Mouth Guards for Sleep Apnea: Benefits and How They Work

Quick Takeaways:

•  Mouth guards for sleep apnea (also called oral appliances) help keep the airway open by gently moving the jaw or tongue forward during sleep.

•  Two main types: mandibular advancement devices (MADs) and tongue retaining devices (TRDs); both can reduce snoring and mild to moderate OSA symptoms.
•  Custom-fit devices prescribed by a doctor and adjusted by a dentist tend to provide the most comfortable and effective results.
•  Mouths guards are an effective alternative to treat OSA, even if CPAP remains the most effective treatment for more people.² But they can be used in combination in select cases 

Obstructive sleep apnea (OSA) is a condition where breathing repeatedly stops and starts due to blocked airways during sleep. Left untreated, OSA can impact nearly every part of your life. It's linked to serious health concerns like high blood pressure, heart disease, and diabetes.

Beyond physical health, sleep apnea can also lead to daytime fatigue, low mood and memory issues that impact your work or social activities.¹ In fact, around 32% of people in romantic relationships say that their partner's snoring or other symptoms associated with obstructive sleep apnea make it harder to sleep.²

For some people with obstructive sleep apnea, mouth guards are a portable, non-invasive treatment option. Explore what sleep apnea mouthpieces are, how they work and what to know before using one below.

What are mouth guards?

 Sleep apnea mouth guards are also called oral appliances for sleep apnea. They're designed to keep your airway open while you sleep.

Many people are familiar with dental night guards, which help protect your teeth from grinding while sleeping. In contrast, oral devices for sleep apnea help reduce pauses in breathing that lead to OSA symptoms like gasping or choking while sleeping.

Two main types of sleep apnea mouth guards are mandibular advancement devices (MADs) and tongue retaining devices (TRDs). Both devices are made from medical-grade materials, such as silicone, acrylic or thermoplastic to support safety, durability and comfort.

How do mouth guards help treat obstructive sleep apnea (OSA)? 

Mouth guards for obstructive sleep apnea work by gently guiding your jaw or tongue forward. This motion helps keep your airway open as you sleep. Keeping your airway open helps you breathe easier, sleep more soundly and wake up less often during the night.

MADs pull the lower jaw forward, helping to better position the tongue, soft palate and uvula. This helps reduce the chance they collapse back and block the airway. TRDs use a gentle suction to hold the tongue forward and away from the back of the throat.

The goal of both devices is to help keep your airway open while you sleep. This makes it easier to breathe, improves sleep quality and reduces OSA symptoms like snoring. It also helps support better breath patterns and oxygen levels during sleep.

Types of mouth guards for obstructive sleep apnea

Sleep apnea oral devices come in two major types: MADs and TRDs. The device that works best for you depends on your jaw structure, personal preference, and other factors.

Mandibular advancement devices (MADs)

MADs are the most common sleep apnea oral appliance. These treatment options gently shift the lower jaw forward to open the airway and ease breathing.

The devices are adjustable and custom-fit, which means they allow precise changes in jaw positioning. The ability to make small changes helps create a fit that's comfortable and effective.

MADs work by gently pulling the lower jaw (mandible) forward. The tongue and soft tissues in the mouth also shift forward, making more room in your throat for air to flow. In a recent study, up to 63% of participants using MADs reported that they stopped snoring³ due to a more open airway.

For a mandibular advancement device to be effective, the bottom and top pieces need to fit comfortably. A sleep specialist can write a prescription for the device. From there, a trained dentist can make adjustments to ensure the new device is comfortable and fits your mouth correctly.

Tongue retaining devices (TRDs)

TRDs work by holding the tongue forward in the mouth via gentle suction. As with MADs, the device helps keep the airway open by bringing the tongue and soft tissue forward. While MADs shift the lower jaw forward, TRDs keep the jaw still and focus on moving the tongue forward to keep your airways open while you sleep.

TRDs may be an option for people with sleep apnea who:

• Prefer not to adjust their jaw due to other dental or health concerns.

• Feel discomfort when their jaw is moved.

• Don't have strong enough teeth for a mandibular advancement device, as MADs are held in place partly by teeth.

TRDs can be available over the counter and may feel like a simpler device compared to MADs. However, not everyone likes the feeling of suction, and some people get used to MADs more easily.

What to consider before using a mouth guard

When considering a MAD or TRD for sleep apnea, it's important to research treatment effectiveness, cost and other factors.

Effectiveness and treatment outcomes 

Many people considering sleep apnea mouth guards want to know if they can replace continuous positive airway pressure (CPAP) therapy. Deciding on a treatment can vary based on many factors and should be made with a doctor.

There are studies that look at health outcomes with CPAP vs. MAD use. In general, CPAP is a proven and widely recognised first-line therapy for people with obstructive sleep apnea (OSA) treatment, including in individuals with complex comorbidities.⁴ However, people who use MADs for sleep apnea are more likely to stick with their treatment.⁵

One study found that after two years, both MADs and CPAP were effective in treating sleep apnea. However, CPAP worked better at helping people get more oxygen while they sleep and at reducing how often their breathing stops or becomes shallow ⁹

Diagnosis and getting started

Oral appliances can sometimes be used to treat obstructive sleep apnea (OSA). OSA is diagnosed with a sleep test — either at home or overnight in a lab. After taking a sleep test, you and your doctor can review the results and, if diagnosed with OSA, determine the best treatment option.

If you and your doctor determine that an oral appliance is appropriate, a dentist will take dental impressions. This can be done with a physical mould or digital scans. The goal is to determine how far forward your jaw needs to move to support comfort and effective OSA treatment.

Next, a custom oral device is made. During fittings, the device is adjusted to fine-tune your jaw position. Once you start sleeping with your mouth guard, you’ll want to follow up with your dentist. During these check-ins, your dentist can make sure your device is properly fitted and effectively treating your OSA.

Side effects and comfort considerations

The most common side effect when using an oral appliance for sleep apnea can be mild discomfort. That may include jaw soreness, tenderness in the mouth, dry mouth or excessive salivation. Often, these minor irritations only occur in the first few weeks as people get used to the mouth guard.¹⁰

Long-term issues are rare but can include tooth movement, ongoing discomfort in the jaw and changes in your bite.¹⁰

People who use sleep apnea mouth guards tend to have better experiences when the devices fit properly and are comfortable. Regular follow-ups can help fine-tune the device’s fit and address any discomfort or changes.

Mouth guards as part of comprehensive obstructive sleep apnea treatment

Oral appliances can be used on their own or alongside other therapies, including CPAP, positional therapy, weight management, and other lifestyle changes.

Because obstructive sleep apnea (OSA) can evolve over time, follow-ups are needed to ensure treatment is still efficiently reducing the frequency of breathing pauses during sleep. They can help check whether a mouth guard is effectively controlling symptoms and provide data that guides necessary adjustments.

Even when mouth guards don't fully resolve OSA symptoms, they may help reduce snoring and improve sleep quality for people with sleep apnea and their bed partners.

If you're ready to learn more about the quality of your sleep, take our home sleep test. 

References:

1. Sleep apnea symptoms and risks. Resmed. https://www.resmed.co.uk/patient/sleep-apnea/symptoms-risks/

2. Resmed's 2025 Global Sleep Survey. https://sleepsurvey.resmed.com/

3. Vecchierini MF, Attali V, Collet JM, d'Ortho MP, Goutorbe F, Kerbrat JB, Leger D, Lavergne F, Monaca C, Monteyrol PJ, Mullens E, Pigearias B, Martin F, Khemliche H, Lerousseau L, Meurice JC. Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data. J Clin Sleep Med. 2021 Aug 1;17(8):1695-1705. doi: 10.5664/jcsm.9308. PMID: 34165074; PMCID: PMC8656912.

4. Understanding Pap, 2021. Division of Sleep Medicine at Harvard Medical School. https://sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-37

5. Basyuni, Shadi, et al. (2018). Journal of Thoracic Disease. https://jtd.amegroups.org/article/view/17794/html

6. Doff, Michiel H. J., et al. (2013). Sleep Research Society. https://pmc.ncbi.nlm.nih.gov/articles/PMC3738037/

7. Dieltjens M, Vanderveken O. Oral Appliances in Obstructive Sleep Apnea. Healthcare (Basel). 2019 Nov 8;7(4):141. doi: 10.3390/healthcare7040141. PMID: 31717429; PMCID: PMC6956298. Oral Appliances in Obstructive Sleep Apnea - PMC