Looking for a CPAP alternative?
If your CPAP spends more nights on the nightstand than on your face, you're in good company, and you haven't failed at treatment. The mask, the hose and the hum of the machine can make it hard to fall asleep, and plenty of people end up setting it aside while the exhaustion comes right back. For mild to moderate sleep apnea, a custom oral appliance is a proven CPAP alternative, and for severe apnea it can work alongside your CPAP. This post covers how an oral appliance works, who it's right for, and how we make sure it's treating your apnea.
Why is CPAP so hard for some people to wear?
CPAP keeps your airway open by pushing a steady stream of air through a mask, and it's very effective on the nights you wear it. Mayo Clinic notes that some people find the mask uncomfortable or loud, and if you feel claustrophobic in a mask, bedtime can start to feel like a struggle.
What protects your health is being treated every night, so the best treatment is the one you'll wear. Dr. Ashlee Goodman-Tabari tells patients who've stopped using their machine, "if you're not using your CPAP, it's better to use something than nothing."
What is the most common CPAP alternative?
The most common CPAP alternative is a custom oral appliance, a small device that fits like a retainer and gently holds your lower jaw forward while you sleep. That keeps your tongue and the soft tissue in your throat from falling back and blocking your airway, so you keep breathing freely through the night, and all you wear is one small, lightweight piece. The ADA's MouthHealthy site notes that research shows oral appliances can successfully prevent sleep apnea in some mild to moderate cases.
The appliance is light enough to fit in your pocket, makes no noise and needs no electricity, which makes it easy to pack for a trip. You can talk with it in and move your jaw freely, so it feels far less confining than a mask for many people.
Is an oral appliance as effective as a CPAP?
For mild to moderate sleep apnea, a custom oral appliance can be as effective as a CPAP, and because it's so much easier to wear, many people use it more consistently. For severe apnea, CPAP remains the most effective option, and Mayo Clinic notes that oral appliances are also used for people with severe sleep apnea who can't use CPAP. In that case we often recommend combination therapy, using your CPAP and your appliance together or on different nights, and we work with your sleep physician to find the right mix.
- How it works: CPAP: A mask and a stream of air hold your airway open. Custom oral appliance: Holds your lower jaw forward to keep your airway open.
- Best suited for: CPAP: Sleep apnea of any severity, especially severe. Custom oral appliance: Mild to moderate apnea, or alongside CPAP for severe apnea.
- Noise and power: CPAP: Runs on a machine with a hose. Custom oral appliance: Silent, with no electricity needed.
- Travel: CPAP: Machine, mask and hose to pack. Custom oral appliance: Fits in your pocket.
How do we make sure your appliance is working?
An appliance only helps if it's treating your apnea, so we confirm it with testing instead of taking it on faith. Here's how the process works with us:
- A sleep study confirms your diagnosis and how severe your apnea is. If your last one was a while ago, we can update it with a simple home sleep test.
- We take a 3D scan of your mouth and choose a comfortable starting position for your jaw.
- Your appliance is custom made in a lab and comes back in about three weeks.
- We fine-tune it over follow-up visits, and if anything rubs or bothers a tooth, we adjust it.
- You take another home sleep test with the appliance in, and we share the results with your sleep physician so everyone can see your treatment is working.
Mayo Clinic recommends close follow-up with a dentist experienced in dental sleep medicine appliances, and that follow-through is part of every appliance we make. You can read more about the fitting process on our oral appliance therapy page, or see a side-by-side on our CPAP vs. oral appliance page.
When should you talk to us about your CPAP?
If your CPAP is sitting unused, or you pull the mask off partway through the night, it's worth a conversation. The same goes if you still snore or feel sleepy even though you're wearing it, which Mayo Clinic says is a reason to check in with your provider. When you come in, bring any current sleep appliance and your sleep physician's contact information, and we'll take it from there.
Frequently asked questions
I was prescribed a CPAP but I can't stand it. What are my options?
You have options. Many people who can't tolerate CPAP do well with a custom oral appliance, especially for mild to moderate sleep apnea. We'll review your diagnosis with your sleep physician, update your sleep study if it's been a while, and find a treatment you'll comfortably wear every night.
Is switching from CPAP to an oral appliance a step down?
For mild to moderate sleep apnea, an oral appliance can be as effective as a CPAP, so you're keeping your protection. What matters most is wearing your treatment every night, and for many people a small, silent appliance is far easier to live with than a mask and a hose.
Can I use an oral appliance and a CPAP together?
Yes. For severe sleep apnea, combination therapy can be a good solution, using your CPAP and an oral appliance together or on different nights. It's especially helpful when you can't wear your CPAP every night. We'll work with your sleep physician to figure out the right mix for you.
Does medical insurance cover an oral appliance for sleep apnea?
Oral appliance therapy is billed through your medical insurance, not dental, because it treats a medical condition. We accept all major medical insurances, verify your benefits before treatment, and explain any out-of-pocket cost up front. Financing through Cherry is also available if you'd like to spread out your payments.
Book your visit in Glen Allen
You deserve a treatment you can sleep with. Call A-Z Sleep & Airway Center at (804)-767-2507 or book online, and we'll look at your diagnosis together and talk through what will work for you. Our office is at 10220 Staples Mill Rd in Glen Allen, inside the Shops at Cross Ridge, and we see patients from across Glen Allen and Richmond.
Published by A-Z Sleep & Airway Center.
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