Snoring is the noise caused by the vibration of soft tissues in the throat as air passes through a partially obstructed airway during sleep. This occurs when the upper airway narrows, often as muscles relax during deep sleep. A snore guard, also known as an oral appliance, is a device worn in the mouth at night to prevent this narrowing and the resulting vibration. These devices offer a non-invasive approach to managing simple snoring.
The Mechanics of Snore Guards
Snore guards function by physically adjusting the position of structures within the mouth to maintain an open airway at the back of the throat. The primary goal is to prevent the base of the tongue and the soft palate from collapsing backward, which causes the sound. Appliances achieve this using two main mechanical principles: mandibular advancement and tongue stabilization.
Mandibular Advancement Devices (MAD)
A Mandibular Advancement Device (MAD) is the most common type. It works by gently holding the lower jaw in a slightly forward position. This movement pulls the tongue and attached soft tissues away from the back wall of the throat, increasing the space for air to flow. The MAD thus reduces the tissue vibration that produces snoring.
Tongue Stabilizing Devices (TSD)
Alternatively, a Tongue Stabilizing Device (TSD), also called a Tongue Retaining Device (TRD), works without significantly moving the jaw. This device uses a small suction bulb or chamber to hold the tongue forward. TSDs prevent the tongue from falling back into the airway and are often recommended for individuals who cannot tolerate the jaw movement required by MADs, such as those with certain jaw joint issues.
Different Types of Oral Appliances
Oral appliances are categorized based on how they are fitted. The first category is the over-the-counter (OTC) option, often utilizing a “boil-and-bite” technique. These devices are heated in water and then bitten into to create a semi-custom impression of the teeth, offering an affordable and readily available solution. However, the generic fit of OTC guards can lead to lower compliance because they may be less comfortable and prone to falling out.
The second, generally more effective category is the custom-fitted oral appliance. A dentist or sleep specialist designs these devices after taking precise molds or digital scans of the patient’s mouth. Custom devices offer a superior fit, which maximizes comfort and ensures the correct degree of jaw advancement for optimal results. Although they are a greater financial investment, the precision of a custom-fit appliance leads to better overall outcomes and higher patient adherence.
How Effective Are They for Snoring?
Snore guards are effective for treating simple, non-apneic snoring, though success rates vary depending on the device and the individual. For people whose snoring is not linked to Obstructive Sleep Apnea (OSA), a custom-fitted mandibular advancement device can often significantly reduce or eliminate the noise. Studies suggest that custom MADs are more effective than over-the-counter alternatives, primarily due to their superior fit and better tolerance by users.
The effectiveness of these appliances is closely tied to the underlying anatomy and the severity of the airway obstruction. In some clinical trials, oral appliances have achieved a complete or partial response in a majority of patients with mild to moderate sleep-disordered breathing, which includes many heavy snorers. However, the appliance may not work for everyone, especially those who primarily breathe through their mouth while sleeping, as the devices often require nasal breathing to be effective. Furthermore, their performance is consistently measured as less effective than the gold-standard treatment for severe OSA, Continuous Positive Airway Pressure (CPAP) therapy, but they represent a viable alternative for those who cannot tolerate CPAP.
Potential Drawbacks and Proper Use
While snore guards are generally considered safe, users may experience common side effects, particularly during the initial adjustment period. Temporary discomfort, such as jaw soreness, tooth pain, or tenderness in the gums, is frequently reported, but this often subsides after the first few weeks of nightly use. Changes in saliva production, which can manifest as either excessive drooling or a feeling of dry mouth upon waking, are also common.
Long-term use of mandibular advancement devices can potentially lead to subtle changes in bite alignment or tooth position due to the continuous pressure exerted on the teeth. Regular dental check-ups are important for monitoring these potential dental and jaw joint changes. For proper use and longevity, the appliance must be cleaned daily with a toothbrush and mild soap or a specialized cleaner to prevent bacterial buildup. Storing the guard in a dry case when not in use helps maintain its shape and material integrity.
Snoring vs. Sleep Apnea: When to Seek Medical Help
It is important to distinguish between simple snoring and Obstructive Sleep Apnea (OSA), a more serious medical condition. Simple snoring is noise caused by soft tissue vibration and does not involve repeated breathing interruptions. Conversely, OSA is characterized by frequent episodes where the airway collapses, causing breathing to repeatedly stop and start throughout the night.
Snore guards are primarily intended for simple snoring or mild to moderate OSA, but they are not a substitute for a medical diagnosis. Consult a physician or sleep specialist if you experience signs of OSA:
- Witnessed pauses in breathing.
- A choking or gasping sound during sleep.
- Excessive daytime fatigue despite adequate sleep time.
- Morning headaches.
- Difficulty concentrating.
- Waking with a dry mouth.
Relying solely on an over-the-counter snore guard to treat undiagnosed OSA can delay necessary medical intervention. Untreated OSA is linked to health risks like high blood pressure and heart disease.