Oral Appliances for Sleep Apnea
by Dr. Scott Bolding
The most common treatment for sleep apnea is the CPAP machine. This machine uses pressurized air to keep your airway open while you sleep. Even though CPAP has been proven to effectively manage sleep apnea, it’s not always the best option for every patient. Many patients find that CPAP is difficult to use long term. In fact, studies have shown that 50% of patients stop using their CPAP over time.
The inconvenience of CPAP leads many patients to search for other options. Some patients opt for surgery, which is the only way to permanently treat OSA. Others however aren’t ready or aren’t candidates for sleep apnea surgery. For these patients, oral appliances, or oral devices, can work as well as a CPAP.
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What is an Oral Appliance?
A sleep appliance is a custom-fit mouth guard that is designed to keep the airway open while you sleep. Oral sleep devices fit in your mouth like an orthodontic mouthguard. They keep your airway from collapsing, allowing you to breathe better at night.
Types of Oral Appliances
There are two different types of oral appliances to treat sleep apnea in adults and one specifically for children. These different devices help to manage different problems that can lead to sleep apnea.
A mandibular advancement device (MAD) connects to your upper and lower teeth. It works to support your jaw and move it forward as you sleep.
MADs help manage one of the most common causes of sleep apnea, underdeveloped jaws. If your jaw did not grow properly as a child, it can impact the size of your airway. This makes it harder for you to breathe easily at night. One solution is to go through MMA surgery, where the jaw is permanently moved forward. However, for patients who aren’t candidates for MMA surgery MADs are an excellent alternative.
MADs are similar to a sports mouthguard and can be customized to fit your mouth. However, we do not recommend going out and buying an over-the-counter mouthguard or a sports guard. These are not custom fitted to your mouth and usually will cause more serious problems. MADs are also different than anti-snoring devices that you can get at the store. MADs will help reduce snoring, but are mainly meant to treat sleep apnea, whereas the snoring devices are not. If you want a MAD to help manage your sleep apnea, you need to get it prescribed by a doctor.
The other type of oral appliance is a tongue stabilizing device (TSD). TSDs work to manage the other main cause of sleep apnea. If your tongue is too big or if it is too far back in your mouth, it can fall back into your throat when you sleep. It then blocks your airway, leading to sleep apnea.
TSDs pull your tongue forward and lets it rest in a plastic blub that protrudes through your lips. This keeps your tongue from falling back in your airway while you sleep.
TSDs are not as common as MADs and have not been studied as thoroughly.
Rapid maxillary expansion (RME) devices are usually used to help kids who have obstructive sleep apnea. They work well for kids whose jaws are not developing properly. RMEs expand the roof of the mouth, similar to an orthodontic expander. The RME fits over the top back teeth and uses pressure to expand the mouth.
>Unfortunately, these expanders are not always effective in treating sleep apnea in children. Studies have shown that they only reduce sleep apnea in 25% of children. They are best used in combination with other treatments like a tonsillectomy.
How Do They Compare to CPAP?
Studies have shown that oral appliances are just as effective in managing sleep apnea as CPAP machines.
In fact, they can actually be more effective in treating sleep apnea. This is due primarily to patient compliance. More patients are willing to use the oral appliance long term compared to CPAP. While only about 50% of patients will use their CPAP long-term, oral appliances see an 80% compliance rate.
Because of the higher compliance rate, oral appliances can be a better option for patients who have a hard time with CPAP. You can get the sleep you need without being hooked up to a machine for the rest of your life.
Benefits of Oral Appliances
Many patients find that oral appliances have several advantages over CPAP machines. The biggest benefit is how easy it is to use.
Other benefits include:
- More comfortable than CPAP
- Easy to clean
- Easier to sleep with
- Better compliance
- Usually cheaper
Side Effects of Oral Appliances for Sleep Apnea
Any medical treatment will have some potential side effects, and the oral appliance is no exception. Most of these side effects are mild and rare. It’s important to talk to your doctor or dentist about all of these so you can make the best decision for your situation.
Side effects of oral appliances may include:
- Changes in alignment
- Pain in teeth
- Problems in the jaw
- Dry mouth
You Deserve Better Sleep
An Oral Appliance Can Help You Get There
Treating sleep apnea is important. And for patients who can’t tolerate the CPAP, there are other options. Oral appliances are an excellent alternative to CPAP therapy. These devices help you manage your sleep apnea comfortably. You get the sleep you deserve without the inconvenience and discomfort of CPAP. If you are ready to sleep better, talk to one of our sleep specialists today about how an oral appliance can benefit you.