Oral Appliances for Snoring and Obstructive Sleep Apnea

Otolaryngol Clin North Am. 2020 Jun;53(3):397-407. doi: 10.1016/j.otc.2020.02.004. Epub 2020 Mar 26.


Obstructive sleep apnea is a common condition, caused primarily by narrowing of the nasal and pharyngeal airway, leading to partial or complete airway collapse during sleep. Treatment with positive airway pressure (PAP) is considered first-line therapy, due to an efficacy rate of approximately 95%, yet long-term compliance with PAP is less than 40%. The efficacy of a sleep oral appliance is lower than PAP, yet it may have similar effectiveness. A sleep oral appliance is a reasonable second-line therapy for patients who refuse or fail PAP and may be reasonable first-line therapy.

Keywords: Mandibular advancement device (MAD); OSAS; Obstructive sleep apnea syndrome; Oral appliance therapy (OAT); Primary snoring; Sleep oral appliance.

Publication types

  • Review

MeSH terms

  • Continuous Positive Airway Pressure
  • Humans
  • Mandible
  • Mandibular Advancement
  • Orthodontic Appliance Design
  • Orthodontic Appliances, Removable*
  • Patient Compliance
  • Polysomnography
  • Randomized Controlled Trials as Topic
  • Sleep Apnea, Obstructive / physiopathology
  • Sleep Apnea, Obstructive / therapy*
  • Snoring
  • Treatment Outcome