If you are one of the unlucky ones who suffer from sleep apnea, you have probably wondered – is an oral sleep apnea device as effective as a CPAP machine? These are the two most common methods of treating obstructive sleep apnea. Are they equally effective?

The short answer – no, they are not. An oral device is an alternative to CPAP therapy. It can be effective in patients with mild to moderate obstructive sleep apnea, but it is not a replacement for CPAP therapy. However, according to long-term studies, the overall health outcomes are similar. (1)

Let’s take a closer look at how oral devices and CPAP machines help treat sleep apnea and what’s the difference between these two methods.

How Can Oral Devices Treat Sleep Apnea?

Sleep specialists determine the severity of a person’s case by performing a sleep study that shows if an oral appliance is an adequate treatment solution. If the answer is yes, one of two types of appliances will be recommended: the mandibular advancement device (MAD) or a tongue retaining mouthpiece.

A mandibular advancement device looks like a mouthguard and works similarly. A MAD snaps over the upper and lower teeth, and metal hinges connect these two pieces. It works by thrusting the tongue and lower jaw slightly forward, which prevents the throat muscles from folding in on themselves when a person is sleeping. This allows the patient to breathe easily throughout the night.

A tongue retaining mouthpiece is recommended when a person’s jaw can’t be repositioned forward. This device has a small compartment that sucks the tongue forward, preventing it from collapsing back into the airway, allowing the patient to breathe freely. However, this treatment is not well tolerated in most people.

Oral appliances are a good choice for patients with mild to moderate obstructive sleep apnea; they do not treat as effectively in people with more severe OSA cases. Oral devices are recommended as a treatment after a patient has given the CPAP therapy an adequate try. Remember – these devices are an alternative, not a replacement for CPAP therapy. (2)

How Can CPAP Machines Treat Sleep Apnea?

A CPAP machine contains a motorized fan. This fan draws air from the room, filters it for dust and other particulates, and humidifies it (this is an optional setting). Humidifying the air helps supply moisture, which prevents dryness in the mouth, throat, and nose. The filtered (and humidified) air is pressurized to the suitable setting and delivered to the patient’s airway via mask and tubing while the patient is sleeping. This continuous stream of air helps keep the airways open.

CPAP machines come in different sizes. No matter the size, all of them require a battery charge or some sort of electricity to function. Some CPAP machines are more compact than others, and they can either cover the nose and mouth, go over the nose alone, or feature nasal plugs that are inserted directly into the nostrils from below.

When it comes to severe cases of OSA, CPAP therapy is an excellent treatment solution, and it will prevent the loss of blood oxygen that can negatively affect the patient’s health. This therapy helps alleviate some unpleasant symptoms, including sore throat, snoring, daytime sleepiness, and headaches.

CPAP machines are an excellent choice for patients with all severity levels of obstructive sleep apnea, whereas oral devices may not be able to treat severe cases of OSA the same.

When it comes to treating severe cases, CPAP machines tend to be more effective than oral appliances.

Besides helping to combat sleep apnea, CPAP machines can also reduce the risk of developing memory, cognitive, and attention problems, diabetes, stroke, high blood pressure, and cardiovascular disease.

What are the Benefits of Oral Devices?

Some of the advantages of using an oral device to treat mild to moderate obstructive sleep apnea include:

  • Ease of use – oral devices are very easy to use – they are portable, small, and don’t need to be plugged in, which means you can use them wherever you want. Maintenance is also pretty easy.
  • Affordability – oral appliances are very reasonably priced, and they won’t significantly affect your budget.
  • Comfort – since these devices are custom fit to your mouth and jaw, they will stay comfortable, no matter which sleeping position you prefer.
  • No interference with allergies and colds – wearing an oral device doesn’t require a clear nasal airway to offer the full benefit.
  • No additional sound – oral appliances don’t create any sound that may keep your partner awake.

What are the Benefits of CPAP Machines?

Benefits of using continuous positive airway pressure machines to treat all severity levels of obstructive sleep apnea include:

  • Effectiveness – CPAP machines are highly effective when it comes to preventing breathing disruptions and treating OSA.
  • Fast benefits – these machines immediately improve breathing while sleeping, thus protecting the patient’s health.
  • Numerous options available – many CPAP users complained about large machines and uncomfortable masks, however, today many equipment options are available. It is easy to find a suitable CPAP machine without sacrificing comfort.

Oral Devices Vs. CPAP Machines

Both oral appliances and CPAP machines can do wonders when it comes to keeping your obstructive sleep apnea in check, and they will help you receive a good night’s sleep.

We’ve explained the basics of these two methods, as well as their benefits, but here is a short comparison:

  • Oral devices are mainly used to treat mild to moderate cases of OSA, whereas CPAP machines are used to treat all severity levels.
  • Oral appliances are worn inside the mouth, and they don’t have any other components attached to your face. On the other hand, using CPAP machines includes wearing a mask over the nose and mouth (depending on the type of CPAP machine), which may prevent you from sleeping on your stomach comfortably.
  • Oral devices don’t produce any sound when used, whereas CPAP machines produce a sound as they blow the stream of air down the throat.
  • Oral devices are portable and don’t need to be plugged in, whereas CPAP machines require electricity or a battery charge to function.
  • Oral appliances may be less effective than CPAP machines for treating sleep apnea, depending on the severity of the case.

Conclusion

As you can see, oral devices and CPAP machines are effective in treating sleep apnea, and they each come with their own pros and cons.
The right treatment for OSA depends on your unique circumstances, such as the severity of your case, personal preferences, the structure of the airways, as well as other medical issues you may have.

If you feel like sleep apnea is affecting your sleep quality and overall well-being, consult a doctor or a sleep specialist to discuss a suitable treatment for your unique situation.

 

Citations:

 

    1. Sutherland K; Vanderveken OM; Tsuda H; Marklund M; Gagnadoux F; Kushida CA; Cistulli PA; on behalf of the ORANGE-Registry. Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med 2014;10(2):215-227.
    1. Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM, Chervin RD. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015. J Clin Sleep Med 2015;11(7):773–827.