Oral devices such as the mandibular advancement splint (pictured) may be a good alternative where CPAP is not appropriate or poorly tolerated.
It is a custom-fitted device that is worn during sleep. It consists of upper and lower pieces that fit over the teeth, joined by a hinge. The effect of the device is to move the lower jaw forward slightly. The helps to lessen upper airway collapse and obstruction during sleep. It is adjustable in fine incements (fractions of a millimetre).
Adequate dental health is required as the device is anchored to the teeth.
Oral devices are, in general, less effective than CPAP, especially for severe sleep apnoea. However, sleep apnoea treatment needs to be tailored to the individual, and an oral device may be the best option in certain circumstances, such as mild-moderate sleep apnoea and positional sleep apnoea (where sleep apnoea occurs predominantly when sleeping flat on one’s back).
Oral devices are not inexpensive and one cannot be certain of treatment success before starting. Often the specialist dentists who fit the devices will offer a guarantee of some sort. Alternatively, temporary oral devices are available – these include “Somnoguard”, “Apnoea-Guard” and “myTAP”. They are of lower cost and can be used for 1-2 months to establish whether the treatment is effective and comfortable.