Long-term compliance and side effects of oral appliances used for the treatment of snoring and obstructive sleep apnea syndrome

J Clin Sleep Med. 2005 Apr 15;1(2):143-52.


Study objective: This study, by means of a mail survey, quantified the compliance with and side effects of the use of an oral appliance for more than five years in patients with snoring or obstructive sleep apnea.

Methods: A questionnaire was mailed to 544 patients who used an oral appliance for the treatment of snoring or obstructive sleep apnea.

Results: Some 46.1% of the patients returned the questionnaire, 37.8% did not, 15% had an invalid address, and 0.9% were deceased. The mean time period between oral appliance insertion and the return date of these surveys was 5.7 +/- 3.5 years. Of the returned sample, 64.1% were wearing their oral appliance (users). There was no significant difference in the baseline and post-titration respiratory disturbance index between the returned and not-returned groups or between patients who had stopped wearing the oral appliance (nonusers) and users. Within the users group, 93.7% used the oral appliance more than 4 nights per week, 100% wore it more than half of each night, and 95% were satisfied with the treatment. The most frequent reasons why patients discontinued wear were uncomfortable (44.4%), had little or no effect (33.6%), or switched to nasal continuous positive airway pressure (23.3%). Snoring was satisfactorily controlled in 75.6% of users and in 43.2% of nonusers. Side effects, such as dry mouth and tooth and/or jaw discomfort, were more frequent and more severe in the nonusers (P < .05). With oral appliance usage, both users and nonusers reported an increase in temporomandibular joint symptoms, but there was no difference in the degree of change.

Conclusions: Subjects who were compliant with oral appliance therapy reported long periods of use and adequate control of snoring.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orthodontic Appliances, Removable / adverse effects*
  • Patient Compliance / statistics & numerical data*
  • Polysomnography
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / complications*
  • Sleep Apnea, Obstructive / therapy*
  • Snoring / etiology*
  • Snoring / therapy*
  • Surveys and Questionnaires
  • Temporomandibular Joint Disorders / diagnosis
  • Temporomandibular Joint Disorders / epidemiology
  • Temporomandibular Joint Disorders / etiology
  • Time Factors
  • Treatment Outcome