Dental appliances for sleep apnea: Do they work?

Keeping your partner – or yourself – awake at night with loud snoring? It could be more than a nuisance. About 25% of men and almost 10% of women suffer from obstructive sleep apnea (OSA), a serious sleep disorder characterized by explosive snoring, growling and gasping. Tissues at the back of the throat temporarily obstruct the airways, causing breathing pauses (apnea) throughout the night. Not only does OSA leave people tired and dizzy, it also exposes them to many health problems, including high blood pressure, depression, and heart disease.

The most effective and well-researched treatment is positive airway pressure (PAP), a small, bedside machine that blows air through a mask to keep your airways from collapsing. But people with mild or moderate OSA sometimes find PAP difficult to use and often wonder about alternatives. Braces (also called oral appliances) are an option for some people. But do your homework before you embark on this path, warns Sogol Javaheri, MD, MPH, MA, a sleep specialist at Brigham and Women’s Hospital, affiliated with Harvard.

Who could benefit from braces for sleep apnea?

“These devices are supposed to reposition your jaw or your tongue to open your upper airways. But they can be really uncomfortable and only work half the time, ”says Dr Javaheri. It’s hard to predict who might benefit from using an oral appliance, and people with very mild OSA and few symptoms may not notice any difference. Therefore, she generally does not recommend them, except for people with mild to moderate OSA or those with severe OSA who cannot tolerate PAP.

Three main categories of dental devices for OSA

Mandibular advancement devices. Made of molded hard plastic, these devices snap onto your lower and upper teeth, and also feature metal hinges and screws that can be tightened to push your lower jaw forward. Some dentists make custom mandibular advancement devices, but before considering purchasing a custom device, be sure to ask if your dentist has experience with sleep-related breathing disorders and is certified by the American Academy of Sleep. Medicine. Some uncertified dentists simply take a mold of your teeth, send it to a company that makes the device, and then sell it to you at a large margin – sometimes totaling $ 4,000 or more. Plus, it’s unlikely to be covered by your dental or medical insurance if it’s used for snoring.

Mouth guard. Similar to mandibular advancement devices, these devices also help reposition your lower jaw, albeit to a lesser extent. Some sleep physicians recommend SnoreRx, which you can buy online for under $ 100. Instead of starting with a dentist impression of your teeth, you use what the company calls the “boil and bite” method. You place the device in a cup of boiling water for a minute, then bite down on the softened plastic to fit your teeth.

Tongue retainers. These devices consist of a soft plastic splint placed around your tongue that keeps it forward and out of your mouth throughout the night. They tend to make your mouth feel very dry and can be quite uncomfortable.

Most insurance plans at least partially cover these devices when they are used for OSA, but not if they are used for simple snoring. Don’t be tempted to try one unless you’ve been officially diagnosed with OSA, says Dr. Javaheri. And even if you have OSA, be sure to call your insurance company to figure out the amount of coverage before having a device manufactured.

Sleep Apnea Braces: Do They Work? first appeared on the Harvard Health Blog.

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