Special mouthguard may be alternative to CPAP for sleep apnea (Progressive custom fitting over weeks is key)

Oral appliances similar to mouthguards—called mandibular advancement devices (MADs)—have been shown to work as well as CPAP in treating sleep apnea for many patients.

"The oral appliances have been around for less time than CPAP, but they've grown a lot in popularity over the last couple of years and they can be as effective as CPAP for the right patient," Wang said.

Obstructive sleep apnea occurs when your throat muscles relax to the point of collapse and block your airway during sleep. When this happens, your body becomes starved for oxygen and you periodically wake up for a few seconds to gasp for air.

People with severe sleep apnea can wake more than 30 times an hour while trying to get their rest. Daytime sleepiness is the most prominent side effect, but sleep apnea also has been linked to serious health problems such as high blood pressure, heart disease and diabetes.

These devices consist of two pieces that cover your upper and lower teeth, connected by a mechanism that uses your upper jaw as leverage to push the lower jaw forward, explained Dr. Colleen Lance.

MADs are similar to over-the-counter devices sold to help treat snoring, but they are custom-made by dentists working with sleep doctors, Lance and Levine said.

The upper and lower pieces are molded to your teeth, and the dentist performs a physical examination of your airway, including X-rays, to determine the exact adjustment you'll need.

"They calculate how many millimeters forward—we're talking about millimeters here, itty-bitty movements of the lower jaw—they would need to move the lower jaw to keep that airway open," Lance said.

These adjustments are usually made very slowly over a matter of weeks to prevent your jaw from aching or your bite from changing dramatically, Lance said.

Don’t know if this helps you but I had a surgery done called a “Hyoid Suspension” that fixed my apnea. I had undiagnosed apnea for 13 miserable years until I met an ENT doc that correctly diagnosed me and recommended that surgery. It’s been a game changer.

There’s a sufficiently wide variety of options that just about everyone can figure out one that works for them; full-face, nose/mouth, and what’s called a nasal pillow. All of these can be had in configurations where the main hose connection is on top of your head so it’s outta your face.

I have used a simple front-ported nasal pillow for years, it’s the lowest profile of all, and routing the hose up to my headboard keeps it out of the way as I don’t tend to toss and turn much.

The straps are cloth, thin, unobtrusive — I can sleep on my side without any issue at all. I haven’t, yet, but am still considering getting the more expensive model with the hose connection on top, but the front port type I have has been fine.

I compare it to when you first started wearing a wristwatch all the time. It’s weird, and you notice it for awhile, but it eventually becomes just another part of your regular sensory environment, and your brain ignores it.

All that said, this other device wouldn’t help me, as my problem isn’t OBSTRUCTIVE; I simply STOP breathing about 70 times an hour.

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