Maybe your CPAP machine is sitting in the closet right now. Maybe it’s on your nightstand, and you wake up at 2 a.m. having pulled the mask off in your sleep again. Or maybe you just got diagnosed with sleep apnea, took one look at the mask, and thought, “There has to be another way.”
You’re not alone. CPAP works very well when people use it. The problem is that a lot of people have a hard time using it every night.
The good news is that CPAP isn’t the only option. For many people with sleep apnea, there are alternatives worth talking about, including one you might not expect: a custom device made by your dentist.
A Quick Refresher on Sleep Apnea
Sleep apnea is a sleep disorder where your breathing stops and starts again and again while you sleep. Each pause can last several seconds. Your brain notices the drop in oxygen and jolts you just awake enough to start breathing again, usually without you ever realizing it.
That can happen dozens of times an hour. No wonder you wake up feeling like you barely slept.
There are three main types:
- Obstructive sleep apnea is the most common. The muscles in the back of your throat relax too much during sleep and block your airway.
- Central sleep apnea happens when your brain doesn’t send the right signals to the muscles that control breathing.
- Complex sleep apnea is a mix of both.
Why does this matter? Because the type of sleep apnea you have decides which treatments can help. Most of the alternatives in this article are for obstructive sleep apnea.
Signs You Might Have Sleep Apnea
Some people know they have it. Others have no idea until a partner mentions it. Common signs include:
- Loud, frequent snoring
- Someone noticing you stop breathing, gasp, or choke in your sleep
- Waking up with a dry mouth or sore throat
- Morning headaches
- Feeling exhausted during the day, even after a full night in bed
- Trouble focusing, or feeling irritable
- Getting up often at night
Snoring alone doesn’t always mean sleep apnea. But if you snore loudly and feel tired all the time, it’s worth finding out.
Why It’s Worth Treating
Sleep apnea isn’t just about feeling tired. Left untreated, it’s linked to serious health problems, including high blood pressure, heart attack, and stroke. The repeated drops in oxygen put strain on your heart and blood vessels.
It can also throw off your hormones and your metabolism, which is why it’s linked to conditions like type 2 diabetes and weight gain. And the daytime fatigue is more than an annoyance. Drowsiness slows your reaction time and increases your risk of accidents, especially behind the wheel.
That’s why finding a treatment you’ll actually use matters so much. The best treatment is the one that works for you every night.
Why CPAP Is Hard for Some People
CPAP stands for continuous positive airway pressure. The machine gently pushes air through a mask to keep your airway open while you sleep. For many people, it’s life-changing.
But it’s not always easy to live with. Common complaints include:
- The mask feels uncomfortable or claustrophobic
- Air leaks, dry nose, or a dry mouth
- The noise of the machine bothers you or your partner
- The hose gets tangled when you turn over
- It’s bulky and a hassle to travel with
If you’re using CPAP and it’s working, please keep using it. But if you’ve tried and it just isn’t happening, don’t give up on treatment. Talk to your doctor about other options.
Oral Appliance Therapy: A Dentist-Made Alternative
For people with mild to moderate obstructive sleep apnea, oral appliance therapy is one of the most popular CPAP alternatives.
An oral appliance is a custom-fitted device you wear in your mouth while you sleep. It looks a bit like a sports mouthguard or a retainer. There’s no mask, no hose, and no machine.
How it works
Oral appliances keep your airway open in one of two main ways:
- By moving your lower jaw forward. The appliance gently holds your jaw slightly forward, which keeps your tongue and the soft tissue in your throat from falling back and blocking your airway.
- By holding your tongue in place. Some designs keep the tongue forward so it can’t slide back and block the airway.
Either way, the goal is the same: a clear path for air all night long.
Why people like it
- It’s comfortable. Because it’s made to fit your mouth, most people get used to it quickly.
- It’s quiet. There’s no machine humming, so your bedroom stays silent. Your partner will likely appreciate the break from snoring, too.
- It travels easily. It fits in a small case you can toss in a bag or suitcase.
- People stick with it. Many patients find it easier to use every night than CPAP, and consistency is what makes treatment work.
What to expect when you start
It can take a little time to adjust. Some people notice mild jaw soreness, extra saliva, or a slight change in how their teeth meet in the morning. These usually settle down within a few minutes of taking the appliance out, and they tend to ease as you get used to it. We’ll check in with you and make adjustments so it stays comfortable and effective.
Other CPAP Alternatives Your Doctor May Mention
Oral appliances are just one option. Depending on your situation, your sleep doctor may also talk with you about:
- Weight loss. For some people, losing weight can reduce the severity of sleep apnea.
- Positional therapy. Some people only have apnea when they sleep on their back. Devices or simple tricks that keep you on your side can help.
- Nerve stimulation implants. For certain patients with moderate to severe obstructive sleep apnea who can’t use CPAP, a small implanted device can stimulate the nerve that moves the tongue forward during sleep.
- Surgery. In some cases, surgery to remove or tighten tissue in the throat or reposition the jaw may be recommended.
- Lifestyle changes. Avoiding alcohol before bed, quitting smoking, and treating nasal congestion can all help.
Your doctor can help you figure out which options make sense for you. For many people, an oral appliance is the simplest place to start.
Is an Oral Appliance Right for You?
Oral appliance therapy tends to work best for people who:
- Have mild to moderate obstructive sleep apnea
- Can’t tolerate CPAP, or want a simpler option
- Snore loudly
- Have healthy enough teeth and gums to support the appliance
It usually isn’t the right fit for central sleep apnea, since that type comes from the brain’s signals rather than a blocked airway. And for severe obstructive sleep apnea, CPAP is often still recommended, though an oral appliance may sometimes be used alongside it or when CPAP isn’t an option.
How It Works at Our Office
Here’s what the process looks like with us.
Step 1: Get a diagnosis
Sleep apnea has to be diagnosed with a sleep study. We work with sleep specialists to make sure you get a complete evaluation. The study may take place in a sleep lab or at home with portable monitoring equipment, and the results show how severe your sleep apnea is.
Step 2: Talk through your options
If you’re a good candidate for an oral appliance, we’ll explain how it works and answer your questions. Tiffany, our treatment coordinator and Sleep Apnea Champion, helps guide patients through each step, so you always have someone to ask.
Step 3: Get your custom appliance
We take precise digital scans of your teeth. No goopy impression trays. Your appliance is made to fit your mouth.
Step 4: Follow up
After you start wearing it, we’ll check the fit and make adjustments as needed. Your sleep specialist may also recommend a follow-up sleep study to confirm it’s working.
Questions People Ask Us
Can a dentist diagnose sleep apnea?
No. A sleep study is needed to diagnose sleep apnea, and that’s done through a sleep specialist. What we can do is spot warning signs, help you get tested, and make and fit your oral appliance once you’re diagnosed.
Will an oral appliance stop my snoring?
For many people, yes. Snoring happens when air struggles to get through a narrowed airway. Keeping the airway open often cuts snoring way down.
Can I use a store-bought snoring mouthguard instead?
Over-the-counter devices aren’t custom-fitted, and they may not be comfortable or effective. They also won’t treat sleep apnea on their own. If you snore and feel tired during the day, get checked first. Snoring can be a sign of something more serious.
How long does an oral appliance last?
With good care, a custom appliance can last for several years. We’ll check it at your regular visits to make sure it’s still fitting and working well.
Restful Nights Await
You deserve to wake up feeling rested. If your CPAP hasn’t worked out, or you’ve been putting off treatment because the mask just isn’t for you, there may be a better fit.
