Oral breathing devices for obstructive sleep apnea

Oral devices (also called oral appliances or mandibular repositioning devices) are sometimes used to treat obstructive sleep apnea (OSA). They push the tongue and jaw forward, which makes the airway larger and improves airflow. This also decreases the chance that tissue will collapse and narrow the airway when you breathe in. See a picture of a mandibular repositioning device (MRD).

Oral breathing devices are sometimes a reasonable alternative to continuous positive airway pressure (CPAP). Although oral breathing devices generally do not work as well as CPAP, they may be considered for people who:¹

• Have mild sleep apnea.
• Prefer not to use or who have failed CPAP treatment.
• Had surgery that did not work.
• Tried behavioral changes that did not work.

Choose a dentist or orthodontist who has experience fitting these devices. And go back to your dentist for regular check-ups to make sure the device still fits well.

Little research has been done on oral breathing devices. Small studies indicate that they may improve breathing at night and reduce daytime sleepiness.² They may be helpful for people who are at a healthy weight.

Possible problems with devices that fit inside the mouth include:

• Buildup of saliva in the mouth, requiring frequent swallowing.
• Discomfort, especially in the morning. The devices can be uncomfortable, and people tend not to use them over the long term.
• Damage to teeth, soft tissues in the mouth, and the jaw joints. So it is important that a skilled dentist or orthodontist fit the device to prevent these problems.

If you use an oral breathing device to treat sleep apnea, use it every night. Excess saliva in your mouth and mild discomfort should become less bothersome with regular use.

An oral breathing device used for a child with sleep apnea must be refitted periodically as the child grows.

Citations

1. Malhotra A, White DP (2002). Obstructive sleep apnea. Lancet, 360(9328): 237-245.

2. Hensley M, Ray C (2006). Sleep apnea. Clinical Evidence (15): 1-18.