About Oral Appliances

If you suffer from obstructive sleep apnea, the most common and effective therapy is continuous positive airway pressure, better known as CPAP. In spite of the treatment's proven effectiveness at reducing sleep apnea episodes, snoring and daytime sleepiness, many users don't reap its benefits.

In some cases, CPAP simply may not be effective. More often, however, patients fail to use the device consistently or they stop using it altogether. Among the most common reasons cited for noncompliance are issues with the mask, such as discomfort or skin or nasal passage irritation. Others say the mask makes them feel claustrophobic or that the device is simply too cumbersome.

If you've experienced these types of problems, the first step is to work with your doctor to try to alleviate them. But if that fails and CPAP compliance remains a problem for you, a mandibular appliance may offer a solution. Also known as oral appliances, or OAs, these devices resemble mouth guards worn by athletes, and a number of recent studies have shown them to be as effective as CPAP at reducing daytime sleepiness in people with mild or moderate sleep apnea.

The American Academy of Sleep Medicine (AASM) has updated its guidelines to reflect these findings. Taking a somewhat controversial position, the AASM now considers OAs to be a reasonable first choice for people with mild or moderate obstructive sleep apnea who prefer oral appliances (though other experts say more long-term study is needed before this recommendation can be made).

OAs are also appropriate for people with mild or moderate sleep apnea who don't respond to or are not appropriate candidates for CPAP. The devices can be considered for patients with severe sleep apnea, but CPAP and, in some cases, upper-airway surgery are preferable.

Publication Review By: Peter B. Terry, M.D., M.A.

Published: 24 Jun 2013

Last Modified: 24 Jun 2013