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Updated on December 29, 2022
5 min read

Mouthguards for Sleep Apnea

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What is Sleep Apnea?

Sleep apnea refers to pauses in breathing during sleep, often due to the airway becoming blocked or collapsing. These pauses can last for several seconds to several minutes and can happen repeatedly throughout the night.

These pauses interrupt a person’s sleep and deprive them of oxygen. People with sleep apnea may feel fatigued even after what seems like a full night of sleep. They have a higher risk of accidents and health complications.

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Sleep apnea is a potentially life-threatening sleep disorder, and several kinds of treatment exist. Many people with sleep apnea benefit from using mouthguards.

How Mouthguards Treat Sleep Apnea

A sleep apnea mouthguard keeps your tongue and/or lower jaw in a more forward position while you sleep. This helps to keep your airway open.

Some mouthguards have a strap that wraps around your head and chin to hold your lower jaw in a specific position.

If your dentist prescribes you a mouth guard or other oral appliance for sleep apnea, you should follow up with them after six months and then at least once a year. This schedule helps ensure that your mouthpiece continues to work correctly. Your dentist can then adjust or replace it if needed.

Best Mouthguards for Sleep Apnea

When choosing a mouthguard for sleep apnea, one of the essential factors to consider is comfort. You’ll be more likely to wear a comfortable oral device consistently.

The two main types of mouthguards for sleep apnea are mandibular advancement devices and tongue-retaining devices:

Mandibular Advancement Device (MAD)

A mandibular advancement device (MAD) temporarily shifts the lower jaw (mandible) and tongue forward. This allows for more airway space, reducing apnea and snoring.

Some MADs, known as boil-and-bite MADs, are available over the counter (OTC). These are made from soft materials that are flexible when exposed to hot water. Biting down on the soft mold helps to fit it into your mouth.

MADs can also be custom-made to fit your mouth from the beginning. Your dentist will take a mold of your teeth and use it to make a mouthguard specifically for the shape of your teeth and mouth. This allows for a better fit than an OTC sleep apnea mouth guard.

Benefits and Risks

Custom-made mouthguards are often more comfortable than OTC options. They’re also more difficult to accidentally move or dislodge while you sleep. 

While custom MADs are more costly than OTC mouthpieces, many medical or dental insurance plans cover some or all of the fees.

However, one of the most common issues with MAD dental devices is tooth shifting and tooth discomfort. These risks are higher with OTC mouthguards since they won’t fit your mouth perfectly. For people with dental problems, MADs may not be suitable.

Tongue-Retaining Device

Tongue-retaining or tongue-stabilizing devices (TSDs) are mouth guards that hold the tongue in a forward position without involving the lower jaw. These are generally available over the counter or online.

Pulling the tongue forward allows for a wider gap between the tongue and the back of the throat. This reduces or stops sleep apnea and snoring because the upper airway is less likely to become blocked.

Benefits and Risks

One advantage of these oral devices is that they’re less likely to make your jaw uncomfortable. They’re also less likely to cause temporomandibular joint and muscle disorders (TMJD) or tooth shifting.

A tongue-retaining device may be more suitable for people with dental problems or missing teeth. However, some people claim to feel uncomfortable with the position it holds their tongue in. This device may also cause you to salivate more than usual.

Costs

Over-the-counter MADs and TSDs will be less expensive than prescription MADs that are custom-made for your mouth. You can find pre-made or boil-and-bite devices for less than $50, whereas a custom MAD may cost around $2,000.

However, if you have been diagnosed with obstructive sleep apnea and have medical insurance, you may have coverage for a custom mouthguard.

Is a Mouthguard Necessary?

Depending on the severity and underlying causes of your sleep apnea, a mouthguard may not be necessary. You may see just as much benefit from a CPAP machine. However, mouthguards provide an effective alternative for people with mild sleep apnea who don’t want to use a CPAP machine.

If you’re still unsure about mouthguards for sleep apnea, speak to your dentist, doctor, or a sleep specialist. They can also help you determine what kind of treatment is best for you.

Other Sleep Apnea Treatments

If using a sleep apnea mouth guard or other oral device doesn’t help, your doctor or a sleep specialist may recommend alternative treatment options to help you maintain an open airway during sleep. 

CPAP Machine

CPAP machine stands for continuous positive airway pressure. CPAP machines are commonly recommended for sleep apnea patients. They use a hose and mask or nosepiece to give you constant and steady air pressure.

Custom-made MADs are likely to cost more than CPAP machines up-front. Over time, however, CPAP machines require extensive repairs and replacements that oral appliances don’t. This can make a custom mouthguard a more affordable choice in the long run.

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Side Effects

CPAP machines can have side effects, including congestion, runny nose, dry eyes, nosebleeds, or a dry mouth.

More severe side effects include stomach discomfort and bloating. If you experience these symptoms, stop using your CPAP machine and speak to your doctor for medical advice. 

Healthy Lifestyle Changes

Your doctor or sleep specialist may suggest making some lifelong healthy lifestyle adjustments to help control or treat sleep apnea. These changes can benefit people experiencing both moderate and severe sleep apnea. These recommendations may include:

  • Eating a healthy balanced diet to protect the heart
  • Limiting your alcohol intake, especially before sleeping
  • Exercising regularly 
  • Aiming for a healthy weight
  • Developing healthy sleeping habits
  • Quitting smoking

Losing weight is incredibly helpful for obese people experiencing sleep apnea. Your doctor may also suggest general healthy sleeping habits, such as sleeping the recommended hours for your age.

Summary

Sleep apnea occurs when people stop breathing during sleep for seconds or minutes at a time. Most of the time, this is caused by the person’s airway being blocked.

Mouthguards are an effective treatment for many people with sleep apnea. They work by holding the tongue and/or lower jaw into a position that keeps the upper airway open.

Like other treatments, these oral appliances come with pros and cons. Your doctor, dentist, or sleep physician can help you choose among the different sleep apnea treatment options available.

Last updated on December 29, 2022
7 Sources Cited
Last updated on December 29, 2022
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. Sleep Apnea.” MedlinePlus.
  2. What is Sleep Apnea?” National Heart, Lung, and Blood Institute (NHLBI).
  3. Jayesh, S. Raghavendra, and Wasim Manzoor Bhat. “Mandibular advancement device for obstructive sleep apnea: An overview.” Journal of pharmacy & bioallied sciences, 2015.
  4. Lazard, Diane S., et al. “The tongue-retaining device: efficacy and side effects in obstructive sleep apnea syndrome.” Journal of clinical sleep medicine, 2009.
  5. Deane, Sheryn A., et al. “Comparison of mandibular advancement splint and tongue stabilizing device in obstructive sleep apnea: a randomized controlled trial.” Sleep, 2009.
  6. Tsuda, Hiroko, et al. "Practical considerations for effective oral appliance use in the treatment of obstructive sleep apnea: a clinical review." Sleep Science and Practice, 2017.
  7. Alshhrani, Waled M., et al. "The efficacy of a titrated tongue-stabilizing device on obstructive sleep apnea: a quasi-experimental study." Journal of clinical sleep medicine, 2021.
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