Dental appliances for sleep apnea: Do they work? – . Health Blog

Do you keep your partner – or yourself – up with loud snores at night? This could be more than a nuisance. Approximately 25% of men and nearly 10% of women suffer from obstructive sleep apnea (OSA), a severe sleep disorder characterized by explosive snoring, grunting, and wheezing. Tissue in the throat temporarily obstructs the airways and leads to breathing pauses (apneas) throughout the night. Not only does OSA make people tired and drowsy, but it also puts them at risk with a variety of health problems, including high blood pressure, depression, and heart disease.

The most effective and well-studied treatment is positive airway pressure (PAP), a small bedside machine that blows air through a mask to keep the airways from collapsing. However, people with mild or moderate OSA sometimes find PAP difficult and often wonder about alternatives. Dental devices (also known as oral devices) are an option for some people. But do your homework before you go that route, warns Sogol Javaheri, MD, MPH, MA, a sleep specialist at .-affiliated Brigham and Women’s Hospital.

Who could benefit from a dental device for sleep apnea?

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

Three main categories of dental equipment for OSA

Feed feeders. Made from molded hard plastic, these devices snap over your lower and upper teeth and have metal hinges and screws that can be tightened to push your lower jaw forward. Some dentists make custom devices to improve the lower jaw. Before you buy a custom device, however, ask yourself if your dentist has any 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 for a hefty premium – sometimes for a total of $ 4,000 or more. Additionally, if you use it to snore, your dental or health insurance is unlikely to cover you.

Mouthguard. Similar to mandibular enhancement devices, these devices also help with repositioning your mandible, albeit to a lesser extent. Some sleep health professionals recommend SnoreRx, which you can buy online for less than $ 100. Instead of starting with a dentist-made impression of your teeth, use what the company calls “boil and bite”. You put the device in a cup of boiling water for a minute, then bite the softened plastic to make it conform to your teeth.

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

Most insurance plans at least partially cover these devices when used for OSA but not when used for simple snoring. Don't try unless you have been officially diagnosed with OSA, says Dr. Javaheri. And even if you have OSA, be sure to call your insurance company so they know how much is covered before you have a device made.