Alternatives to PAP Therapy
Oral appliances, also called dental appliances, may be an option for patients who cannot tolerate positive airway pressure therapy. The American Academy of Sleep Medicine recommends oral appliances for patients with mild-to-moderate obstructive sleep apnea who are not appropriate candidates for PAP or who have not been helped by its use.
Most dental devices are acrylic and fit inside your mouth, much like an athletic mouth guard or orthodontic appliance. Others fit around your head and chin to adjust the position of the lower jaw. The mandibular repositioning device and the tongue retaining device open your airway by bringing the lower jaw or tongue forward during sleep.
I used an oral device for about seven months. My biggest problem with it was lip and tongue biting. Your lower jaw is in the extended position for 6-7 hours, so when the device is removed, you have a tendency to bite the inside of your lower lip and side of your tongue. Most dentists that prescribe the device recommend a bite exercise after the device is removed. It is important to get evaluated and fitted by a dentist that specializes in sleep apnea and to see the dentist on a regular basis for any problems that may occur.
While oral devices are less cumbersome than PAP and relatively simple to use, they are only effective for some patients with sleep apnea. As with any treatment option, many factors may determine its effectiveness, including the severity of the sleep-disordered breathing and the patient's preference. The important thing to remember is that alternatives exist, and it sometimes takes different therapies for successful treatment of sleep apnea.