Sleep apnea is a common sleep disorder where breathing repeatedly stops and starts during sleep. These interruptions, which can last from a few seconds to minutes, prevent restful sleep and can lead to various health concerns. Oral appliances, often resembling mouthguards, offer a potential treatment option by helping to keep the airway open.
Understanding Sleep Apnea
Sleep apnea is a common sleep disorder where breathing repeatedly stops and starts during sleep. The most common form is Obstructive Sleep Apnea (OSA), occurring when throat muscles relax during sleep. This relaxation causes soft tissues, like the soft palate and tongue, to collapse and block the airway.
When blocked, the brain senses lack of oxygen and briefly rouses the individual to reopen it. These awakenings disrupt the sleep cycle, preventing restorative sleep. Risk factors for OSA include obesity, large tonsils, a thick neck, and being male.
How Oral Appliances Work
Oral appliances are dental devices worn during sleep to help maintain an open airway. The two primary types are Mandibular Advancement Devices (MADs) and Tongue Retaining Devices (TRDs). MADs, the most common type, work by holding the lower jaw slightly forward. This repositions the jaw and tongue, increasing space at the back of the throat and preventing airway obstruction.
TRDs, while less common, use suction to hold the tongue forward. Both device types prevent the airway from narrowing or closing, reducing snoring and sleep apnea events. This ensures continuous airflow.
Effectiveness and Who Benefits
Oral appliances are an effective treatment option for individuals with mild to moderate Obstructive Sleep Apnea and can also reduce snoring. While Continuous Positive Airway Pressure (CPAP) therapy is often considered the standard treatment, oral appliances are a viable alternative, particularly for those who find CPAP uncomfortable or difficult to use consistently. Studies indicate that oral appliance therapy can reduce the severity of OSA by more than half for about 70% of people, and for some, it can even resolve symptoms entirely.
Candidates for oral appliance therapy often cannot tolerate CPAP or prefer a less intrusive option. Patients with healthy teeth and gums are generally better suited for these devices, as the appliance relies on dental structures for stability. Oral appliances can also improve daytime fatigue and enhance overall well-being.
Considerations and Next Steps
Despite their benefits, oral appliances have potential side effects and limitations. Short-term effects include jaw discomfort, tooth pain, increased salivation, or dry mouth, which usually improve with adjustment. Long-term use may lead to unwanted tooth movement or bite changes, requiring regular dental monitoring. Oral appliances are not recommended for severe OSA or effective for central sleep apnea.
A medical diagnosis of sleep apnea by a healthcare professional is necessary before considering an oral appliance. Custom-fitted oral appliances, made by a qualified dentist, are crucial for safety and effectiveness, offering superior results compared to over-the-counter options. If you suspect sleep apnea or are interested in oral appliance therapy, consult your doctor or dentist to determine suitability.