Sleep Apnea Mouth Guard Guide: Types, Costs, and Effectiveness

Can Dental Appliances Address Sleep Apnea? 

Sleep apnea is a serious sleep disorder characterized by repeated interruptions in breathing during sleep, often due to airway obstruction. Continuous Positive Airway Pressure (CPAP) therapy remains the gold standard for treating obstructive sleep apnea (OSA), but some individuals have found success with dental appliances or mouth guards. 

The Sleep Syndicate will be exploring the effectiveness of sleep apnea mouth guards, the different types available, maintenance tips, and the importance of using them under medical supervision.

No material on this site or in this article is intended to be a substitute for professional medical advice, diagnosis or treatment. Do not do something on your own without the supervision of a medical practitioner, Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking changes to health-related habits, and never disregard professional medical advice or delay in seeking it because of something you have read here.

Effectiveness of Dental Appliances for Sleep Apnea

Mandibular advancement devices (MADs) and tongue-retaining devices (TRDs) are the two primary types of sleep apnea mouth guards. These devices help keep the airway open by repositioning the lower jaw or tongue or stopping them from sliding back and blocking your airway while you’re sleeping. 

Scientific research supports the efficacy of oral appliances, particularly for mild to moderate OSA cases:

A meta-analysis published by Sleep Science found that MADs significantly reduced the apnea-hypopnea index (AHI) [1]. 

Another study in the American Journal of Respiratory and Critical Care Medicine highlighted that MADs improved daytime sleepiness and overall sleep quality in OSA patients [2]. 

While CPAP remains the most effective treatment, studies have shown that MADs are a viable alternative for patients who cannot tolerate and undergo CPAP therapy.

Types of Sleep Apnea Mouth Guards

There are several types of mouth guards available for sleep apnea treatment. Choosing the right type depends on the severity of your condition, personal comfort, and guidance from a sleep specialist.

1. Mandibular Advancement Devices (MADs)

MADs work by gently pushing or holding the lower jaw forward to prevent airway collapse. 

Research published in the American journal of respiratory and critical care medicine suggests that MADs significantly reduce snoring and AHI in patients with mild to moderate OSA [3].

2. Tongue-Retaining Devices (TRDs)

A clinical trial by the American Academy of Sleep Medicine reported that TRDs were particularly useful for individuals with tongue-based airway obstruction but had lower adherence rates compared to MADs [4].

TRDs function by holding the tongue in place to prevent airway obstruction. This research above highlighted the efficacy and usefulness of TRDs but MADs were found to be more effective.

3. Custom vs. Over-the-Counter Mouth Guards

Custom-fitted mouth guards are more effective than over-the-counter options, as demonstrated in a study from Sleep Medicine Clinics [5]. 

Although more costly, custom appliances provide a better fit, leading to improved compliance and efficacy.  Regardless of which type of mouthguard or sleep dental appliance you’re looking at, it’s important to work with a sleep specialist to ensure the chosen dental appliance is having a sufficient positive effect.  This usually involves taking part in a sleep study with the chosen device.  The sleep study will measure several key readings as you sleep and determine whether the dental device is effectively reducing or eliminating your sleep apnea.

How to Clean a Sleep Apnea Mouth Guard

Proper maintenance of a sleep apnea mouth guard is essential to prevent bacterial buildup and ensure longevity. The following evidence-based recommendations highlight best practices for cleaning and maintaining oral appliances.

1. Daily Cleaning

Studies done by the International Journal of Molecular Sciences indicate that using mild soap and lukewarm water is an effective and non-damaging method for cleaning oral appliances [6]. 

Avoid using toothpaste, as it may be abrasive and degrade the material over time.

2. Deep Cleaning

Research by PeerJ found that solutions containing sodium hypochlorite (a chemical compound that's commonly used as bleach) and glutaraldehyde (also known as also known as a dialdehyde or pentanedial) effectively disinfect oral devices without causing structural damage [7].

Weekly soaking in a non-alcoholic antimicrobial solution may help remove stuck plaque and bacteria. Be sure to follow the manufacturer’s guidelines and recommendations from your dentist and sleep specialist to improve the life of your sleep apnea dental appliance.

The Importance of Medical Supervision

While dental appliances can be an effective way to manage sleep apnea for some people, their use should be at the direction of a physician.  Sleep apnea is a serious medical condition that can cause an increased risk to your health, so be sure to treat it with the support of a medical professional.  As mentioned, an overnight sleep study, or polysomnography, is necessary to confirm their efficacy. 

The American Academy of Sleep Medicine advises against self-treatment with over-the-counter oral devices without medical oversight as it may lead to unprecedented damages both to a person’s health and your sleep [8].

Fixing Your Sleep Habits 

Even if you have sleep apnea and whether you’re using CPAP or a sleep apnea dental appliance, you can benefit from following sleep habit best practices.  Science has shown that improving overall sleep habits using online sleep improvement programs may significantly enhance treatment outcomes as mentioned in a research by  Clocks and Sleep [9]. 

The Sleep Syndicate offers a six-weeks sleep habits improvement program, including:

• Proven behavior modification techniques to guide you into long-term beneficial change
• Customizable text message reminders to prompt you when you most need it
• Educational content on sleep hygiene, sleep disorders, and evidence-based relaxation techniques.
• Sleep habits tracking app to monitor progress and assess improvements over time.
• Guided nightly wind-down podcasts, incorporating Science-backed techniques to enhance sleep quality.

By integrating a structured sleep improvement plan with your mouth guard treatment, you are on the way to achieving a better sleep and better overall health.

The Sleep Syndicate’s 6 Weeks To Better Sleep program

Conclusion

Sleep apnea mouth guards can be a successful management tool for OSA, particularly in mild to moderate cases. Scientific evidence supports their effectiveness, though they should be used under medical supervision and validated with a sleep study. 

Proper maintenance is crucial to ensure their longevity and efficacy. 

Following sleep hygiene best-practices is always recommended.  Learn more at The Sleep Syndicate.

Citations

1. Manetta, I. P., Ettlin, D., Sanz, P. M., Rocha, I., & Meira E Cruz, M. (2022). Mandibular advancement devices in obstructive sleep apnea: an updated review. Sleep science (Sao Paulo, Brazil), 15(Spec 2), 398–405. https://doi.org/10.5935/1984-0063.20210032
2. Phillips, C. L., Grunstein, R. R., Darendeliler, M. A., et al. (2013). Health outcomes of CPAP versus oral appliance treatment for obstructive sleep apnea: A randomized controlled trial. American Journal of Respiratory and Critical Care Medicine, 187(8), 879-887. https://pubmed.ncbi.nlm.nih.gov/23413266/
3. Vanderveken, O. M., Devolder, A., Marklund, M., Boudewyns, A. N., Braem, M. J., Okkerse, W., Verbraecken, J. A., Franklin, K. A., De Backer, W. A., & Van de Heyning, P. H. (2008). Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. American journal of respiratory and critical care medicine, 178(2), 197–202. https://doi.org/10.1164/rccm.200701-114OC
4. Iftikhar, I. H., Hays, E. R., Iverson, M. A., Magalang, U. J., & Maas, A. K. (2013). Effect of oral appliances on blood pressure in obstructive sleep apnea: a systematic review and meta-analysis. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 9(2), 165–174. https://doi.org/10.5664/jcsm.2420
5. Ng, J. H., & Yow, M. (2019). Oral Appliances in the Management of Obstructive Sleep Apnea. Sleep medicine clinics, 14(1), 109–118. https://doi.org/10.1016/j.jsmc.2018.10.012
6. Wezgowiec, J., Paradowska-Stolarz, A., Malysa, A., Orzeszek, S., Seweryn, P., & Wieckiewicz, M. (2022). Effects of Various Disinfection Methods on the Material Properties of Silicone Dental Impressions of Different Types and Viscosities. International journal of molecular sciences, 23(18), 10859. https://doi.org/10.3390/ijms231810859
7. Qiu, Y., Xu, J., Xu, Y., Shi, Z., Wang, Y., Zhang, L., & Fu, B. (2023). Disinfection efficacy of sodium hypochlorite and glutaraldehyde and their effects on the dimensional stability and surface properties of dental impressions: a systematic review. PeerJ, 11, e14868. https://doi.org/10.7717/peerj.14868
8. Ramar, K., Dort, L. C., Katz, S. G., Lettieri, C. J., Harrod, C. G., Thomas, S. M., & Chervin, R. D. (2015). Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 11(7), 773–827. https://doi.org/10.5664/jcsm.4858 
9. Contreras, D. A., Williams, E., & Tucker, R. M. (2023). Equivalent Improvements in Sleep Duration and Sleep Quality Regardless of Program Delivery Modality: The SLeep Education for Everyone Program (SLEEP). Clocks & Sleep, 5(2), 226-233. https://doi.org/10.3390/clockssleep5020018