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Sacramento Natural Dentistry

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Affidavit For Intolerance To Cpap

I have attempted to use nasal CPAP to manage my sleep related breathing disorder (apnea) and find it intolerable to use on a regular basis for the following reason(s):
Mask leaks
Mask uncomfortable/Device uncomfortable
Unable to sleep comfortably
Noise disturbs my sleep and/or bed partners sleep
Restricts movement during sleep
Does not seem to be effective
Straps/headgear cause discomfort
Pressure on the upper lip cause tooth related problems

* Because of my intolerance/inability to use CPAP I wish to have an alternative method of treatment. That form of therapy is an Oral Airway Dilator appliance, as prescribed to me by Dr. Azouz.

(Your digital signature (full name) is as legally binding as a physical signature.)