Oral appliance therapy for sleep apnea explained

If you've been diagnosed with sleep apnea, you might be wondering about your treatment options. While CPAP machines are often the go-to solution, they're not always a perfect fit for everyone. That's where oral appliances come in - they're like the quiet, less obtrusive cousin in the sleep apnea treatment family.

Sleep apnea 101

First things first - let's talk about sleep apnea. It’s a common sleep disorder where breathing repeatedly stops and starts during sleep. The most prevalent form is obstructive sleep apnea (OSA), where the airway becomes partially or completely blocked. This can lead to loud snoring, gasping for air, and disrupted sleep patterns.

CPAP therapy, which uses a machine to deliver constant air pressure through a mask, is highly effective and remains the first-line treatment for most cases of sleep apnea, especially moderate to severe OSA. However, some patients find CPAP uncomfortable or difficult to use consistently. (Let's face it, strapping a mask to your face isn't everyone's idea of a relaxing bedtime routine.)

That’s where oral appliances come in — a potential alternative or complementary treatment for certain cases of sleep apnea.

Oral appliances: a closer look 

Oral appliances for sleep apnea are custom-fitted devices worn in the mouth during sleep. They work by repositioning the jaw or tongue to help maintain an open airway. The most common types include:

1. Mandibular advancement devices (MADs)

These sleep apnea mouth guards move the lower jaw slightly forward, which helps keep the airway open.

2. Tongue Retaining Devices

These hold the tongue in a forward position to prevent it from blocking the airway.

Are they right for you?

Oral appliance therapy for sleep apnea can be particularly helpful for:

• Patients with mild to moderate OSA

• Those who can't tolerate CPAP therapy

• Individuals who prefer a more portable treatment option

• Some cases of severe OSA, when CPAP isn't an option (though this is less common)

While oral appliances can be effective, they're not suitable for everyone. A thorough evaluation by a sleep specialist is crucial to determine the most appropriate treatment approach. After all, we're not just picking out a new pair of shoes here!

The journey to better sleep with oral appliances

If you and your sleep specialist decide to explore oral appliance therapy, here's what you can expect:

1. Consultation

A sleep doctor will assess your sleep apnea severity and overall health to determine if an oral appliance might be beneficial.

2. Dental assessment

If appropriate, you'll be referred to a dentist specializing in sleep medicine. They'll examine your oral health and take impressions for a custom-fitted device.

3. Fitting and adjustment

Once your oral appliance for sleep apnea is ready, you'll learn how to use and care for it. The dentist may make adjustments for optimal comfort and effectiveness.

4. Follow-up

Regular check-ups are crucial to ensure the device is working correctly and to address any issues. Your sleep specialist will likely want to reassess your sleep apnea to confirm the treatment is effective.

Effectiveness and considerations

Research shows that oral appliances can be effective in reducing the severity of OSA for many patients. A study published in Sleep Medicine found that about 52% of patients using oral appliances experienced a significant reduction in their sleep apnea symptoms ^[1].

However, it's important to keep in mind that while oral appliances can be beneficial, they may not be as consistently effective as CPAP for all patients, especially those with more severe sleep apnea.

Potential side effects and adjustments

Like any treatment, oral appliances can have some side effects, particularly in the early stages of use. These may include:

• Jaw or tooth discomfort

• Excessive salivation or dry mouth

• Minor bite changes

• Loosening of dental restorations

Most of these effects are temporary and can be addressed with adjustments to the device [2]. Your dental sleep specialist will work with you to minimize any discomfort and ensure the best possible fit.

The importance of professional guidance

While you might come across over-the-counter oral appliances for snoring, it's crucial to work with qualified healthcare professionals for sleep apnea treatment. Over-the-counter devices or those fitted without proper medical supervision may not effectively treat your sleep apnea and could potentially cause harm. A sleep specialist can guide you through the pros and cons of oral appliance therapy for sleep apnea and help you make an informed decision about your treatment options.

Remember, effective treatment of sleep apnea is crucial for your overall health and well-being. Whether it's CPAP, an oral appliance, or a combination of treatments, the goal is to find an approach that works for you and that you can stick with consistently.

If you're experiencing symptoms of sleep apnea or are having difficulty with your current treatment, don't hesitate to consult with a sleep specialist. They can help you navigate the various treatment options and find the best path to restful, restorative sleep.