CPAP vs Dental Mouthguard

6 Reasons CPAP Users Turn to Custom Dental Mouthguards for Sleep Apnea

If you have been diagnosed with obstructive sleep apnea and having difficulties with CPAP (Continuous Positive Airway Pressure) therapy, custom dental sleep mouthguards may be your best solution to treating your condition and improving your sleep.

Sleep is vital to our lives, and often considered the third pillar of health along with nutrition and exercise. However, millions of Americans are suspected of having a common, yet serious sleep breathing disorder called obstructive sleep apnea or OSA. Over 80-90% of patients thought to have OSA remain undiagnosed. Unfortunately, a large proportion who do seek treatment cannot tolerate the prescribed treatment known as CPAP(Continuous Positive Airway Pressure) therapy.

If you have been diagnosed with obstructive sleep apnea, it is likely that you have been prescribed CPAP therapy. CPAP therapy involves the use of an air-pressured breathing device and is often considered the 1st treatment of choice for OSA.

It’s estimated that as much as 30-50% of CPAP users do not use their device regularly and often abandon treatment.

Do you fall into this category? Is CPAP causing you distress or have you given up on sleep apnea treatment? If this sounds like you, custom dental devices may be your solution to treating apnea and the symptoms often associated with poor sleep.

Although not effective in all cases, a large percentage of sleep apnea sufferers may find a resolution of apnea events and symptoms associated with apnea with custom made dental sleep mouth guards. Research also suggests that because sleep apnea mouthguards (also known as oral appliances, or dental mouthguards) are often tolerated better and worn for more hours per night than CPAP, the overall positive effects may be similar between the two therapies.

Many unsuccessful CPAP users find refuge in treating obstructive sleep apnea (OSA) with custom dental sleep mouthguards. Additionally, many patients who do use CPAP successfully also seek out therapy with dental sleep apnea devices, merely for enhanced comfort and ease of treatment.

What Are Custom Sleep Apnea Dental Devices?

Custom sleep apnea dental devices are called oral appliances or mandibular advancement splints. These custom-made mouthguards reposition and stabilize the jaw in a forward position helping to prevent muscles and tissues from collapsing back into the airway that causes the obstructions that occur during obstructive sleep apnea and snoring. The area within the dental field that includes the treatment of snoring and apnea patients with mandibular advancement splints is called oral appliance therapy.

In oral appliance therapy, retainers are used to help combat the symptoms of obstructive sleep apnea (OSA). The majority of patients that attempt oral appliance therapy will find successful results after obtaining a sleep apnea mouthguard. Sleep apnea mouthguards, dental sleep devices, and oral appliances for sleep apnea are all interchangeable names for devices used in oral appliance therapy. Oral devices are generally much more easily tolerated and worn for longer hours during the week.

Sleep apnea dental mouthguards or oral appliances can be prescribed by physicians after an obstructive sleep apnea diagnosis has been confirmed. Oral Appliance Therapy is best treated by qualified dentists trained specifically in airway breathing disorders such as snoring, apnea, and upper airway resistance syndrome.

Let’s review some of the most  common reasons why an apnea patient who has been using or given up on CPAP therapy may consider oral appliance therapy:

1.   Residual Apnea Symptoms May be Improved with Sleep Apnea Mouthguards

Woman Sleeping on Kitchen Counter

Individuals who do use  CPAP regularly may still experience symptoms of unrefreshed sleep, daytime sleepiness, and snoring. In many cases, patients complain of mask leaks, ill-fitting- masks, or trouble falling asleep after bathroom breaks during the night.  Patients with facial hair, especially, may find increased problems of air leaks. These problems all contribute to a poor night of sleep and the feeling that your CPAP is not working.

However, with custom oral mandibular devices or mouthguards, there is no cumbersome equipment involved such as hoses or masks. You can eliminate the need to reattach or re-adjust CPAP equipment after bathroom breaks.  Patients with facial hair do not see additional problems with oral apnea devices as with masks.

The positive design characteristics of oral appliances help prevent residual apnea symptoms that lead to poor sleep quality. Additionally, oral appliances have a positive effect on health outcomes, such as decreasing daytime sleepiness and blood pressure.

2. Custom sleep apnea mouthguards allow you to sleep in any position.

Woman sleeping comfortably on stomach in bed

When using CPAP therapy, many people have problems sleeping in a position that will prevent hoses from being tangled, or they miss sleeping on their stomachs. Often CPAP users feel forced to sleep on their backs, but these individuals may naturally never sleep on their back due to preference or back issues.

Sleep apnea dental custom mouthguards do not confine your choice of sleeping position. When oral appliances are first made, individuals are instructed to sleep in any position most comfortable for them during the home adjustment period. More patient instructions may apply regarding the recommended sleeping position after the effectiveness of the device has been confirmed and reviewed.

If you have previously given up on other apnea therapies that involve hoses and other bulky equipment, sleep apnea mouthguards can give you freedom from confinement and a tangle-free option.

3. Traveling ANYWHERE is Easy with Apnea Dental Devices.

Family camping in tent

Traveling with a custom oral device is quite easy. The device fits in the palm of your hand and can be stored in a small container, much like a sports mouthguard or dental retainer.
Oral appliances don’t require plugs, extension cords, hoses, water supplies, or electricity. They are discreet during airport security, unlike the suspicious-looking CPAP.  They can even be worn during a flight for the jetlagged traveler!

As well as being much less difficult to travel with than CPAP, custom mandibular devices can also be used to treat apnea more easily during camping, boating, mission trips, or even remote travel!

Sleep apnea oral appliances will help you get rest wherever you are, giving you back the ability to travel with ease. Simply put, dental sleep apnea devices are EASY to travel with. There is no need to lug a bulky CPAP machine on delay your adventures any longer.

4.   Custom Sleep Apnea Mouthguards Provide Discreet Treatment for OSA

How do Sleep Apnea Mouthguards Compare to CPAP?

Many individuals who struggle with Obstructive Sleep Apnea (OSA) are often embarrassed when they have to take out their bulky and noisy CPAP machines in order to sleep. With custom mandibular devices for treating sleep apnea, wearers can be discreet.

Adult users are allowed more mobility when wearing their custom oral devices when children or grandkids stay over. There’s also the plus of being able to be discreet in dating situations. When worn, custom oral appliances are not visible to bed partners when the wearer’s mouth is closed.

Younger users, including college-aged adults, are often embarrassed when using CPAP, due to its size and bulkiness. With custom oral devices, the compact and portable nature makes them easy to use without drawing attention, optimal for those with roommates or close living situations.

Awkward social situations can be avoided with custom oral devices during group trips or outings. Using discreet oral devices, there is no need to avoid overnight trips with friends or family.

Custom oral devices allow for freedom in travel and freedom from embarrassment due to a sleep condition. Golfing trips, fishing trips, getaways, and family vacations can now be enjoyed with the discreet nature of sleep apnea mouthguards.

5.    Minimize Sinus Conditions with Dental Sleep Devices

Woman suffering from a sinus headache

Dental sleep devices also may help to minimize sinus conditions. Many patients who use CPAP often complain of congestion or may have an increased chance of developing sinus infections. Oral devices do not supply forced air through the wearer’s nose or throat and therefore added congestion is rare.

Users of sleep apnea mouthguards may see a decrease in chronic upper respiratory issues and respiratory infections that occur from poor hygiene of CPAP tubing. Since apnea mouthguards do not contain tubings, there are also fewer time restraints in cleaning these devices in comparison with CPAP maintenance.

When the user of a custom sleep apnea mouthguards is ill with a common cold, he or she may find it less interfering to use oral devices than CPAP. CPAP users have trouble when they have colds or allergies because CPAP requires a clear nasal airway to receive the full benefit. At most times custom device users can still use their therapy even with a stuffed-up nose during sickness or allergy seasons.

6.   Common CPAP Irritations (Skin, Eye, and Dry Mouth) Can be Eliminated with Custom Oral Sleep Devices

Man with skin irritation caused by CPAP machine

Other problems may arise with CPAP users who do overall adapt well to therapy. These CPAP problems can range considerably and include the patient’s skin, eye, and mouth.  In the end, these irritations may prevent full acceptance of CPAP.

With custom oral devices, patients do not have to suffer from skin irritations that are associated with CPAP. With oral appliance therapy, patients do not have irritating mask materials that irritate rosacea and other skin conditions. CPAP can also cause prolonged markings on the wearer’s face after use, which is not present in custom oral devices.

Also, CPAP may lead to eye irritations. The artificial air flow from the CPAP masks can cause air to flow in a way that leads to dry eyes. The unnatural air pressure created by CPAP creates prolonger periods of air blowing into the user’s eye, which can create chronic eye irritations. However, sleep apnea mouthguards use natural breathing to help reduce the effects of OSA eliminating associated eye problems.

The air flow in a CPAP mask can also create dry mouth for the individual from the amount of air that flows during use. Users find it necessary to drink water as a result, and this forces the wearer to remove the CPAP machine. Oral devices have the added benefit of being able to be constricted to keep the users mouth closed and prevent dry mouth. The user can also drink water WITHOUT removing the device!

Patients often report fewer long-term problems with sleep apnea mouthguards than CPAP.

Users who choose custom oral devices find a plethora of benefits that patients of CPAP treatment often find unbearable. Custom oral devices are being used increasingly for the treatment of OSA  due to their comfort, ease of use, and travel friendly-design. Frustrated OSA sufferers can often find relief with sleep mouthguards and not only improve their sleep, but greatly enhance the quality of their lives.

Interested in obtaining a custom dental mouthguard?

If you are interested in finding out if oral appliance therapy with custom dental mouthguards can help treat your apnea, talk to your doctor, sleep specialist, or a dentist trained in dental sleep medicine. You can also visit the American Academy of Dental Sleep Medicine Find-a-Dentist page to find a qualified dentist near you.


Success/Effectiveness rates:

  1. Mintz, S.S. & Kovacs, R. Sleep Breath (2018) 22: 541.
  2. Sutherland, K., Phillips, C.L. & Cistulli, P.A. (2015). Efficacy versus effectiveness in the treatment of obstructive sleep apnea: CPAP and oral appliances. Journal of Dental Sleep Medicine, 2(4), 175–181.
  3. Almeida, F. R., & Bansback, N. (2013). Long-term effectiveness of oral appliance versus CPAP therapy and the emerging importance of understanding patient preferences. Sleep, 36(9), 1271–1272.

Common disorder:

  1. Franklin, K. A., & Lindberg, E. (2015). Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. Journal of thoracic disease, 7(8), 1311-22.
  2. American Academy of Sleep Medicine:


  1. Hiestand et, al. “Prevalence of Symptoms and Risk of Sleep Apnea in the US Population”. Elsevier. Volume 130, Issue 3, September 2006, Pages 780-786
  2. Finkel et, al. “Prevalence of undiagnosed obstructive sleep apnea among adult surgical patients in an academic medical center”. Volume 10, Issue 7, August 2009, Pages 753-758.
  3. “A very short course on sleep apnea”. American Sleep Apnea Association.

Oral Appliance Therapy: American Academy of Dental Sleep Medicine

CPAP Side Effects: Brostrom, A., Arested, K. Stromberg, A., Ulander, M. Savanborg, E., ( 2010) The side‐effects to CPAP treatment inventory: the development and initial validation of a new tool for the measurement of side‐effects to CPAP treatment Journal of Sleep Research Vol.19 Issue4 Dec2010 p.603-611

This article is general in nature and for educational purposes only. Please consult with your sleep health provider before starting any treatment option for snoring and apnea.