Let’s review how to clean and adjust your Prosomnus PH (Precision Herbst) sleep apnea mouthguard.
The PH Prosomnus is available in a wrench style or a pinhole adjustment mechanism.
We will also review and point you to potential oral appliance side effects and accompanying solutions.
What to expect the first few nights wearing my Prosmonus PH (Precision Herbst) oral appliance device?
The appliance will feel strange in your mouth for the first few nights of wearing it.
Although most patients adjust easily to the snug feeling around the teeth early on, it may take up to several weeks to build up your tolerance to wearing the device.
Patients who have worn a night guard for teeth grinding, orthodontic retainers, or Invisalign often adjust very easily to wearing a Prosomnus PH oral appliance.
The Prosomnus PH device offers the patient quite a bit of lateral movement (side to side), one of the advantages of this device. Patients who grind their teeth at night, appreciate the freedom of movement of the PH sleep appliance.
The initial goal of oral appliance therapy is to sleep comfortably, without discomfort and to eliminate noticeable symptoms of obstructive sleep apnea.
Possible side effects of wearing the Prosomnus PH
The side effects of this device are similar to all other custom dental sleep apnea appliances.
Here are the most common side effects when wearing your Prosomnus PH oral sleep device and what to expect.
Nighttime success tips
Here are some tips to help you establish a routine:
- Brush and floss your teeth before inserting your device(very important)
- Apply lip moisturizer (optional)
- Rinse your dental device with cool water before inserting (optional)
- Drink water only – once inserted, you can swallow easily and usually drink water. Please avoid other beverages.
- Go to sleep!
How to insert your PH oral sleep device
With both hands, hold the upper and lower segments together like a sandwich. Most patients like to place the upper tray first.
Step 1. With both hands hold your device segments together like a sandwich and insert into the mouth.
Step 2. Line the upper segment up along your top teeth and press onto your teeth with both hands. Sometimes a slight rocking movement may be necessary.
Step 3. Once the upper segment is secure, repeat with the lower segment pressing down onto your teeth.
Step 4. Close together gently.and try to close your lips if possible. This may be difficult early on but over time, you may find this more natural to do.
A general mouth posture positional goal with your device inserted would be to have your lips together and your teeth apart.
Removing your Prosomnus PH oral sleep device
To remove your oral appliance, always do what feels most comfortable.
In most cases, patients will find the following a comfortable way to remove the dental device:
Step 1. Lift the edges of the lower tray with both hands where you can get a grip. Many use the metal housing bumps that are protruded. Move upwards on both sides in a rocking motion.
Step 2. Repeat for the upper arch using the edges of the device on both sides towards the back. Dislodging towards the back molar areas on both sides is often more comfortable then starting with the front area.
TIP: Be careful not to drop your device. The Prosomnus PH device is very strong but can crack when dropped on a hard surface.
Developing a morning routine after removing your Prosomnus PH device
There are three areas of routine to consider after removing your oral appliance. See the links for detailed information:
Performing these as recommended will increase the longevity of your dental sleep device, prevent unwanted side effects and increase your comfort level during your oral appliance treatment.
How to clean your oral device
Cleaning your device is crucial in improving the longevity of your oral appliance. Careful cleaning will also reduce odors and diminish discoloration on your device.
Learn more by watching My Sleep Device’s educational videos or read our articles on how to clean your dental sleep device.
For your specific type of Prosomnus device, you may follow any of the suggestions on our site except for:
- Daily (Part 1, video)cleaning is recommended only
- Weekly special cleaning (Part 2) is NOT necessary
- The Prosomnus company DOES NOT recommend soaking their device in any cleaning tablets/solutions
- Scrub with soft brushes and only use liquid detergents (dishwashing liquid or hand soap)
- Air dry in an open container
- The manufacturer currently does not recommend the use of home ultrasonic units
Jaw stretches and morning aligners for your oral sleep appliance
It is normal for your teeth to feel strange after removing your Prosomnus device for up to an hour.
This occurs most commonly from your jaw not being realigned into its regular position. This is commonly experienced.
To help prevent bite changes and help the jaw realign into its natural position, there are 2 actions recommended: performing jaw stretches and using a morning aligner tool.
Performing jaw stretches and using a morning repositioning tool (if provided) are very important to long-term oral appliance care.
When do I need to advance the Prosomnus PH Oral Sleep Appliance?
The starting position of your PH device has been determined by your sleep apnea dentist. For some patients, the original starting position is the most effective treatment position and you will not need to further advance your jaw.
For many others, further jaw protrusion (advancement) is needed for the dental sleep device to be effective.
Here is a review of when it’s best to begin or stop advancing your device.
The following is a list of positive effects that would indicate that minimal or no changes are needed:
- Bed partner or roommate observes that your snoring is significantly reduced or gone
- No apnea is or waking up gasping for air is witnessed by the bed partner
- Increased dreaming
- Decreased or complete elimination of nighttime walking or urination
- Decreased leg movements (for those who have Restless Leg Syndrome)
- Feeling refreshed upon waking and daytime sleepiness is diminished or gone
These subjective changes help us determine when to advance the appliance.
Once you are comfortable with general wearing but still have noticeable apnea symptoms such as snoring, daytime sleepiness, or poor sleep quality, it’s time for you to advance your dental sleep device.
How to advance the Prosomnus PH sleep mouthguard
Your PH device will have one of the 2 types of PH mechanisms available. Which you have is determined by the selection of your sleep apnea dentist. We will review directions for both here.
First, determine which style of PH you have. The tools for advancement will be different depending on which mechanisms you have the wrench style or the pinhole style.
- Determine which style of PH device you have
- Do not adjust the appliance for the first several nights
- If advancements are needed based on above descriptions, follow these directions:
PH Type Pinhole Oral Appliance Device:
Step 1. Holding the 2 segments together, snugly hold the device in one hand
Step 2. Take the other hand and insert the tool into the pinhole of the barrel. (Either a white-handled tool or small metal tool of the same diameter)
– Start with the pinhole located furthest from the tip of the arrow, or closer to the base of the arrow
Step 3. Move the barrel with the tool inserted in the direction of the arrow until it can not go any further (this is not a full revolution).
– This counts as “one turn” for most dental providers. Each 90 degree turn is equal to .1 mm
Step 4. Adjust the same number of turns on both sides, usually not more than 5 turns every 3-4 days.
Step 5. See the next section below on when to stop advancing the device. (1/2mm)
Note: The device may start with it adjusted to 1 mm. In the event the initial starting point feels too aggressive. This would allow adjustment in the direction opposite of the arrow.
**** MY SLEEP DEVICE VIDEO – Pinhole Advancement demo video coming soon.
For now, please refer to this similar device demo video.
Advance the same number of turns on each side, usually not more than 5 turns on each side, every 3-4 nights.
Wrench Type Oral Appliance Device:
Step 1. In one hand, spread the 2 segments of the device apart while keeping your finger in between the segments and hold steady
Step 2. With the other hand, engage the wrench onto the square nut of the barrel
– Turn in the direction of the arrow until it can not go any further
– This counts as 1 advancement turn for most dental providers
– Each 90 degree turn is equal to .1 mm
Step 3. Adjust the same number of turns on both sides
– Usually not more than 5 turns, every 3-4 days (½ mm)
Step 4. See next section below on when to stop advancing the device
Note: The device may start with it adjusted to 1mm in the event the initial starting point feels too aggressive. This would allow adjustment in the direction opposite of the arrow
VIDEO DEMO: Wrench Style demo video coming soon.
For now, please refer to this oral appliance device advancement video.
NOTE: When watching this helpful video, please forward to timestamp 3:14 (3 minutes and 14 seconds) into the video for the adjustment titration demo. Ignore the section before the titration segment on cleaning products.
Here is a helpful device adjustment table from the ProSomnus Product Guide – link to their site or the guide:
When do I STOP advancing the oral sleep device?
It’s time to stop advancing your PH oral sleep appliance if any one of these occurs:
- If pain occurs and doesn’t readily resolve, you may need to skip a night
- If comfort doesn’t increase over a few days, you may need to return the appliance to the previous comfortable tray combination by decreasing the advancement setting
- All symptoms are resolved, and you feel the device is working well
- Reports of snoring have stopped
- You might awaken feeling refreshed, you no longer have headaches and you are less sleepy during the day
- You reach the maximum position of your PH mechanism of 7mm.(1mm was present on the mechanism when received, and up to 6 more mm of adjustment possible..)
- In this case, your dental provider may be able to make changes for further advancement capability if he or she feels advisable.
The best way to establish that your device effectively treats your sleep apnea and eliminates oxygen desaturations is to perform another sleep test, either with a home sleep test or polysomnography test performed by your sleep apnea medical or dental team.
Your sleep apnea dentist will help guide you as to the proper timing of getting a sleep test with your oral appliance inserted.
If you live alone and snoring is your only symptom
If you live alone or cannot receive feedback on your snoring levels, it may be challenging to know if the device is working and if an adjustment is required.
For these circumstances, I recommended using the Snorelab App. Click here to learn more about this useful app.
Monthly tightening of housing screws
With either type of Prosomnus Herbst device, the wrench or the pinhole, it is important to check housing screws are secure with the wrench tool.
Remember: “Righty tighty, lefty loosie” or “To the right is tight”.
Using too much force can strip the screw. Engage the screw with the wrench tool.
Turn to the right and make sure the housing screw is snugly secured.
Repeat with the 3 other screws.
What do I do if my mouth drops open when wearing my Prosomnus PH oral appliance?
Some Prosomnus devices have built-in acrylic hooks that can accommodate small elastic bands.
Elastic bands can be worn on your Prosomnus sleep device if you experience dry mouth or feel your mouth is popping open during sleep.
Nasal breathing, if possible, is encouraged with oral appliance therapy. Nasal breathing may improve the results of your therapy and keep your mouth free from dryness.
Non-latex material elastics are also available. If you have a latex allergy, it is important to use non-latex elastics. To order elastics, see the Dry Mouth Resources section on our My Sleep Device’s Resource page.
If your trays do not have any hooks, your sleep apnea dentist may ask the dental lab to accommodate this request. Other suggestions may include using mouth tape. You can find these under our Dry Mouth Resource section of the Resource Page.
What follow-up appointments are recommended once I start wearing my Prosomus PH?
Approximately 2-3 appointments are recommended with your sleep apnea dental team to help you maximize the results of your appliances and to troubleshoot issues that may arise. Some dentists may request you come in more often as needed.
It is important to follow up with a visit to your oral appliance dentist to verify the device is working beyond symptom relief. In many situations, the device may need further advancements to eliminate oxygen desaturation and/or sleep apnea events.
Once there is verification that your oral appliance is effective in controlling your symptoms and apnea events, it is recommended you return in 6 months then annually.
At these visits, your sleep apnea dentist will evaluate the integrity of your oral device, and assess for potential dental /oral side effects.
Please contact your prescribing sleep apnea dentist If you have questions or need help.