by Sleep Better Columbus | May 19, 2025 | Sleep Apnea Treatments
Oral appliance therapy is a proven alternative to CPAP for individuals diagnosed with obstructive sleep apnea (OSA). Patients who cannot tolerate CPAP or are looking for a more convenient solution often consider a custom oral appliance for sleep apnea. These appliances are not over-the-counter devices—they are custom-made to fit the patient’s unique dental and jaw structure.
Understanding the oral appliance fitting process helps patients know what to expect and make informed decisions about their treatment. This guide explains each step in the process, from initial evaluation to final fitting and follow-up.
Step 1 – Initial Evaluation and Treatment Candidacy
The first step in receiving a custom oral appliance is a clinical evaluation by a trained sleep dentist. This appointment includes a review of your medical and dental history, a sleep apnea screening, and a physical examination of your mouth and jaw.
If the patient has not yet received a diagnosis of sleep apnea, a sleep study may be recommended. Most commonly, a home sleep apnea test is used to confirm the presence and severity of obstructive sleep apnea. Once diagnosed, the dentist determines if the patient is a good candidate for oral appliance therapy.
Key Criteria for Oral Appliance Eligibility
- Diagnosis of mild to moderate obstructive sleep apnea
- Inability to tolerate or preference against CPAP therapy
- Adequate dental health and jaw structure for appliance support
- No significant issues with temporomandibular joint (TMJ) function
During this evaluation, the dentist explains how the oral appliance works, what results can be expected, and how it will be customized for the patient’s mouth. Patients can ask questions about the fitting timeline, comfort, and ongoing care.
This first step is essential to ensure the appliance is both safe and effective for long-term use in managing sleep apnea symptoms.
Step 2 – Impressions and Digital Scanning
Once a patient is approved for oral appliance therapy, the next step involves capturing precise measurements of the mouth. This is done to ensure that the custom oral appliance for sleep apnea fits securely and aligns properly with the jaw and teeth.
Methods Used for Dental Impressions
There are two main techniques used to capture the patient’s oral anatomy:
- Digital Intraoral Scanning: A handheld scanner creates a 3D image of the teeth, bite, and gums. This method is highly accurate and more comfortable for the patient.
- Traditional Dental Impressions: A moldable material is placed in a tray and pressed against the upper and lower teeth to create a precise impression. While effective, this method is less commonly used when digital scanning is available.
Recording Bite Registration and Jaw Position
In addition to the impressions, the provider records how the upper and lower teeth come together (bite registration) and measures the ideal position for the lower jaw. These measurements are critical for setting the appliance to gently advance the jaw, which helps maintain an open airway during sleep.
Importance of Accurate Scans
Accurate impressions and scans enable the dental lab to fabricate an appliance tailored to the individual’s oral structure. A properly fitted appliance minimizes jaw strain, improves comfort, and increases patient compliance with nightly use.
This step typically takes less than an hour and is a non-invasive procedure. The data collected is then sent to a dental laboratory for the fabrication of the appliance.
Step 3 – Custom Appliance Fabrication
After the digital scans and bite records are complete, the data is sent to a dental laboratory that specializes in the fabrication of sleep apnea appliances. The lab utilizes this information to create a custom oral appliance for sleep apnea that is tailored to the patient’s unique anatomy.
Materials and Design
The appliance is made from biocompatible, medical-grade materials designed for durability, safety, and long-term wear. These materials are strong enough to hold the jaw in a forward position during sleep while remaining comfortable inside the mouth.
Each appliance is designed to:
- Maintain an open airway by advancing the lower jaw
- Align with the patient’s bite without causing tooth movement.
- Prevent pressure on soft tissues and joints.
- Be adjustable, if required, for further jaw advancement.
There are various types of oral appliances, and the dentist selects the appropriate design based on the patient’s anatomy, the severity of sleep apnea, and their personal comfort needs.
Turnaround Time
The production process typically takes 2 to 3 weeks. During this time, the lab fabricates the appliance according to the dentist’s specifications and the patient’s scanned models. Once complete, the appliance is shipped back to the dentist’s office for final fitting.
This step is essential to ensure that the final product delivers both comfort and effectiveness in managing obstructive sleep apnea.
Step 4 – Appliance Fitting and Adjustment
Once the custom oral appliance is returned from the lab, the patient returns to the dentist’s office for the fitting appointment. This step ensures that the oral appliance for sleep apnea fits securely, functions properly, and feels comfortable during use.
What Happens During the Fitting
The dentist places the appliance in the patient’s mouth and checks the following:
- Alignment with the upper and lower teeth
- Jaw position and bite registration
- Comfort around gums and soft tissues
- Retention and ease of insertion/removal
The goal is to ensure that the appliance fits snugly without causing irritation, tooth movement, or jaw discomfort. If any areas feel tight or cause pressure, the dentist can make minor adjustments on-site.
Initial Jaw Advancement Settings
Most oral appliances are adjustable. During the fitting, the dentist sets an initial level of jaw advancement tailored to the patient’s specific needs. This position helps open the airway without straining the jaw or causing TMJ discomfort.
Patients are instructed on:
- How to insert and remove the device properly
- Cleaning and storage procedures
- How to track comfort and sleep quality at home
Importance of a Proper Fit
A properly fitted appliance is essential for effective treatment. Poor fit may lead to reduced efficacy, discomfort, or poor compliance. This fitting appointment allows the dentist to ensure the device is ready for daily use and helps the patient feel confident in using it correctly.
The patient is typically asked to wear the appliance nightly for a few weeks before returning for follow-up adjustments.
Step 5 – Follow-Up and Long-Term Monitoring of Your Sleep Apnea Device
After the patient begins using the custom oral appliance for sleep apnea, regular follow-up is essential to confirm the therapy’s effectiveness and to make any necessary adjustments. This phase ensures long-term comfort and consistent results.
Follow-Up Oral Appliance Appointments
The first follow-up typically occurs within a few weeks of the fitting. During this visit, the dentist evaluates:
- Appliance comfort and fit
- Changes in sleep quality or symptoms
- Any side effects, such as jaw soreness or bite changes
If necessary, the jaw advancement setting may be adjusted to optimize airflow during sleep. Additional follow-ups may be scheduled over the next few months to fine-tune the appliance.
Ongoing Monitoring of Sleep Apnea
To confirm the effectiveness of the treatment, patients may be asked to complete a follow-up sleep study, often using a home sleep testing device. The results help determine if the appliance is reducing apneic episodes and improving oxygen levels.
Patients are encouraged to report any new symptoms or discomfort they experience. Some individuals may require minor refitting over time due to dental changes, weight fluctuations, or other factors.
Long-Term Appliance Maintenance
Patients should schedule routine dental check-ups to monitor oral health, jaw alignment, and appliance wear. With proper care, most custom oral appliances can last several years, although replacement may eventually be necessary.
Good maintenance practices include:
- Cleaning the appliance daily with non-abrasive cleanser
- Storing it in a protective case
- Avoiding exposure to heat or pressure
Long-term follow-up helps ensure that oral appliance therapy remains a reliable and comfortable alternative to CPAP.
From Design to Delivery: Your Path to Better Sleep with Oral Appliance Therapy
A custom oral appliance for sleep apnea offers a practical, comfortable, and effective treatment option for individuals who cannot tolerate CPAP or are seeking an alternative. The process—from clinical evaluation through digital impressions, fabrication, and fitting—is designed to ensure that each device is tailored to provide maximum comfort and optimal results.
Understanding the oral appliance fitting process can help patients feel more confident in their decision to choose this treatment path. With professional guidance, long-term follow-up, and a fully customized approach, oral appliance therapy can improve sleep quality and reduce the health risks associated with untreated sleep apnea.
For those in the Columbus area ready to explore custom oral appliance therapy, Sleep Better Columbus is here to help.
📞 Call Sleep Better Columbus at (614) 777-7350 to schedule your consultation to get started.
by Sleep Better Columbus | Apr 21, 2025 | Sleep Apnea, Sleep Apnea Treatments
Millions of individuals rely on sleep apnea devices to manage obstructive sleep apnea and improve their quality of life. However, recent safety alerts have raised concerns about the long-term reliability of specific invasive treatment options. According to the FDA’s Recall Notice for the Inspire IV Implantable Pulse Generator (IPG), the device may cause unintended electrical current flow, potentially leading to serious patient harm. This recall adds to growing concerns about the risks associated with implantable and device-based sleep apnea therapies.
For individuals affected by these developments—or those considering treatment options—exploring safe, effective alternatives is essential. Sleep Better Columbus offers noninvasive alternatives to recalled CPAP devices, helping patients manage sleep apnea without surgical implants or electrical stimulation.
The Recent Recall and Why It Matters
The Inspire IV Implantable Pulse Generator (IPG), an alternative to traditional CPAP machines, was recently the subject of an FDA Class I recall. This classification is the most serious type, indicating the potential for severe injury or death. The recall notice explains that specific units may deliver unintended electrical pulses, even when the device is turned off, possibly resulting in discomfort, muscle stimulation, or disrupted sleep.
This development is especially concerning for patients who choose implantable sleep apnea devices to avoid the discomfort or inconvenience of continuous positive airway pressure (CPAP) machines. While these alternatives were promoted as low-maintenance solutions, the recall highlights an important issue: no implant device-based treatment is without risk.
Patients using the affected devices may be advised to consult their provider, but many are now reconsidering whether invasive or surgical solutions are the right long-term approach. This moment offers an opportunity to re-evaluate treatment options and to learn more about noninvasive alternatives to recalled CPAP devices, which do not carry the same mechanical or electrical risks.
Sleep Better Columbus is committed to helping patients make informed decisions by offering safe, effective, and non-surgical sleep apnea treatments designed to reduce reliance on recalled or high-risk devices.
Risks Associated with Invasive Sleep Apnea Treatments
Patients often turn to CPAP alternatives, such as implantable devices or surgical procedures, in search of convenience or comfort. However, these invasive sleep apnea treatments can introduce new risks that may outweigh the benefits for some individuals.
Health Risks of Implantable Sleep Apnea Devices
Implantable sleep apnea devices, like the recently recalled Inspire IV IPG, are designed to stimulate airway muscles to prevent obstruction during sleep. While they may help reduce apnea events, these devices carry potential risks:
- Unintended electrical stimulation
- Infection at the implant site
- Device malfunction or failure
- Long-term complications requiring revision or removal surgery
The FDA’s recall underscores the concern that device-based solutions may malfunction without warning. These issues can lead to disrupted sleep, physical discomfort, or additional medical procedures.
Surgical Sleep Apnea Treatments Are Not Without Complications
Other invasive options, including upper airway surgeries, can permanently alter airway structure. While some patients experience improvement, others report persistent discomfort, voice changes, or limited success in reducing apnea episodes. Recovery times can be extensive, and revisions are not always possible.
Psychological and Emotional Impact
Beyond physical risks, device recalls and surgical complications can affect a patient’s emotional well-being. Patients who believed they had found a long-term solution may feel anxious or frustrated. Trust in medical devices may decrease, causing some to delay further treatment.
In light of these concerns, many individuals are actively seeking noninvasive alternatives to recalled CPAP devices—options that are safer, more manageable, and less likely to result in complications.
Why Now Is the Time to Explore Noninvasive Alternatives to Recalled CPAP
The recent FDA recall of the Inspire IV Implantable Pulse Generator has raised important questions about the long-term safety of invasive sleep apnea treatments. As more patients become aware of the potential complications of surgical and device-based therapies, interest in safer, more conservative approaches is growing.
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Increased Demand for Safer Sleep Apnea Treatments
With the risks of implantable devices now under greater scrutiny, patients and providers are focusing on noninvasive treatment methods. These options do not rely on surgical procedures, electrical stimulation, or permanent implants. Instead, they focus on repositioning the airway and supporting healthy breathing during sleep—without the risk of hardware failure or systemic complications.
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What Noninvasive Treatment Options Are Available?
Noninvasive alternatives to recalled CPAP and surgical implants include several evidence-based therapies. These options are often preferred for their safety, ease of use, and high patient compliance.
Oral appliances are custom-fitted devices worn during sleep to reposition the jaw and maintain an open airway. The American Academy of Sleep Medicine recommends this form of therapy for patients with mild to moderate obstructive sleep apnea and for those who cannot tolerate CPAP.
Some individuals experience more apnea events when sleeping on their back. Positional therapy uses specialized devices or training to encourage side-sleeping, which can improve airflow and reduce obstruction.
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Lifestyle and Behavioral Modifications
Noninvasive treatment also includes adjustments to daily habits such as weight loss, smoking cessation, and reducing alcohol intake—factors that can directly impact sleep apnea severity. While these changes may not eliminate the condition, they often enhance the effectiveness of other noninvasive therapies.
Benefits Over Invasive or Recalled Devices
Unlike CPAP machines and implantable devices, noninvasive sleep apnea treatments avoid the complications of electrical malfunctions, surgical risks, and mechanical failures. They offer a practical solution for patients who manage their condition without additional medical risks.
For individuals in Columbus and surrounding areas, providers like Sleep Better Columbus are making it easier to transition to noninvasive alternatives to recalled CPAP devices. They offer safe, proven treatments with patient comfort in mind.
How Sleep Better Columbus Offers Safe, Noninvasive Sleep Apnea Solutions
Sleep Better Columbus provides patients with safe, noninvasive treatments without surgical intervention or electrical stimulation. Their approach focuses on personalized care and clinically supported therapies that reduce the health and safety risks associated with recalled CPAP devices and other invasive options.
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Focused Expertise in Oral Appliance Therapy
One primary solution at Sleep Better Columbus is oral appliance therapy. This FDA-approved treatment uses a custom-designed device that repositions the jaw during sleep to keep the airway open. Oral appliances are compact, quiet, and easy to maintain. They are widely accepted as a frontline treatment for patients with mild to moderate obstructive sleep apnea or those unable to tolerate CPAP.
Each device is fitted to the patient’s oral structure to ensure comfort and effectiveness. Sleep Better Columbus uses advanced imaging and dental scanning to create precise, individualized appliances for long-term use without discomfort.
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Non-Surgical and Patient-Centered Treatment Plans
Unlike surgical treatments or implantable devices, the care offered at Sleep Better Columbus does not involve cutting, implants, or permanent physical alterations. This reduces both the physical risks and emotional stress associated with invasive procedures.
Patients benefit from:
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- No surgical recovery time
- No mechanical parts or electrical failures
- Regular follow-ups to ensure ongoing effectiveness
- Custom treatment plans tailored to the severity of each case
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Local, Accessible Care in Columbus
Sleep Better Columbus serves patients in greater Columbus, providing convenient access to noninvasive alternatives to recalled CPAP devices. With a patient-centered model, the practice supports each individual from initial evaluation through long-term treatment management.
Focusing exclusively on noninvasive sleep apnea treatments, Sleep Better Columbus offers a safer and more sustainable option for those concerned about the risks linked to recalled or implantable devices.
Addressing Patient Concerns About Effectiveness and Comfort
One of the most common concerns for individuals considering noninvasive alternatives to recalled CPAP devices is whether these treatments will be as effective as more traditional methods. At Sleep Better Columbus, patient satisfaction and comfort are top priorities, and the practice ensures that every treatment plan is practical and comfortable for the individual.
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Clinical Outcomes of Oral Appliance Therapy
Oral appliance therapy effectively treats mild to moderate obstructive sleep apnea. Studies have demonstrated that oral appliances can significantly reduce the frequency and severity of apnea events, improving overall sleep quality. Many patients experience enhanced energy levels, improved concentration, and decreased symptoms like snoring and choking during sleep.
Sleep Better Columbus utilizes proven, FDA-approved devices that have been clinically validated for managing sleep apnea. The effectiveness of these devices is regularly monitored and adjusted to ensure the best possible outcome for each patient.
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Comfort, Convenience, and Compliance Benefits
One key reason patients prefer noninvasive treatments like oral appliance therapy is the comfort and convenience they offer. Unlike CPAP machines, which can be bulky, noisy, and uncomfortable for some users, oral appliances are small, portable, and easy to wear. They require little maintenance and do not have the intrusive mask or hose systems associated with CPAP machines.
Additionally, patients who struggle with CPAP compliance often find oral appliances more comfortable and easier to incorporate into their nightly routine. This higher compliance rate can lead to better long-term outcomes, as consistent use is critical for managing sleep apnea effectively.
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What to Expect from an Evaluation and Treatment Plan
At Sleep Better Columbus, the process begins with a comprehensive evaluation that thoroughly reviews the patient’s sleep patterns, medical history, and lifestyle factors. This helps the team develop a personalized treatment plan. After fitting the oral appliance, follow-up appointments are scheduled to assess its effectiveness and make any necessary adjustments.
Patients are informed at every step of the process, ensuring they feel confident in their treatment plan and know what to expect. For those new to sleep apnea treatment or seeking alternatives to recalled CPAP devices, the support and education provided can help ease concerns and improve the overall experience.
Questions to Ask When Exploring Noninvasive Alternatives
When considering noninvasive alternatives to recalled CPAP, patients should ask their provider key questions, including:
- What treatment options are available for my specific condition?
- How effective is oral appliance therapy for my severity of sleep apnea?
- What should I expect regarding comfort, cost, and follow-up care?
- How will my treatment be monitored over time to ensure effectiveness?
By addressing these concerns early on, patients can make informed decisions about their treatment options and feel confident in their care plans.
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How to Determine If Noninvasive Sleep Apnea Treatment Is Right for You
The best way to determine if noninvasive alternatives to recalled CPAP devices are right for you is to consult a trusted provider. Sleep Better Columbus offers comprehensive evaluations to assess your sleep apnea severity and recommend the most appropriate treatment. This personalized approach ensures that patients receive the care best suited to their needs and goals.
Ready to Ditch the Risks? Schedule a Consultation with Sleep Better Columbus
If you’re looking for a fairer, noninvasive alternative to a recalled CPAP device, Sleep Better Columbus is here to help. Schedule a consultation today to learn more about how oral appliance therapy and other noninvasive treatments can improve sleep quality without the risks of invasive treatments or device malfunctions. Reclaim restful sleep with confidence and peace of mind.
by Sleep Better Columbus | Mar 8, 2024 | Sleep Apnea Treatments
Millions of people have sleep apnea and use devices like continuous positive airway (CPAP) machines, bilevel positive airway pressure (BiPAP) machines, ventilators, or oral appliances to treat their sleep apnea. When you rely on a device to help you breathe, it is highly concerning when it is recalled.
Recall of Philips Respironics Products in 2021
In June 2021, Philips voluntarily recalled many of its Respironics products used to treat sleep apnea. The recall included CPAP machines, BiPAP machines, and ventilators. These devices were recalled because of an issue with the sound-dampening foam inside them.
The Philips recall affected millions of sleep apnea patients, including many who used CPAP machines, BiPAP machines, or ventilators to treat their sleep apnea between 2009 and 2021. While Philips now uses a different sound-dampening foam in their Respironics products, their sleep apnea devices continue to be scrutinized and cause health concerns.
Philips Devices That Were Recalled
Philips recalled several continuous positive airway (CPAP) machines, bilevel positive airway pressure (BiPAP) machines, and ventilators between 2009 and April 26, 2021. Recalled devices include:
- A-Series BiPAP A30
- A-Series BiPAP A40 (ventilator)
- A-Series BiPAP Hybrid A30
- A-Series BiPAP V30 Auto (ventilator)
- C-Series ASV (ventilator)
- C-Series S/T and AVAPS
- DreamStation
- DreamStation ASV
- DreamStation Go
- DreamStation ST, AVAPS
- Dorma 400
- Dorma 500
- E30
- Garbin Plus, Aeris, LifeVent (ventilator)
- OmniLab Advanced+
- REMstar SE Auto
- SystemOne ASV4
- SystemOne (Q-Series)
- Trilogy 100 (ventilator)
- Trilogy 200 (ventilator)
Additionally, Philips recalled specific models of Trilogy Evo ventilators distributed from April 15, 2021, to May 24, 2021, with specific serial numbers.
Why Were Philips Sleep Apnea Devices Recalled?
The recalled Philips Respironics continuous positive airway (CPAP) machines, bilevel positive airway pressure (BiPAP) machines, and ventilators all had polyester-based polyurethane (PE-PUR) foam inside them. This foam was used to reduce any noise and vibrations the machines generated.
Over time, the sound-dampening foam inside of the machines was likely to break down—mainly when sterilized with an ozone cleaner or exposed to heat and humidity—and release toxic chemicals and tiny particles that could travel through the air tubes of the sleep apnea devices and into sleep apnea patients’ lungs. Users of these devices have reported finding sticky residues or black dust inside their sleep apnea machines’ tubes, filters, and chambers.
Possible Health Risks Sleep Apnea Patients Can Experience from Recalled Devices
The toxic chemical vapors and small particles released by disintegrating PE-PUR foam inside Philips Respironics CPAPs, BiPAPs, and ventilators can harm sleep apnea patients. Documented health effects experienced by sleep apnea patients who used these devices to treat their sleep apnea include:
- Asthma
- Cancer of the sinuses, throat, esophagus, kidney, and liver
- Chronic headaches
- Coughing
- Dizziness
- Nausea and vomiting
- Sinus congestion
- Skin, nose, and eye irritation
- Sore throat
Are There Effective CPAP Alternatives for Sleep Apnea Treatment?
You have options if you no longer feel comfortable using a CPAP, BiPAP, or ventilator from Philips or any other company after the recall.
Oral appliance therapy is an effective sleep apnea treatment for many people who have sleep apnea. An oral appliance is a specially fitted device custom-made by a dentist trained in sleep medicine. An oral appliance’s primary purpose is to keep the airway open during sleep so the normal airflow during breathing isn’t blocked.
Mandibular advancement devices (MADs) and tongue-retaining devices (TRDs) are two commonly used oral appliances for sleep apnea treatment. MADs keep your airway unobstructed by moving your jaw forward, and TRDs keep your tongue from sliding to the back of your mouth and blocking your airway.
A qualified dentist trained in dental sleep medicine will choose the right oral appliance for you based on factors such as mouth size and degree of snoring and create a custom-fitted appliance. Oral appliances are comfortable, relatively nonintrusive, and easily portable, and they can be appealing CPAP alternatives for those seeking treatment for sleep apnea without CPAP, making it easier for people to be compliant with their treatment.
Benefits of Oral Appliance Therapy Over a CPAP, BiPAP, or Ventilator to Treat Sleep Apnea
Oral appliances offer an effective treatment option for people with sleep apnea who no longer feel comfortable using their CPAP, BiPAP, or ventilator after the Philips recall or have concerns about potential health and safety risks.
Benefits of oral appliances include:
- more comfortable and easier to use than a CPAP, BiPAP, or ventilator
- doesn’t require electricity to work
- easy to take care of and keep clean
- improves symptoms of OSA like focus issues and daytime sleepiness
- more cost-effective than other treatments
- no loud noise
- portable and more accessible to take when traveling
- reduces or eliminates snoring
Sleep Apnea Specialists in Columbus, Ohio
Sleep apnea is a severe condition, and the sleep apnea specialists at Sleep Better Columbus can help.
Sleep Better Columbus is committed to providing compassionate care for all patients and helping each patient find the best sleep apnea treatment for them.
Sleep Better Columbus’s sleep apnea therapy solution is simple and comfortable, helping those with sleep-disordered breathing sleep better quickly. Their specially designed mouthpieces are an effective and comfortable sleep apnea treatment alternative for those who no longer feel safe or comfortable using a CPAP, BiPAP, or ventilator after the Philips Respironics recall.
by Sleep Better Columbus | Jun 2, 2021 | Sleep Apnea
People with sleep apnea who can’t tolerate the noise and discomfort of a CPAP machine might benefit from a mouth guard or surgery.
By Nicholas Bakalar
Article Published May 31, 2021
Many people wear a CPAP machine at night to treat the interrupted breathing of obstructive sleep apnea, a condition that affects an estimated 22 million Americans. However, CPAP machines can be noisy, cumbersome, and uncomfortable, leading many to stop using the devices altogether, which can have dire long-term consequences for treating OSA.
Mouth guards may be a more comfortable and easy-to-use alternative for many people with obstructive sleep apnea, according to a new report. The study, published in Laryngoscope, looked at 347 people with sleep apnea who were fitted with a mouth guard by an otolaryngologist. Two-thirds of patients reported they were comfortable wearing the devices, and the devices appeared to be effective in helping to relieve the disordered breathing of obstructive sleep apnea.
The lead author of the study, Dr. Guillaume Buiret, head of otolaryngology at Valence Hospital in Valence, France, said that if he had sleep apnea, he would choose an oral appliance first.
“It’s easy to tolerate, effective and it costs a lot less than CPAP,” he said. “Thirty to 40 percent of our patients can’t use CPAP, and these patients almost always find the dental appliance helpful. I would recommend it as a first-line treatment”
Loud snoring may be the most obvious consequence of sleep apnea, but the condition, if left untreated, can lead to a broad range of complications, including high blood pressure, heart disease, liver dysfunction and Type 2 diabetes.
The problem develops when the soft tissue at the back of the throat collapses during sleep, blocking the airway. This leads to breathing cessation for brief periods, gasping for air, difficulty staying asleep, and all the problems of daytime sleepiness, from poor job performance to fatal accidents. Animals can have it too — bulldogs, for example, have a narrow airway and a soft palate that can easily block it. Their sleep apnea is almost identical to the human version.
The severity of the condition varies widely from a very mild problem that may need no treatment at all to severe or even life-threatening disease. Dr. Sara E. Benjamin, a neurologist and sleep specialist at Johns Hopkins, said that spending a night in a sleep laboratory monitored by a technician is the best way to diagnose apnea. A lab study offers the most thorough analysis, and can detect many other sleep problems besides apnea, but there are home test kits that are easy to use and cost-effective. They test breathing effort and oxygen levels, but not the brain waves, muscle tone and leg movements that a lab test records.
How can you know that you need a sleep assessment? “It’s a low standard to get evaluated, either by home testing or in a sleep lab,” Dr. Benjamin said. “If a person feels sleep problems are impacting daily activities, that’s enough to go and get evaluated. If the cause is a breathing problem, you don’t want to ignore it.”
A CPAP — continuous positive airway pressure — machine is usually the first option for treating sleep apnea. The device has a motor that delivers pressurized air through a tube attached to a mask that covers the nose, or both the nose and the mouth. This keeps the airway open. Some machines can automatically change the pressure to compensate for changes in sleep position; others require manual adjustment. Headgear varies, but all have adjustable straps to get the right fit. There are newer models that can deliver heated or humidified air, depending on the patient’s preferences, and there are small travel models as well.
“We recommend a custom device made by a dentist,” Dr. Benjamin said. “And you should be retested to see how well it’s working. There’s subjective and objective improvement that should be tracked.”
But there are people for whom neither CPAP nor dental appliances work, either because they cannot use them consistently or correctly, or because the devices themselves do not solve the problem even when used properly. For these patients, there are various effective surgical procedures.
The most common is soft tissue surgery, which involves modifying or excising tissue at the back of the mouth. Depending on the structures and musculature of the mouth, the surgeon can trim the soft palate and the uvula, remove the tonsils, shrink tissues with a heated instrument, straighten a deviated septum, or alter the position of the tongue muscles, all with the aim of improving air flow.
There are also bone surgeries that move the jaw forward to make the entire breathing space larger, a procedure that can involve a protracted recovery period.
In 2014, the Food and Drug Administration approved a device called Inspire Upper Airway Stimulation. This is a small appliance implanted under the skin like a heart pacemaker. Using two electrical leads, it senses the breathing pattern and stimulates the nerve that controls the tongue to move it out of the way and allow air to pass freely. Implanting it is a day surgery procedure that takes about two hours.
“It doesn’t change the anatomy, and recovery is easier than with other surgeries,” said Dr. Maria V. Suurna, an associate professor of otolaryngology at Weill Cornell Medicine who specializes in surgery for sleep apnea. “It’s effective. It has the lowest complication rate of all the surgeries.
“But it’s not for everyone. It’s approved only for adults 18 and older who are not overweight and who have moderate to severe apnea.” Some people may be ineligible because of the structure of their anatomy.
“Surgery is tricky,” Dr. Suurna said. “But there’s no ideal treatment for apnea. Each has pros and cons, benefits and risks.”
by Sleep Better Columbus | May 19, 2021 | Sleep Apnea
Suffering from sleep apnea can not only disrupt your sleep, but it can be a serious health problem. This is why it’s important to get diagnosed so that you can get the treatment you need. One of the treatments that many people choose is an oral appliance. For many, this is much easier to use than some other available therapy options.
But, as with many medical treatments, the cost can be an issue. Although you have health insurance, many people still wonder, what do insurance companies consider oral appliance for sleep apnea? Let’s answer that question and look at some of the issues surrounding sleep apnea.
What is Sleep Apnea?
If you are diagnosed with sleep apnea, this means you pause when you’re breathing during sleep, or there is a reduction in your breathing. If someone stops breathing completely or takes less than 10% of a normal breath for ten seconds or more, they are experiencing an apnea or obstructive sleep apnoea. If you are experiencing sleep apnea, you may suddenly wake up or move from a deep sleep to a more shallow sleep.
To determine if you have sleep apnea, a sleep study is generally needed. During a sleep study, sleep patterns are monitored to see if someone stops breathing during the middle of the night and at what frequency. This will help doctors determine if they have sleep apnea and what type. From there, the proper course of sleep apnea treatment can be devised.
Once you’re diagnosed with sleep apnea, it’s time to get treatment. Oral appliances are a popular option over using a continuous positive airway pressure (CPAP) machine. Some people find these CPAP therapy machines to be noisy and intrusive.
Oral appliance therapy works to treat sleep apnea by moving the lower jaw forward to open the airway and unblock the windpipe, which can improve breathing and lead to a better night’s sleep. FDA-registered oral devices can be used to treat sleep apnea when they are given by a qualified dentist trained in dental sleep medicine. At Sleep Better Columbus, we can help you find the right oral appliance to treat your sleep apnea and get you a better night’s sleep.
Insurance and Oral Appliance Treatment for Sleep Apnea
Since all insurance companies are different, you’ll need to contact your specific insurance company to make sure that you are covered for an oral appliance for sleep apnea. Generally, plans will at least cover a portion of the cost.
Most health insurance plans consider oral appliances or dental appliances for sleep apnea as a piece of medical equipment. This is why they will cover it. There are more than 100 FDA-approved oral appliances available to help treat sleep apnea. Your insurance may specify the type of oral appliance that they will cover instead of letting the doctor and patient choose. These are things you will need to ask your benefits department.
To get coverage for an oral appliance for sleep apnea, you’ll have to show that you suffer from the condition and not just chronic snoring. A copy of the sleep study and any medical notes from your sleep apnea screening appointment is also necessary. Your medical history will also be considered. Some insurance companies may also require other documentation, so it’s best to ask so that you are prepared.
Of course, for your insurance company to pay for an oral appliance for sleep apnea, it needs to be prescribed by your doctor. The insurance company will need to see that documentation to provide any level of coverage.
Although the equipment goes in your mouth, an oral mouthpiece is treated under your health insurance, not your dental insurance. The device is being used to treat a medical condition, not one that is specific to your dental health. An oral appliance is seen as a piece of medical equipment because it can be used to improve your health.
When people begin using oral appliance treatment for sleep apnea, they can also help to avoid serious health problems such as:
- High blood pressure
- Stroke
- Diabetes
- Heart disease
If you have a medical history of any of these or a family history of them, it’s important to get treatment for your obstructive sleep apnea as soon as possible.
How Much Do Oral Appliances for Sleep Apnea Cost?
This is a difficult question to answer because there are so many oral devices for sleep apnea available. Since they are custom-fit to each patient and everyone may choose something different depending on their condition, it’s best to ask your doctor which ones are best for you. From there, you can price them out and get a better idea of the cost.
Once you have an estimate, you can find out how your insurance may cover it. This will also vary depending on your plan. If you have a deductible, this will come into play, as well as if you have any co-insurance. Many times patients do need to pay for a percentage of the cost. But, the exact dollar amount will depend on your insurance coverage.
Contact Us!
When you need an oral appliance to treat obstructive sleep apnea (OSA), visit Dr. Mark Levy at Sleep Better Columbus. Dr. Levy is trained in treating sleep apnea and can recommend dental appliances for sleep that can help. Let Dr. Levy and his dental sleep staff show you the alternative to CPAP machine to improve the quality of your sleep.
The dental sleep medicine staff at Sleep Better Columbus can help you find an oral device for sleep apnea that your insurance will cover so that you can get your obstructive sleep apnea under control. Once you do, you’ll notice you’re getting a better night’s sleep as well as an improved quality of life. When you have your sleep apnea treated, you’ll feel energized and healthy.
Call Sleep Better Columbus today at 614-362-7292 to find out more about oral appliances to treat your sleep apnea.
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