If you snore or have been diagnosed with obstructive sleep apnea (OSA), your doctor or a sleep medicine dentist may recommend that you try an oral appliance to open your airway.
For people who can’t tolerate a CPAP machine, a dental oral appliance can be a simple solution to a vexing problem affecting your sleep. Due to their ease of use, dental oral appliances are being recommended as a first-line therapy by more and more by sleep physicians. Oral appliances have many advantages, including their small size and portability.
What Is a Sleep Apnea Mouthpiece?
A sleep apnea mouthpiece, is designed to keep your airway open when you sleep. It’s a custom-fitted splint you wear in your mouth. Visually and in terms of comfort and fit, it resembles a sports mouth guard.
Sleep apnea dental devices are custom-made by dentists who are specially trained to practice dental sleep medicine; according to The American Academy of Dental Sleep Medicine (AADSM), 2,800 dentists around the world are qualified to fit you for an oral device.
Right now, over 100 different styles of sleep apnea mouthpiece are FDA-approved for use in the treatment of snoring and obstructive sleep apnea. (Note, central sleep apnea is altogether different, and has its root causes in your nervous system; an oral appliance will not be a suitable treatment for this type of apnea.)
Designs of oral appliances for obstructive sleep apnea (OSA) vary slightly and are offered by multiple manufacturers. Your sleep medicine dentist, together with your sleep doctor, will make a recommendation for a style suitable for you. However, the basics are the same across most oral apnea appliances:
- A sleep medicine dentist will custom-fit a sleep apnea device to your mouth and jaw. (This normally takes a few visits for an exam and measurements, taking a mold of your mouth, and having the resulting device adjusted to your mouth and jaw.)
- The oral device will shift your lower jaw forward, just enough to create additional space at the back of your throat.
- This shifting creates extra space for your tongue and soft tissue at the back of your throat. It eliminates the airway obstruction that leads to snoring and apnea.
Many OSA patients and snorers prefer to start out trying an oral appliance before committing to CPAP therapy. Here’s why.
Benefits of Using an Oral Appliance for Obstructive Sleep Apnea (OSA), and Uses
Some snorers have not been diagnosed with OSA. If you’re one of those people, you may not qualify for CPAP machine therapy. Regardless, you (and your frustrated bed partner!) may want to try something to help you stop snoring. An oral appliance may be the answer.
For those who do have mild to moderate OSA, there are a couple good reasons why you might consider trying an apnea mouthpiece:
- Compliance—you’ll actually use it. Studies indicate that up to half (50%) of CPAP users discontinue their CPAP therapy within 3 weeks. If your sleep specialist recommends CPAP, give yourself a chance to adjust to the feel of the mask and the upkeep requirements of caring for the filters and tubes. It’s worth putting in the effort; for treating moderate to severe OSA, CPAP efficacy is better than an an oral device. However, if you know yourself and realize you’re never going to stick with CPAP for some reason—due to fit, feel, noise, or some other reason—a dental device may be a more realistic option. The bottom line: no therapy works for you if you don’t commit to it. Many people find mouthpieces easier to use, and some health benefit is better than no treatment at all.
- It’s handy to have an alternative. If you have OSA, maybe you’re OK with CPAP—some of the time. If you’re not going to use your machine regularly, having an oral device on hand can be a helpful alternative. Many people with apnea like to have an oral device as a backup if their CPAP needs repair or replacement, of if they are waiting for replacement parts to arrive.
In addition to these practical reasons to consider an apnea mouthpiece, consider the many other benefits to owning an oral device.
- They’re easy to use. Oral appliances are simple and “old school.” They have no replacement parts to order from a website or medical supply catalogue. They don’t necessitate your plugging them into an outlet. They have no batteries to recharge or carry. Their care is easy (as opposed to CPAP, which requires changing filters and cleaning out lengths of of tubing).
- They’re comfortable. The custom design of an oral appliance ensures comfort. Also, a mouthpiece only engages with your mouth, unlike CPAP, which touches your face, head, nostrils, or hair. Oral devices don’t cause skin chafing, skin reactions, ingrown hairs (for those with beards) or acne breakouts. Wearing a mouthpiece doesn’t affect your nostrils when you have a cold or the flu. A mouthpiece also does not affect your sleep position, unlike CPAP, which has tubing that can tangle or come undone if you move around a lot in your sleep.
- They’re less conspicuous. Oral devices are more “low profile” than a CPAP machine. If you’re shy about the idea of wearing a mask to bed or keeping a medical machine on your bedside table, a mouth splint may be more your style.
- They’re silent. A CPAP blows air continuously all night. For some light sleepers (bed partners included), this quiet and steady hum is distracting and may cause insomnia. A mouthpiece creates no such sound.
- They’re easy to carry. Anti-snoring mouthpieces are portable and come with their own cases. They are small and lightweight, making them ideal for travel. They won’t trigger a TSA inspection when you’re traveling through security in an airport. Though convenience should not be your sole factor in making a decision about your health, if you travel frequently for work, you may find an oral device much easier to fit into your lifestyle.
- They’re affordable. Anti-snoring oral appliances are usually less costly than CPAP. However, this is moot if your insurance covers both therapies.
Sleep Apnea Oral Appliance Uses
Sleep apnea oral appliances can be useful for:
- People with mild to moderate OSA (if your specialist advises so)
- Snorers without OSA
- Those who cannot tolerate CPAP
- People who will not comply with CPAP regularly
- Those who want a backup option to CPAP (for example, if your CPAP is being serviced for replacement parts, or if you live in a place that loses power frequently)
Talk to your sleep specialist about your options. Obstructive sleep apnea is a serious condition; if you are diagnosed, you need to address this sleep disorder with whichever treatment is most effective for you. Consistency is key.
Indications for a Sleep Apnea Mouthpiece
How do you know if you need a sleep apnea mouthpiece or oral appliance? First, look at your symptoms for a clue that you may need to see a sleep specialist. Are you experiencing:
- Sore throat upon waking
- Fragmented sleep or insomnia (which may be caused by apneas—cessations of breathing that cause your body to wake up throughout the night)
- Excessive daytime sleepiness
- Unwanted napping during the day
- Drowsy driving
- Brain fog and concentration problems
- Memory loss
If you have some of these symptoms, you have might have fragmented sleep due to sleep apnea. To find out for sure if you have obstructive sleep apnea, you’ll need an exam by a board certified sleep specialist.
The only way to positively diagnose OSA is with a sleep study. During the overnight exam, a sleep specialist will monitor you as you sleep in order to determine if your sleep apnea originates in the brain and nervous system (central sleep apnea, which is relatively rare) or if it’s caused by a mechanical airway obstruction.
If you’re found to have mild to moderate OSA, and if your sleep physician thinks an oral therapy approach may benefit you, there’s a high probability of success with oral appliance therapy (OAT). When used correctly, OAT is as effective as CPAP therapy—which is why the American Academy of Sleep Medicine (AASM) approves its use for treating mild and moderate OSA.
If you would like to learn more about our solutions to your snoring, sleep apnea, or sleep disordered breathing please call Premier Sleep Associates today at (425) 698-1732.
The American Academy of Dental Sleep Medicine (AADSM)