Do Oral Appliances for Sleep Apnea Work?
Dr. Angel Rivera
If you have been diagnosed with sleep apnea, your doctor may have recommended an oral appliance as a treatment option.
Oral appliances are devices that are worn in the mouth to keep the airway open during sleep.
They are often used to treat mild to moderate sleep apnea, in addition to other treatments such as CPAP or continuous positive airway pressure therapy.
In this article, we will answer some common questions about oral appliances for sleep apnea.
We will discuss what sleep apnea is, how it is diagnosed, and the benefits and risks of using oral appliances to help you make an informed decision about whether or not oral appliance therapy is right for you.
Sleep apnea is a serious sleep disorder that causes you to stop breathing in your sleep. It occurs when your throat muscles relax and collapse, blocking the airway.
This causes you to stop breathing for anywhere from a few seconds to a minute or more. When this happens, your body wakes up so that it can breathe again which prevents you from getting quality sleep.
This can lead to a number of health problems, including high blood pressure, heart disease, heart attack, and stroke.
There are three types of sleep apnea, with one type more common than others.
Obstructive sleep apnea, or OSA, occurs when the soft tissue in the back of your throat collapses during your sleep causing a blockage. Obstructive sleep apnea is the most common type.
Central sleep apnea, or CSA, is a less common form of the condition that occurs when your brain does not send the correct signal to your muscles telling them to breathe.
Complex or mixed sleep apnea, or MSA, is rarer still and refers to people who have both obstructive and central sleep apnea.
The most common symptom of sleep apnea is loud snoring, although not everyone who snores has sleep apnea.
If you have sleep apnea you will often gasp or choke during these respiratory events, too.
Other symptoms include insomnia, restless sleep, waking up with a dry mouth or sore throat, and feeling sleepy during the day.
If you feel very sleepy throughout the day this is called excessive daytime sleepiness or EDS and can lead to a number of other problems such as difficulty concentrating, mood swings, and irritability.
Morning headaches are also a common symptom of sleep apnea due to the lack of oxygen your body receives during sleep. If you suffer from these effects of sleep apnea we recommend you talk to your doctor.
In order to diagnose sleep apnea, your doctor will ask you a series of questions about your symptoms and perform a physical exam.
They will also recommend that you participate in a sleep study, called polysomnography, in order to determine if you have the condition.
A sleep study is an overnight test monitored by a sleep specialist where electrodes are attached to your body to track your breathing, heart rate, muscle movements, and brain activity in a clinical setting.
The test can be done in a hospital or sleep center where you will have your own room with equipment to monitor you while you sleep.
At-home sleep tests are also available, but they are not as accurate as a sleep study done in a lab.
An oral appliance, which is also called an oral device, dental device, or dental appliance, is something that you wear in your mouth to help treat sleep apnea.
It looks like a sports mouthguard or retainer and fits over your teeth. The appliance pushes your lower jaw and tongue slightly forward which opens up your airway and prevents it from collapsing.
There are a number of different oral devices for sleep apnea available and your doctor will help you find the best one for you.
What type of apnea can use an oral appliance?
Obstructive sleep apnea syndrome is the only type of sleep apnea that can be treated with an oral appliance.
If you have central sleep apnea or mixed sleep apnea, oral appliances will not be effective in treating your condition and another effective treatment may be recommended to help you get restorative sleep.
What are the different types of oral appliances?
There are a number of oral appliance options available for sleep apnea treatment. Some oral appliances fit over both your upper and lower teeth while others cover only one of them.
There are also a variety of materials oral appliances can be made from, including plastic, metal, and acrylic. Below is a closer look at the different types of oral appliances.
Mandibular advancement device (MAD)
Mandibular advancement devices, also called a mandibular advancement splint, are oral appliances that move your lower jaw slightly forward in order to keep your airway open.
The device fits over the top and bottom teeth and has hinges or screws that force your jaw forward.
MADs reduce snoring and help treat mild to moderate sleep apnea by increasing the size of the area behind your throat so that it doesn’t collapse during sleep.
This oral appliance looks similar to a mouthguard or retainer and is available in both custom and over-the-counter (OTC) varieties.
Tongue retaining device (TRD)
Tongue retaining devices are oral appliances that hold your tongue down so that it doesn’t block your airway during sleep.
This oral appliance is a small, U-shaped piece of plastic that fits over your top teeth and has a hole in the middle for your tongue.
The TRD oral appliance prevents your tongue from falling back into your throat during sleep causing it to block or partially obstruct the airway.
This oral appliance is available in both custom and over-the-counter varieties, but they are less common than mandibular advancement devices since they can fall out while you sleep or be difficult to keep in place.
Tongue retaining devices also tend to lead to mouth dryness which can be uncomfortable when you wake up.
Mouth guards are oral appliances that prevent your teeth from grinding together during sleep.
They also help keep your airway open by holding the tongue and jaw in place. This oral appliance is similar to a sports mouth guard and fits over both the upper and lower teeth as well as under your tongue to hold it in place.
Mouth guards can be custom-made or over-the-counter and they tend to be easier to keep in your mouth while you sleep.
Over-the-counter mouth guards are fitted in a very similar way to store-bought sports mouth guards. You boil water and place the device in the water to soften the material and then bite down on it to custom fit it to your teeth.
Are there any risks to using an oral appliance?
There are a few risks associated with oral appliance therapy for sleep apnea.
The most common is that the oral appliance can cause temporomandibular joint (TMJ) pain, which is when you experience pain and discomfort in your jaw joint.
With an oral appliance, you also risk tooth movement and changing your bite due to your teeth shifting from the device in your mouth all night which is similar to how a retainer works.
Other risks include excessive salivation, dry mouth, and skin irritation around the mouth. If you are experiencing any of these side effects, talk to your doctor right away as they may recommend alternative treatments.
How do I get an oral appliance?
Your doctor will likely refer you to a dentist who specializes in oral appliances for sleep apnea.
The dentist will take impressions of your teeth and send them off to the lab to create a custom oral appliance for you.
Once you have the oral appliance, your dentist will teach you how to use it and how to care for it. Be sure to follow the oral appliance instructions exactly so that you can get the most benefit from it.
There are over-the-counter mouth guards and other over-the-counter oral appliances you can buy. However, custom-fitted ones from dentists seem to work best.
Oral appliances are an effective and non-invasive device for sleep apnea treatment that can be used alone or in combination with other treatments.
Oral appliances tend to work best if you have mild-to-moderate sleep apnea since it still allows you to breathe through your mouth when using oral appliance therapy.
They work by pushing your lower jaw forward which can open up your upper airway as you sleep.
Some options are available over-the-counter but getting a custom-made oral appliance from a dentist who specializes in them works best.
If you have any further questions or have severe sleep apnea, please talk to your doctor or healthcare provider to determine which is the most effective oral appliance treatment option for you.
References and Sources:
American Academy of Dental Medicine