Sleep Apnea Treatment Options: Oral Appliances

Sleep apnea is a common sleep disorder that interrupts breathing and disrupts restorative sleep. Untreated, sleep apnea can lead to a variety of medical complications, including hypertension and heart disease. The goal of sleep apnea treatment is to open up the airways and restore regular breathing. While CPAP treatment is the most common and effective treatment option, oral appliances offer an alternative that can be used alone or with a CPAP machine.

Deciding on a Treatment Option for Sleep Apnea

Before any treatment option is decided, a sleep study is necessary to determine the severity of your sleep apnea. While one way to achieve this is a sleep study at a medical center, you can also opt for a home sleep study in the comfort of your own bed. Once a diagnosis and the severity of sleep apnea is confirmed, you can talk with your doctor about treatment options and the one that will work best for you. While most cases of sleep apnea are best treated with a CPAP machine, some people find them uncomfortable and difficult to use. If this is the case, an oral appliance may be an option. In cases of mild sleep apnea, an oral appliance is often all that is needed to restore regular breathing.

What is a Sleep Apnea Oral Appliance?  

An oral appliance for sleep apnea is actually a dental appliance. There are two main options, both with the goal of keeping your airway open.

Mandibular Advancement Devices, or MADs, are a dental appliance that is made up of two pieces hinged together. Each piece fits over your teeth. The device works by pushing your lower jaw and tongue forward while you sleep. This helps to prevent the collapse of your throat muscles and tissue during sleep, keeping your airway open for regular breathing.

Tongue Retaining Mouthpieces are an option that, while similar to MADs, have an area that suctions your tongue in a forward position, keeping it from falling back into the airway and blocking your breathing.

Benefits of Oral Appliances for Sleep Apnea Treatment

When it comes to any sleep apnea treatment, the goal is always to restore regular breathing. While a CPAP is what most medical professionals will recommend as a first treatment option, an oral appliance does offer benefits to those with mild sleep apnea or those finding it difficult to use a CPAP machine. Some benefits of an oral appliance include:

  • Easier to use – For some people, using a CPAP machine can be difficult as they may feel claustrophobic or find they are unable to sleep with the device. This can contribute to non-compliance and lead to non-treatment. An oral appliance is small, easy to use, and non-cumbersome.
  • Convenience and Portability - An oral appliance is easy to clean and care for. For those that travel for work, an oral appliance is simple and easy to travel with.
  • Quiet – An oral appliance is silent and a good option for light sleepers.
  • No Need for Electricity – For those looking to save electricity, an oral device does not require an energy source. This also makes it a good option for those that go camping or spend time away from electricity on a regular basis.
  • Benefit CPAP Users – An oral appliance can benefit patients with severe sleep apnea already using a CPAP. With an oral appliance in place, patients can often reduce the pressure required by the CPAP machine.
  • Cost – Despite being custom-made, oral appliances are typically less expensive than other forms of sleep apnea treatment. For patients that must pay out-of-pocket, this can be a significant savings.

Disadvantages of an Oral Appliance

While oral appliances may seem like a great sleep apnea treatment option, they do not work for everyone and can cause other issues. For people with moderate or severe sleep apnea, an oral appliance is often not enough to keep the airway open and is ineffective. Because an oral appliance is moving the jaw, people can experience jaw pain and soreness, often leading to temporomandibular joint arthritis, or TMJ. People can also experience sore teeth and gums, excessive saliva, dry mouth, and damage to dental restorations. Continued regular use of a dental appliance can cause your teeth to shift and may require regular orthodontic care to maintain normal teeth position.

Which Patients Benefit from Oral Appliances?

Because CPAPs are considered the best treatment option for sleep apnea, most physicians will automatically turn to that treatment option. However, there are some cases where an oral appliance may be more beneficial. Patients with mild sleep apnea may not need the added airway pressure of a CPAP and an oral appliance is enough. If sleep apnea treatment has not been successful, an oral appliance may be added or substituted for treatment.

Compliance is the Most Important Part of Sleep Apnea Treatment

Whether you and your physician decide on CPAP treatment or an oral appliance, the most important part of treatment is actually using it. While CPAP has been shown to be the most effective treatment option for sleep apnea, this is only true if the patient wears the mask every night. While compliance issues happen for both CPAP and oral appliances, comfort and ease of use make a person more likely to comply with their treatment choice, and for some, an oral appliance is easier.

CPAPs collect compliance data and provide your physician with regular monitoring while many oral appliances do not. While this was always a benefit over oral appliances, new technology allows some oral appliances to provide compliance stats as well, making it just as easy for your physician to monitor use.

While CPAPs are the most common and effective sleep apnea treatment option, oral appliances offer a different treatment alternative that can benefit patients who may not like, or find success, with a CPAP. While they offer many different benefits, there are also some negative side effects to consider. Together with your health care professional, you can determine which treatment method will work best for you, both in treatment and compliance.