Oral Appliances for Sleep Apnea – Pros & Cons of Using Them

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For those living with sleep apnea, achieving a good night’s rest can be a challenge.

Quality shuteye is essential for a healthy mind and body, so it’s understandable to seek effective treatment. CPAP devices are a popular choice, but they also involve wearing a mask over your face and using a machine. Therefore, you may wonder what other options are out there.

In this article, we’ll share helpful information about oral appliances for sleep apnea, discuss the pros and cons of these devices, and answer some common questions that come up when considering them.

What is Obstructive Sleep Apnea?

Obstructive Sleep Apnea[1] – or OSA – is a disorder in which your throat muscles relax to a point where they collapse, closing off the air supply. This causes you to repeatedly stop breathing while asleep.

Your brain, which will sense the air blockage, briefly wakes you up to resume breathing. While you may not be entirely conscious when this happens, it does interfere with your sleep. Additionally, snoring and gasping for air are several of the noisy symptoms of OSA that may also prevent your partner from getting quality rest.

OSA is the most common form of sleep apnea. The other two types are central and complex[2].

While OSA occurs when a part of your body doesn’t work as it’s supposed to, central is characterized by a neurological condition in which the brain doesn’t send the proper signal to breathe. Complex apnea is a combination of obstructive and central.

Animated Image of a Woman Struggling to Fall Asleep Because Her Partner Has Sleep Apnea

Dental Devices for Sleep Apnea

Mandibular Advancement Devices

The goal of dental devices is to keep the airways unobstructed by opening up the jaw and preventing the tongue from collapsing back into the throat. One of the most popular tools used is a mandibular advancement device (MAD). Mandibular means lower jaw.

The device looks like a mouth guard, but it has custom springs and adjustments that push the lower jaw and tongue forward. This, in turn, opens up the mouth and airway, keeping you breathing peacefully through the night.

Not only should mandibular advancement devices reduce symptoms, but they also work to strengthen the muscles of the tongue and surrounding mouth muscles. When these muscles become stronger, the prevalence of apnea tends to decrease.

Tongue Retaining Mouthpieces

This mouthpiece is more straightforward than a MAD and resembles a pacifier.

A tongue retaining mouthpiece works by holding the tongue forward. You insert your tongue into the device, and it keeps it in a prominent position, away from the back of your throat.

View Our Guide: Best Rated Snoring Mouthpiece

Do Oral Appliances Work for Sleep Apnea?

Mouthpieces are typically recommended[3] for people with mild to moderate cases of OSA or those with more severe apnea who do not want to use a CPAP machine. Sleep specialist Dr. Sogol Javaheri adds that it can be difficult to determine who will find success with them. Your best bet is to consult with a dentist and sleep expert to help you find the appropriate device for you.

The good news is that research[4] suggests dental appliances can be effective for treating obstructive apnea.

illustration of a person putting mouth guard before sleep

Pros and Cons of Oral Appliance Therapy



A CPAP machine can cost[5] upwards of 3,000 dollars, whereas a mouthguard can be significantly cheaper at a price point around 1,800-2,000 dollars. Furthermore, health insurance providers are more likely to cover the cost of oral devices than CPAP treatment.

Compact and Portable

Mouthpieces are significantly smaller and easier to transport than CPAP devices, making them more convenient for storage and travel.


One of the possible side effects of sleep apnea is snoring, and if you’re concerned about your partner’s slumber, you don’t want your treatment to be equally disruptive. While less obtrusive than snoring, a CPAP can still be noisy[6]. However, a mouth appliance should not make any sounds.

Energy Efficient

CPAP machines run on electricity, which means they use up more energy and increase your electric bill. On the other hand, mouth devices don’t need to be plugged in, and therefore, are more environmentally friendly and cost-effective.


Bite Changes

Since these products force the jaw into a forward angle, they could change the position of your bite.


These appliances may also cause pain and discomfort[7] in the jaw, teeth, and temporomandibular joint (TMJ).

Excessive Saliva or Dry Mouth

Individuals who typically breathe through their mouth may experience drooling or dry mouth.

Loosening of Dental Restorations

Another risk is that these items could cause dental work such as bridges or crowns to loosen over time. In this case, it is important to consult with your dentist, who can make any necessary adjustments and monitor your previous dental work for changes.

Frequently Asked Questions

How do I get a sleep apnea mouthpiece?

To get a mouthguard, you will need to see a dentist specializing in this treatment, who will then evaluate you and create a custom-made device. While some oral appliances are sold online, the American Sleep Association[8] warns that they may not be effective. They add that you should only use appliances approved by the FDA.

Are these better than the CPAP machine?

According to the American Sleep Association, CPAP machines are still the most popular treatment. However, a CPAP and oral appliance each have their advantages and disadvantages that you will need to consider when seeking treatment for your sleep apnea.

illustration of CPAP kit

Sources and References:

  • [1] “Obstructive Sleep Apnea”, Mayo Clinic, July 27, 2021
  • [2] “Sleep Apnea”, Mayo Clinic, July 28, 2020
  • [3] “Dental Appliances for Sleep Apnea: Do They Work?”, Harvard Health Publishing, April 28, 2021
  • [4] Kate Sutherland PhD, Olivier M. Vanderveken MD PhD, Hiroko Tsuda PhD, Marie Marklund PhD, Frederic Gagnadoux MD PhD, Clete A. Kushida MD PhD FAASM, Peter A. Cistulli MD, “Oral Appliance Treatment for Obstructive Sleep Apnea: An Update”, 2014
  • [5] “The Cost of Sleep Apnea Treatment”, Smiles of North Dallas
  • [6] “Quiet CPAP Machines for Quiet CPAP Therapy”, CPAP, February 1, 2021
  • [7] “Oral Appliance Therapy for Obstructive Sleep Apnea”, Cleveland Clinic, March 30, 2020
  • [8] “Mouthpieces and Dental Devices”, American Sleep Association

Jill Zwarensteyn is the editor for Sleep Advisor and a certified sleep science coach. She is enthusiastic about providing helpful and engaging information on all things sleep and wellness.

Based in Los Angeles, she is an experienced writer and journalist who enjoys spending her free time at the beach, hiking, reading, or exploring new places around town.

She’s also an avid traveler who has a personal goal of being able to successfully sleep on an airplane someday.

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