There are several alternatives to CPAP for sleep apnea treatment. One of the options is sleep apnea mouthpieces. Sleep apnea mouthguards are custom made by dentists using a plastic-like mold to form to the specific shape of the patient's teeth and mouth. Not only do they help with sleep apnea, but certain oral devices can also prevent snoring.
Most sleep apnea mouthpieces work by moving the jaw forward. Also called jaw advancing devices (JAD) or mandibular advancement devices (MAD), these sleep apnea mouthguards increase the size of the upper airway, thus reducing the air resistance that leads to sleep apnea and snoring. Some sleep apnea mouthpieces allow the user to adjust the degree to which their jaw is moved forward. An example of this kind of sleep apnea mouthpiece is the Thornton Adjustable Positioner (TAP).
Tongue retaining devices are another type of sleep apnea mouthpiece. These oral devices for sleep apnea use a splint that keeps the tongue in place to ensure that the airway remains open during sleep.
Although anti-snoring devices work in a similar way, if you are suffering from sleep apnea the oral device you use must be designed for sleep apnea specifically.
Oral devices for sleep apnea are often used as a substitute for CPAP or sleep apnea surgery, as they are more cost-expensive and less invasive. Sleep apnea mouthpieces can be used in conjunction with a weight loss program if the patient is overweight. If you also suffer from snoring, you may find that your sleep apnea mouthguard also reduces airway turbulence.
Sleep apnea mouthpieces are not suitable for all patients. They are generally more effective in mild to moderate sleep apnea cases, although they may be recommended to patients with severe sleep apnea who cannot tolerate CPAP. It is important to work with your doctor to determine whether this treatment would be right for you.
Even after you have received your sleep apnea mouthguard, your doctor may request a sleep study to determine if it is effective. Follow-up care is imperative to ensure that you are getting the right treatment.
When used consistently and under the guidance of your doctor, you may experience many benefits from your sleep apnea mouthpiece. Most patients see an improvement to their sleep quality after the first night of use. And because sleep apnea mouthpieces are easy to use, there is a higher rate of compliance compared to other treatments for sleep apnea.
Other benefits of oral devices for sleep apnea include:
Some sleep apnea patients who use sleep apnea mouthpieces experience temporomandibular joint (TMJ) arthritis or arthralgia. Others report an unusual sensation shortly after removing the device in which they have difficulty bringing their teeth together in the usual position. Some patients experience teeth shifting after prolonged use. Occasionally orthodontic care is required to normalize the teeth positioning.
One of the complaints with sleep apnea mouthpieces is that they are difficult to monitor compliance. Most new CPAP machines have tracking software which shows the patient and the healthcare providers the amount of hours of use and the presence of persisting respiratory events. Because of their size, oral devices for sleep apnea are not able to contain the same amount of technology that a CPAP device contains. However, there are some newer sleep apnea mouthpieces with microchips that are able to measure the amount of hours of use.
Another reported problem with sleep apnea mouthpieces is that they have a limited life expectancy. They are not designed to last forever. Many are only effective for a year or two before the materials weaken and the appliances lose efficacy. If you choose to use an oral device for sleep apnea, you will probably have to replace it regularly.
The first step to getting any sleep apnea treatment is talking to your doctor. You may be a candidate for certain sleep therapies while others may be excluded because of your medical history or anatomy. Discuss your symptoms with your healthcare professional. You may be asked to undergo a sleep study and if you are diagnosed with sleep apnea, you and your doctor can discuss treatment options.
With the increase in supply of manufacturers and qualified dentists, oral devices for sleep apnea have become a popular treatment for sleep-disordered breathing and snoring. If a dental device is indicated, you will be referred to a dentist who specializes in the treatment of sleep apnea. The dentist usually takes an impression of your teeth bite called a bite registration. A reproduction of your teeth is then made of plaster. Your sleep apnea mouthpiece will be designed using this model so that it fits your teeth and mouth perfectly.
You should only seek oral devices for sleep apnea that are FDA cleared. Although there are businesses that sell sleep apnea mouthpieces on the internet, it is important that your sleep physician, primary care doctor, and/or dentist approve the appliance. Many of the over-the-internet ‘boil and bite’ sleep apnea mouthguards are not effective.
The average cost for a sleep apnea mouthguard is estimated at $1800 – $2000. This includes the actual sleep apnea mouthpiece, dentist visits, adjustments, follow-ups, and modifications to the dental device. Most health insurance companies and Medicare cover oral devices for sleep apnea.
For more details on sleep apnea mouthpieces and prices, take a look at our review page here.
To arrange for a sleep apnea mouthpiece, contact your local dentist or primary care provider.
© 2020 American Sleep Association.