apnea. This is an awful ordeal to go thru. I am the first sleep apnea patient in my cardiologist's office and I honestly do not they are taking it as seriously as I am.

Thank you for the video.

From my experience, I intermittently fasted and this stopped my snoring and my sleep was markedly improved. I think this should be tried first.

Thank you for sharing this information with us, I've been diagnosed as having chronic sleep apnea for over 5 years now and everything you said about the symptoms are 100 percent facts from being tired all day to not ever having the feeling of a good night's sleep, I've had that c-pap machine delivered to me from a sleep study institute only to feel like I'm Frankenstein's monster with that thing pushing gallons of air into my mouth and nose while only trying to sleep, it is very uncomfortable and I have only wore it a couple of times in 5 years, anyway if you or anyone else out there has this monstrous problem, please share your thoughts or comments on trying to solve this problem. Thank you again for sharing your time and help for those of us who suffer day and night from this problem amen 🙏

I am diagnosed with sleep apnea and I have a cpap. I love it

Thank you this was very informative 😊

If you suspect you may have sleep apnea and have a Fitbit, you can monitor your sleep patterns to determine if you are not going into REM during the night. If your REM is not present or very low, then you are in danger of the symptoms of sleep apnea. Another problem if you don't sleep well and wake up with blocked passages, you may be experiencing allergy symptoms and that can also affect REM sleep. I have sleep apnea but have difficulty with the mask. Was able to get the machine via Medicare and the accessories. When I was able to use the machine and mask, did sleep better. Also, installed an air purifier in my house. One that is an active system, not passive. The one I bought is the CIMR 2000 which is one that will treat the air in a home up to 2000 square feet. The technology entails taking the oxygen and hydrogen molecules from the ambient air, pulling it though a cell with a specific lining with a light spectrum set at a specific level. The oxygen and hydrogen molecules are broken down and reassembled into a dry, hydrogen peroxide molecule with a positive and negative charge. The molecules seek out all airborne and surface pathogens anywhere air can access, mold and mildew (inactivates but does not remove the dead mold and mildew shells), and pet dander, immediately attaching to each one and rendering them harmless and then they destruct. The molecules then return to their natural state. This technology has been used by the military and the only one approved by the military. If anyone is interested, you can go the www.CIMRtech.com and read up on the systems for yourself. They do work very well, and they do not have to have filters changed every month or year, take out of the box, use the appropriate plug, plug in, turn on, use the appropriate settings, and let the unit run 24/7 until it needs minor cleaning that one can perform on their own. Recommend checking the link out and determining for yourself if you want to investigate the technology further.

Three things: 1) I was diagnosed with Obstructive Sleep Apnea (via a home monitoring device) 2) I don't sleep on my back, I sleep on my side 3) I can't sleep with a CPAP. It keeps me wide awake all night (I am assuming that I am getting more oxygen, thus breathing better and staying awake?)

This is a very helpful "mini-class" on what sleep apnea is, how serious it is, and what we can do if we have it. My girlfriend said I wasn't breathing much at night; being knowledgeable she said I should have a sleep study. I've been diagnosed with this after my sleep tests at the hospital lab. I will have my lab follow up visit with the doctor in 4 days -- about getting my CPAP machine & learning how insurance can cover it. Good video!

Keep up the good work

I’ve been using my cpap 3-4 years being very consistent but I’m still feeling exhausted. My AHI is any from .5 to 2 but I do notice I have 30-40 arousals that don’t get counted as apneas. I’m 99% sure it’s all the times that I’m rolling to my side and to my back.

As far as I know there are other 2 options to tackle sleep apnea. First, a surgery on the back of your mouth in which, among other things, they cut the uvula. Second, a surgery in which they push the jaw forward. In both cases, the goal is to increase the airway

Your videos are spot on❤

IMO this is the best video, on sleep apnea thank you doc

I have moderate sleep apnea. Stopped using the CPAC as I found it too much trouble. Now I use surgical tape and it's worked out really well for me. Love the ease of use and the simplicity.

I'm lucky that I was diagnosed with obstructive sleep apnea when it was extremely mild and have been using a CPAP with near 100% compliance since then. The threshold for diagnosis is 5 on the AHI, and my sleep study came back with a 5.1 (about 6 years ago). I probably prevented a ton of damage by starting CPAP so early.

This is excellent

Thanks a lot for your information God bless you

Would sleeping in a prone position help with apnea? I wonder if crib death isn't related to this as well. That oral appliance reminds me of a pacifier. Sleep is so important! You should have Dr. Walker on your show-he studies sleep and wrote a book on it. Maybe you know this. Excellent discussion. I learned more from you. Thanks for a great presentation.

Excess deaths at night? Are you referring to the recent dramatic increase in sudden deaths in the last year and a half?

The best explanation on you tube

Don’t mouth breathe, have proper tongue posture(myofunctional therapy), mouth tape at night. Narrow long face high palate not good. Dna appliance is approved for sleep apnea. If tongue tie is bad get looked at ez

This puzzles me! If it’s so easy to die from suffocation while sleeping, how did we ever survive as a species?

Helpful video, thank yoU!

Thank you for your information

I always said I was not tired in the day when doctors asked... then, after using a cpap, i felt like a teenager again and realized that I had no idea what not feeling tired felt like lol 😆

My wife did the dental device and it did fix the problem. Be aware those devices can take up two years to reshape the jaw so you need patience if you do it.

v Very informative lecture. Thanks