If you are unfortunate enough to suffer from obstructive sleep apnea (OSA), there are a couple of effective ways to manage the condition. One way is to use a CPAP machine. The alternative is to use a sleep apnea mouth guard.
In severe cases, CPAP is generally the best option but, for mild to moderate sleep apnea, a mouth guard can work extremely well.
Also known as mandibular advancement devices (MADs), mouth guards are oral devices that push the lower jaw forward during sleep. In addition to being an effective treatment for mild to moderate OSA, mouth guards are also good for controlling normal snoring.
Quick Look: Best Sleep Apnea Mouth Guard
1. Airsnore – Editors Choice
Sleep apnea mouth guards resemble the gumshields boxers wear but, instead of only encasing the top teeth, they fit over the bottom teeth as well.
Due to the way they are set up, a sleep apnea mouth guard requires you to advance your lower jaw slightly to get the bottom teeth inside.
This advancement pulls the tongue forward, opening up the airway at the back of the throat. By doing this, the device prevents the back of the tongue from interfering with normal breathing, causing the pause known as a “sleep apnea.”
Although the basic design concept is good, the quality of sleep apnea mouth guards can vary considerably. The use of cheap materials and/or basic design flaws can make this type of device less effective or cause it to be uncomfortable to use.
We’ve put together a list of the best mouth guards for controlling OSA. Regardless of whether you are new to this type of device or looking for a replacement for your old mouth guard, our list is a very good place to start.
The 5 Best Mouth Guards for Controlling Sleep Apnea
Our list of best sleep apnea mouth guards is not for people who have severe OSA. It’s for people whose doctor has told them their OSA is mild enough to manage without CPAP.
AirSnore – snoring and sleep apnea mouthpiece
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AirSnore is a boil and bite mouth guard. During the initial setup you need to soften the device in hot water and then bite down on it to allow the thermoplastic to mold to your teeth.
AirSnore also produces aromatic drops that help keep your nasal passages clear. Although the mouth guard works fine without them, they are an optional extra many people appreciate.
One of the most surprising things about the AirSnore mouth guard is the price. It’s unusually cheap for such a high-quality device and its reputation for delivering results is second to none.
AirSnore has already helped more than 80,000 people sleep better at night and the manufacturer offers a 60-day money-back guarantee.
If you want a top sleep apnea mouth guard and incredible value for money, AirSnore is an excellent choice.
VitalSleep – anti-snoring mouthpiece complete solution
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VitalSleep is a high-quality mouth guard with plenty of good customer reviews. As with most of the best mouth guards for controlling sleep apnea, the initial setup is done via boil and bite.
However, VitalSleep has a unique patented system called Accu-Adjust that makes it possible to fine-tune your lower jaw position if you feel it’s not quite right.
The Accu-Adjust mechanism works via a screw that provides an 8 mm adjustment. This makes it possible to advance the jaw by up to 4 mm if necessary and, of course, to go up to 4 mm in the other direction.
VitalSleep boasts a low-profile design that enables maximum comfort during use. It’s also available in a choice of two sizes. The standard size is best for most men but the smaller version may be a better fit for women, who tend to have slightly smaller mouths.
Regardless of all the extra refinements, VitalSleep is a surprisingly cheap mouth guard to buy. It doesn’t cost much more than AirSnore, has a 60-day money-back guarantee, and has already helped more than 40,000 people to sleep better at night.
ZQuiet – anti-snoring mouthpiece
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ZQuiet is a little different from the rest of the top sleep apnea mouth guards because it doesn’t boil and bite. However, like VitalSleep, ZQuiet is available in a choice of two sizes.
In this case, there is no need to worry about which size will fit best. The box contains one of each so you can try them and see.
ZQuiet has a clever design feature called Living Hinge Technology. It does not require any setting up, making this mouth guard very easy to use.
The special hinge at the rear of the device advances the lower jaw in a unique way that provides maximum flexibility and comfort. The Living Hinge Technology also allows the ZQuiet to work equally well if your mouth is open during the night instead of closed.
None of the other options can do this, so, if your mouth tends to open during sleep, ZQuiet is easily the best mouth guard to choose.
The other interesting thing about this option is you don’t need to buy it outright. You only have to pay the initial shipping costs because the manufacturer offers a 30-day trial.
SnoreRX – adjustable anti-snoring device
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SnoreRX is an adjustable boil and bite mouth guard that’s good for controlling mild to moderate sleep apnea and is an extremely popular anti-snoring device as well.
After completing the boil and bite, the device’s Posi Lock system gives you a further 6 mm of adjustment to play with. It’s not difficult to adjust and there is no requirement for special tools. All you need to do is grasp the device, squeeze the sides, and rock the lower section forward or backward 1 mm at a time.
Most people find 3-5 mm works best so it’s a good idea to make sure the device is set to 4 mm before commencing the boil and bite.
Like all the best mouth guards, SnoreRX is built to very high-quality standards and has plenty of excellent customer reviews.
The Posi Lock system isn’t the only feature that makes this option extra special, the device has an air vent at the front as well. This is a godsend for anyone who suffers from OSA and is unable to use a standard mouth guard because they cannot breathe through the nose.
Unfortunately, SnoreRX is a little costlier than the other options on this list but you can’t put a price on good sleep and your investment is always safe because the manufacturer offers a 30-day trial.
SnoreMeds – budget option
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SnoreMeds is a no-frills boil and bite mouth guard that’s popular with people who want to advance their lower jaws with minimum expense or fuss. Just pop it in hot water, advance your jaw, take a bite, and you are good to go.
Although SnoreMeds is cheaper than the other options, the manufacturer has not cut any corners when it comes to quality. This mouth guard provides excellent value for money and, when you buy SnoreMeds you get two devices for the price of one. The standard size is generally the best fit for most men, while the smaller version is likely to work better for women.
Although SnoreMeds does not have the fine-tuning option some of the other mouth guards do, it does have a generous vent at the front. Cheap and cheerful it may be but it’s still one of few options available that are good for people who have difficulties breathing through the nose.
With all the alternative options, you need a spoon or fork to fish the device from the water during the boil and bite. Not so with SnoreMeds. The device comes with a custom tool that makes it extra easy to lift it in and out of the water.
Once the device is free of the water, you can even use the tool to place it into your mouth. This may not seem like a great virtue but it helps make the boil and bite process as fiddle-free as possible.
Like all the other mouth guards on our list, SnoreMeds has a money-back guarantee. If you are not delighted with your purchase, you can claim a refund if you let the manufacturer know within 45 days.
How We Ranked The Best Sleep Apnea Mouth Guards
Due to the basic design concept, it’s easy to presume all sleep apnea mouth guards will work the same. This is anything but the case.
There are many poor-quality options on the market that are uncomfortable to use and may fall from the mouth during sleep. Problems such as rough edges, and unpleasant tastes and smells can make these options a nightmare to use.
Low-quality mouth guards may also lack durability and it’s not always the ones with the cheapest prices that let people down. There are plenty of manufacturers willing to sell poor-quality oral devices at vastly inflated prices.
All five of the mouth guards we are recommending on this page are produced by reputable companies that are keen to retain customers by providing excellent value for money.
All of the mouthpieces for sleep apnea are available over the counter and without prescription.
Depending on your personal preferences, certain mouth guards may be more appealing than others, but no matter which option you choose, you will be backing a winner and the money-back guarantees and trial periods give you everything to gain and nothing to lose.
What is Sleep Apnea?
A sleep apnea is a temporary cessation of breathing that occurs during sleep.
Apneas are very common. It’s normal to have up to five of them an hour. It’s only when you begin getting more that it becomes a cause for worry.
People with severe sleep apnea may have 30 – 100+ apneas an hour. This dramatically reduces sleep quality and can be very detrimental to health.
Doctors use a special scale for measuring the severity of sleep apnea. It’s called the apnea-hypopnea index (AHI).
It looks like this:
Normal sleep: Five or fewer apneas (on average) per hour
Mild sleep apnea: 5-14 apneas per hour
Moderate sleep apnea: 15-29 apneas per hour
Severe sleep apnea: 30+ apneas per hour
In addition to there being different levels of severity, there are also different types of sleep apnea.
The three most common forms are:
1. Obstructive Sleep Apnea: This is the most common type of sleep apnea. The apneas happen due to the throat muscles relaxing during sleep. This causes the flesh around them to sag causing an airway blockage.
2. Central Sleep Apnea: In this case, the apneas are due to disruptions in the signals the brain sends to the muscles responsible for respiration.
3. Complex Sleep Apnea Syndrome: This is a hybrid condition where the apneas are due to a combination of obstructive sleep apnea and central sleep apnea.
Who Could Benefit From a Sleep Apnea Mouth Guard?
As we mentioned earlier on in this article, sleep apnea mouth guards offer the best results to people suffering from mild to moderate OSA. They can be equally effective for controlling snoring.
Although snoring is one of the most noticeable symptoms of OSA, people who snore don’t always have the condition.
In the case of normal snoring, all that nocturnal rasping is caused by vibration in the soft tissues at the back of the throat. The tissues vibrate when the throat muscles relax during sleep. The situation is often made worse when the tongue drops backward, causing a further obstruction.
In the case of OSA, the airflow impedance may happen slowly enough to cause snoring before respiration stops. With normal snoring, the airflow restriction does not become severe enough to completely block the throat.
When doctors diagnose mild sleep apnea, a mouth guard is generally one of the primary treatment suggestions.
In the case of anything more than mild sleep apnea, doctors might recommend mouth guards. However, the decision may be based on a variety of factors including their patients’ overall health and the sleep apnea severity level on the AHI scale.
When doctors consider the condition too severe to be effectively controlled by a mouth guard, it’s highly likely they will suggest CPAP instead.
How Effective are Sleep Apnea Mouth Guards?
Mouth guards can be extremely effective for controlling sleep apnea, but they do not work well for everyone. Nor are they suitable for some people.
Due to their reliance on strong teeth, a sleep apnea mouth guard is unsuitable for people who have frontal crowns or false teeth. They are equally unsuitable for people who have teeth braces or use night time retainers.
Presuming there are no dental restrictions and the sleep apnea is not severe, a good mouth guard can work exceptionally well and there’s plenty of research that proves it.
The researchers responsible for one study, published in the Journal of Thoracic Disease (Jan 2018), describe CPAP as the “gold-standard” treatment for OSA and then point out oral appliances are the leading alternative. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803051/)
Pros & Cons of Using Mouth Guards to Control Sleep Apnea
Cheaper than many alternatives
Do not require a prescription
Safer than surgical procedures
Controls snoring + apneas and help you to wake up refreshed
Helps prevent headaches, mental fog, memory problems, and other problems attributable to sleep apnea.
May cause drooling during the night
Requires strong teeth
Unsuitable for severe cases of OSA
May cause temporary jaw discomfort during the early stage of use
Alternative Sleep Apnea Solutions
Using a mouth guard may be one of the most popular ways to control sleep apnea but it’s far from being the only one.
As we mentioned earlier, CPAP is generally seen as the gold standard so we’ll look at that first.
CPAP is an acronym for continuous positive airway pressure. It’s more complicated and expensive than mouth guards because it requires a special machine.
The machine is basically an air pump that pushes air down a tube into a face mask you have to wear during sleep.
The continuous air pressure from the machine pressurizes the airways at the back of the throat. Although the pressure is not strong enough to prevent normal exhalation, it is still powerful enough to prevent the sagging flesh and other obstructions that cause apneas.
CPAP is an extremely effective sleep apnea treatment and, although a minority of candidates find it unsuitable, the majority of people respond exceptionally well.
Believe it or not, pillow position can also influence sleep apnea. If your pillows elevate your head too much or too little, it may make the condition worse.
However, although choosing a more favorable pillow setup may work well alongside another treatment such as CPAP or a mouth guard, unless the condition is very mild, pillow positioning is not a viable primary treatment.
Nerve Stimulation Devices
These are electronic devices that are sometimes called tongue pacemakers. Hypoglossal nerve stimulator is a more accurate terminology because, instead of stimulating the heart as a pacemaker does, the device stimulates the hypoglossal nerve.
Having said that, the technology is very similar and, like a pacemaker, the device is surgically embedded into the chest. The battery lasts for a number of years but each replacement has to be done via surgery.
The hypoglossal nerve runs between the base of the brain and the tongue. It provides conscious motor control and enables involuntary actions as well, such as swallowing.
Hypoglossal nerve stimulation devices operate via a stimulation wire similar to the one used in pacemakers. Instead of sending an electrical current to the heart, it acts on the tongue.
When the device senses an apnea, it stimulates the tongue, moving it forward to open the throat.
Although hypoglossal nerve stimulation devices can be very effective, many eligible candidates choose not to accept such an invasive treatment.
Sleep Apnea Surgery
Having a nerve stimulation device fitted is only one of several surgical sleep apnea treatments. A lot of the alternative options are equally unpleasant. Some of them necessitate removing flesh from the tongue or the back of the throat. Others reposition the lower jaw via surgical means.
An anterior inferior mandibular osteotomy is one of the options available. During surgery, the surgeon splits the chin bone. This helps pull the tongue forward, opening up the back of the throat.
Although this could be seen as a hardcore approach, the post-treatment recovery time is much faster than with many other surgical options.
There are risks with this type of treatment and there is no guarantee the surgery will have the desired result. Nevertheless, the treatment is effective for a great many people.
Diet and Exercise
Being overweight or obese can make sleep apnea worse. This is due to the build up of excess fat around the neck and throat.
Where excess weight is a contributing factor, diet and exercise bring forth reasonable improvements. In the case of very mild sleep apnea, losing the excess fat may even prevent the apneas from occurring.
In borderline cases, where the doctor has opted for CPAP, losing weight may make it possible to ditch the machine and manage the condition with a mouth guard instead.
Needless to say, there are many other arguments for losing weight. Losing your excess fat can improve your overall health and quality of life.
If you were to change your diet for the better it could help you stop snoring, get better quality sleep and treat sleep apnea!
What are boil and bite mouth guards?
Boil and bite mouthguards are made from a special type of thermoplastic. When you immerse them in boiling water, the plastic becomes soft enough to penetrate with your teeth and make an impression.
After the plastic has cooled, the plastic retains a custom fit that is snug to your teeth. There is no wobble or movement so, when you place the device in your mouth before going to sleep, it holds your jaw in position (brings jaw slightly forward) throughout the night.
How do you clean a sleep apnea mouth guard?
Although it’s possible to get your mouth guard reasonably clean by holding it under the faucet, it’s generally better to use a toothbrush and toothpaste instead.
Using a denture cleaner is another good option. Regardless of which option you choose, it’s important to thoroughly clean your mouth guard between uses. Apart from ensuring adequate hygiene, keeping it clean may also extend the life of the device.
How long does a mouth guard last?
The lifespan of a boil and bite sleep apnea mouth guard can vary. However, if you purchase a good quality device from a reputable supplier, you can generally expect it to last for six months to a year.
A custom-built dental mouth guard may last for up to three years but your dentist will likely charge you upwards of $1,000 to build the device. Even if you are using two boil and bite mouth guards per year, it’s still going to be better value for money.
Sleep Apnea Mouth Guard Summary
Using an anti snoring mouthpiece or device such as a mouth guard is a highly effective and cost effective way of treating sleep apnea.
There are dozens of mouth guards for snoring on the market and most of them can be used as sleep apnea devices.
Our top sleep apnea mouth guard is AirSnore – due to its build quality, price and after sales service.