The People's Perspective on Medicine

Treating Sleep Apnea with an Oral Appliance

A custom-fitted, adjustable oral appliance reduced snoring and sleep apnea, but volunteers still suffered from daytime sleepiness.
Sleepy car driver sleep

Sleep apnea and snoring are common problems, affecting nearly a fourth of middle-aged men and 9% of women.

What Is Sleep Apnea?

Sleep apnea describes breathing that pauses frequently during sleep, from several seconds to a minute or longer. This can lead to daytime drowsiness or fatigue, impaired reaction time and judgment, and a range of other psychological and physiological problems. Irritability, mood swings, headaches and insomnia are common symptoms.

What Causes Sleep Apnea?

Obstructive sleep apnea may be due to chronic nasal congestion or collapsing airways. The usual recommended treatment is a device to provide continuous positive airway pressure, or CPAP. Although this often works well, many people find it too uncomfortable to use regularly.

Oral Appliance for Treating Sleep Apnea:

A Swedish study just tested an adjustable, custom-made oral appliance that moves the lower jaw forward slightly during sleep. The 96 participants were randomly assigned to the oral appliance or a placebo appliance for four months.

The device was able to reduce sleep apnea, snoring and restless leg symptoms significantly. Unfortunately, it did not reduce daytime sleepiness or improve quality of life.

JAMA Internal Medicine, Aug, 2015

Rate this article
4.9- 27 ratings
About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
Getting a Good Night’s Sleep

Tips for beating insomnia: foods to avoid, foods that help, herbal remedies, sleeping pills. Our online guide includes drugs that may cause insomnia. Learn about the latest medication, Belsomra.

Getting a Good Night’s Sleep
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

Showing 11 comments
Add your comment

I was diagnosed with severe sleep apnea (stop breathing 36 times per hour) after a overnight sleep study. I am claustrophobic so no matter what cpap mask they tried, I couldn’t use it. Eventually my pulmonologist sent me to a dentist who decided to change career direction and focus on oral devices for sleep apnea.

I got my device, it adjusts on the side and brings forward your lower jaw, which opens your air passage way. After another sleep study, I was down to 13 times per hour. A increase in adjustment will cure that as well. The devices really are not uncomfortable at all andI am sleeping so much sounder and waking up more refreshed. Highly recommended.

I suffered from apnea bad but after trying all the torturous cpap masks I now treat it by doing tongue exercises (Stop Sleep Apnea Now on youtube and others), elevating my head with a wedge pillow under the mattress, using a firm pillow which does not allow my head to sag, nasal strips, and circulating the air in my bedroom with a fan. It IS possible to treat apnea without cpap, except in the most severe cases. You don’t get enough oxygen breathing through the machine anyway, compared to breathing the open air. There is a study that shows the tongue exercises work.

Forgot to mention you must sleep on your side also. Supine sleeping is terrible for apnea. Hope this helps others struggling with this debilitating condition.

I too, was diagnosed with sleep apnea after having a monitored test at a local hospital. I was told that I stopped breathing during the test and the conversation immediately shifted to a CPAP machine. (My sister also has apnea and uses the CPAP.) I refused the use of this monstrosity and decided to try something on my own. I bought a special pillow (Homedics) filled with microscopic silicone beads. Then I made sure that I was sleeping on my sides all the time. It helped almost immediately! The shifting support of this pillow also helped my neck pain, as well as the apnea. I now sleep exclusively with this pillow. Where there’s a will, there’s a way.

My husband was told he stopped breathing during his test 40 times per minute, which they said was huge. He went for the test because of the loudness of snoring and I noticed he stopped breathing and then started again very noisily, thrashing about and his restless legs in action. I never got a good night’s sleep. He has to been using the CPAP machine for about ten years, and it has not stopped the snoring at all. In fact I would say if anything, it’s worse.

The c pap is very uncomfortable. I have used numerous masks, fittings etc. it is hot, restrictive, uncomfortable, and unattractive. There has to be a better solution . I hope this dental appliance works.

I actually tried an oral appliance that must have been like the one described. It help somewhat but I had to stop using it when I had a crown replaced and the appliance did not fit any more. The lingering effect of having worn it however somewhat reduced my apnea to the point I can sleep on my side in perfect comfort.

About ten years ago I was diagnosed with hypopnea, wherein your breathing is shallow and your oxygen levels drop during sleep. They put me on a cpap machine. It was very difficult to use, the seal loosens and then the whistle wakes you up. It definitely made my sleeping worse; thereby worsening my QOL. Additionally, I had about nineteen awakenings per minute that were not linked to breathing difficulties. Too bad there is no such thing as a pain meter! If there are not accompanying changes to the pain levels, what is the sense of even struggling with this most uncomfortable method? I would imagine a custom made appliance would be expensive, and, because it is not the standard of treatment, not covered by insurance. Obviously from this study not worth the cost nor effort.

I gave up on CPAP because of the awkwardness of it, and I wear an oral appliance at night for my mild to moderate obstructive sleep apnea. It does the trick. I have two appliances. My dentist made them, and my medical (not dental) insurance covered the cost.

I am a sleep apnea patient, suffering long term from central apnea (I believe, in which the brain fails to send breathing signals to the body at night), as opposed to obstructive apnea. Most have heard the colloquialism “the workman’s (physical laborer’s) sleep is sound.” I hypothesize, in the case of central apnea, that just as our dreams during sleep can be traced back to thoughts or emotional experiences that we had the previous day, so our pattern of breathing during sleep can be traced back to our physical activity and breathing during the day. Therefore, if one has exercises actively during the day, causing deep breathing, then the same pattern of breathing will occur during sleep at night. This has been my experience. I enjoy hiking in the mountains. When I hike for 3 to 5 hours, then I sleep more soundly, and my body is refreshed in the morning. So central sleep apnea may, in part, be caused by our modern sedentary lifestyle. Most athletic coaches can testify to the fact that athletes get a “second wind” (noticeably improved breathing), about an hour into practice or into a game.

Any thoughts on why it did not improve quality of life ? Does not make sense if it resolves underlying issues.

* Be nice, and don't over share. View comment policy^