Sleep Apnea Mouthpieces

To arrange for a sleep apnea mouthpiece, contact your local dentist or primary care provider.

Mouth Devices for Sleep Apnea

If you have been diagnosed with obstructive sleep apnea — a condition in which relaxation of the muscles around the tongue and throat causes the tissues to block airflow to the lungs while you sleep — there are a number of treatment options to discuss with your doctor. Two of the most widely used and most effective are continuous positive airway pressure (CPAP) and dental appliances, or mouth guards.

CPAP (Continuous Positive Airway Pressure)

The most effective treatment for obstructive sleep apnea, CPAP blows air with continuous pressure down your throat at night to keep your airways open while you sleep. The treatment is done using a CPAP machine, which consists of three main parts:

• Mask that fits over your nose — or your nose and mouth — and is held in place with straps while you sleep
• Motor that blows air
• Large tube called a cannula that connects the motor to the mask

CPAP machines are small, lightweight, and fairly quiet. If you travel, you should take your CPAP with you.

Benefits of CPAP include keeping your airways open while you sleep, easing snoring, improving sleep quality, relieving daytime sleepiness, and lowering blood pressure.

Although you will likely feel better rested and alert once you start CPAP, getting used to the device can take some time. Some people have difficulty sleeping the first few nights of treatment.

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Side effects of CPAP use are usually minor and may include:

• Feelings of confinement from the face mask
• Sore or dry mouth
• Nasal congestion, runny nose, sinusitis, or nosebleeds
• Irritation and sores over the bridge of the nose
• Stomachbloating and discomfort
• Discomfort in chest muscles.

If you are having any of these or other problems, call your doctor. An adjustment to your CPAP machine may make it more comfortable. Some CPAP machines have special features such as heated humidifiers to reduce problems such as drying of the airways. Other possible fixes include using a cushioned face mask, chin straps, and nasal saltwater sprays. Your doctor may have additional suggestions.

Mouth Devices

If you have mild to moderate obstructive sleep apnea and can’t tolerate or haven’t been helped by CPAP, oral appliances may be an effective treatment option.

These devices, which must be fitted by a dentist or orthodontist, and worn in the mouth at night include:

Mandibular advancement device (MAD). The most widely used mouth device for sleep apnea, MADs look much like a mouth guard used in sports. The devices snap over the upper and lower dental arches and have metal hinges that make it possible for the lower jaw to be eased forward. Some, such as the Thornton Adjustable Positioner (TAP), allow you to control the degree of advancement.

Tongue retaining device. Used less commonly than MAD, this device is a splint that holds the tongue in place to keep the airway open.

For people with mild to moderate sleep apnea, particularly those who sleep on their backs or stomachs, dental devices may improve sleep and reduce the frequency and loudness of snoring. Also, people are more likely to use their dental appliances regularly than CPAP.

Dental devices have also been shown to control sleep apnea long term compared to uvulopalatopharyngoplasty (UPPP), the standard surgical procedure for apnea, in which the surgeon removes soft tissue from the back of the throat. However, dental devices do have some potential drawbacks, including altered bite, movement of teeth, pain, arthritis of the temporol mandibular joint (TMJ), dry lips, and excessive salivation.

If you are fitted with a dental device you should have a checkup early on to see if it is working and periodic checkups for possible adjustment or replacement. If you experience pain or changes in your bite, your dentist or orthodontist who fitted your device may be able to make modifications to correct the problem.

The best treatment for obstructive sleep apnea depends on a number of factors, including the severity of your problem, the physical structure of your upper airway, other medical problems you may have, as well as your personal preference. You should work with your doctor or sleep specialist to select the best treatment option for you.

Show Sources

The Ohio State University Medical Center: “Obstructive Sleep Apnea (OSA).”

National Heart Lung and Blood Institute: “What Is CPAP?”

MedlinePlus: “Nasal CPAP.”

University of Maryland Medical Center: “Obstructive sleep apnea – Dental Devices.”

American Sleep Apnea Association: “Taking a Bite Out of OSA.”

Academy of General Dentistry: “Breathing Easier.”

American Sleep Apnea Association: “Treatment Options for Adults with Obstructive Sleep Apnea.”

New York University Langone Medical Center: “Continuous Positive Airway Pressure.”

Sleep Apnea Mouthpieces

We regularly update our articles to include the latest research, expand coverage, and add new information as it becomes available.

Updated December 13, 2022

Mouthpieces can be used to treat a variety of sleep issues.

Teeth grinding, or Bruxism, is a condition that can lead to jaw pain and damage to the teeth. Teeth with extensive cavity fillings are particularly vulnerable to grinding and can break while asleep, leading to expensive crown work.

Snoring is another common ailment that can be treated with a mouthpiece. Many have found relief using these snoring appliances, as have their sleep deprived partners. There are a variety to choose from and can be purchased without prescription.

Mouthpieces can also be used as an alternative to CPAP for sleep apnea treatment. Sleep apnea is a serious medical condition, if untreated, can lead to heart disease and stroke. Sleep apnea mouth guards 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.

How Do Sleep Apnea Mouthpieces Work?

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.

How Effective Are Sleep Apnea Mouthpieces?

Although CPAP is the most popular sleep apnea treatment, dental appliances are becoming more common as research solidifies their efficacy in treating mild to moderate sleep apnea and snoring.

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 mouth guard 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 mouth guard, 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.

Benefits of Oral Devices for Sleep Apnea

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:

• Convenience – Sleep apnea mouthpieces are compact and portable
• Discreteness – Sleep apnea mouthpieces are not visible to your bed partner when your mouth is closed
• Energy conservation – Unlike CPAP machines, sleep apnea mouthpieces do not use any electricity. You don’t have to plug them into a wall to function, which means they are easier and cheaper to use.

Click here to see the pros and cons of the more popular oral devices and anti-snoring mouthpieces available online.

Disadvantages of Oral Devices for Sleep Apnea

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 from people using a mouthpiece to treat sleep apnea is the difficulty in monitoring 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.

Getting an Oral Device for Sleep Apnea

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.

How Much Do Sleep Apnea Mouthpieces Cost?

The average cost for a sleep apnea mouth guard 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.

About The Author

Staff Writer, Sleep Health

With a bachelor’s degree in anthropology from Indiana University Bloomington, Rebecca enjoys making accurate, up-to-date health information accessible to all readers. As a freelance writer and editor, she has covered everything from healthcare and experimental music to education. Rebecca lives in Tennessee, where she spends her free time reading, writing fiction, and making music.

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