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Several oral devices have been tested to treat people with snoring and sleep apnea, including a tongue-retaining device that is worn while sleeping. It pushes the tongue and jaw forward, improving airflow. Changing the position of the lower jaw enlarges the airway and decreases the chance that it will collapse when you inhale. This may reduce snoring. This device is called a mandibular repositioning device. Some oral breathing devices supply electrical stimulation to the throat muscles to prevent the airway from collapsing when you sleep. Research shows that oral breathing devices can reduce snoring. Oral appliances are most effective in the treatment of mild to moderate sleep apnea although they do provide a treatment alternative for patients with severe OSA who cannot or will not tolerate positive airway pressure therapy. Despite their double-retainer-like appearance, oral appliances are said to be comfortable to use. Sometimes for more complicated sleep apnea an oral appliance and CPAP are used in combination. In the United States, oral devices to treat OSA cannot be sold over the counter. They must be prescribed by a physician and fitted by a dentist, oral surgeon or ENT who has sleep medicine experience.
What we recommend:
The Silent Nite® by GlidewellWe help patients achieve a deeper, more satisfying night’s sleep using the Silent Night Sleep Appliance from Glidewell. The Silent Nite Sleep Appliance is flexible, thin and comfortable, and it exhibits documented clinical success in mitigating or preventing the disruptive, unhealthy effects of snoring and mild to moderate sleep apnea. The Silent Nite appliance is designed to gently shift the lower jaw forward in a therapeutic position during sleep. This activates the airway muscles and ligaments to prevent the airway from collapsing. Each Silent Nite case includes extra connectors, in various sizes, and an AM Aligner to aid patients in exercising and realigning the jaw after nighttime mandibular advancement.
Patient SatisfactionOral appliance therapy (OAT) is very effective in treating patients with sleep-disordered breathing, with a compliance rate shown to be as high as 90% over a 2.5-year period.1 OAT is associated with greater patient satisfaction than nasal continuous positive airway pressure (CPAP) therapy.2 In a randomized crossover trial comparing OAT to CPAP in patients with obstructive sleep apnea, about 81% preferred OAT.3
Improved HealthAmong patients with obstructive sleep apnea, both continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) were associated with reductions in blood pressure. Network meta-analysis did not identify a statistically significant difference between the blood pressure outcomes associated with these therapies.4 A mandibular advancement device for obstructive sleep apnea reduces nocturnal blood pressure in women.5
- Yoshida K. Effects of a mandibular advancement device for the treatment of sleep apnea syndrome and snoring on respiratory function and sleep quality. Cranio. 2000 Apr;18(2):98-105.
- Ferguson KA, Ono T, Lowe AA, Keenan SP, Fleetham JA. A randomized crossover study of an oral appliance vs. nasal-continuous positive airway pressure in the treatment of mild-moderate obstructive sleep apnea. Chest. 1996 May;109(5):1269-75.
- Tan YK, L’Estrange PR, Luo YM, Smith C, Grant HR, Simonds AK, Spiro SG, Battagel JM. Mandibular advancement splints and continuous positive airway pressure in patients with obstructive sleep apnoea: a randomized cross-over trial. Eur J Orthod. 2002 Jun;24(3):239-49.
- Bratton DJ, Gaisl T, Wons AM, Kohler M. CPAP vs. mandibular advancement devices and blood pressure in patients with obstructive sleep apnea: a systematic review and meta-analysis. JAMA. 2015 Dec 1;314(21):2280-93.
- Rietz H, Franklin KA, Carlberg B, Sahlin C, Marklund M. Nocturnal blood pressure is reduced by a mandibular advancement device for sleep apnea in women: findings from secondary analyses of a randomized trial. J Am Heart Assoc. 2018 Jun 21;7(13).