Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy

Publication Date: July 1, 2015
Last Updated: March 14, 2022

Recommendations

1. We recommend that sleep physicians prescribe oral appliances, rather than no therapy, for adult patients who request treatment of primary snoring (without obstructive sleep apnea). (STANDARD)

2. When oral appliance therapy is prescribed by a sleep physician for an adult patient with obstructive sleep apnea, we suggest that a qualified dentist use a custom, titratable appliance over non-custom oral devices. (GUIDELINE)

3. We recommend that sleep physicians consider prescription of oral appliances, rather than no treatment, for adult patients with obstructive sleep apnea who are intolerant of CPAP therapy or prefer alternate therapy. (STANDARD)

4. We suggest that qualified dentists provide oversight— rather than no follow-up—of oral appliance therapy in adult patients with obstructive sleep apnea, to survey for dentalrelated side effects or occlusal changes and reduce their incidence. (GUIDELINE)

5. We suggest that sleep physicians conduct follow-up sleep testing to improve or confirm treatment efficacy, rather than conduct follow-up without sleep testing, for patients fitted with oral appliances. (GUIDELINE)

6. We suggest that sleep physicians and qualified dentists instruct adult patients treated with oral appliances for obstructive sleep apnea to return for periodic office visits— as opposed to no follow-up—with a qualified dentist and a sleep physician. (GUIDELINE) (, )
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Recommendation Grading

Overview

Title

Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy

Authoring Organization

Publication Month/Year

July 1, 2015

Last Updated Month/Year

January 10, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

 The purpose of this new guideline is to replace the previous and update recommendations for the use of OAs in the treatment of obstructive sleep apnea (OSA) and snoring.

Target Patient Population

Patients with obstructive sleep apnea and snoring

Target Provider Population

Dentists/physicians

Inclusion Criteria

Female, Male, Adolescent, Adult, Older adult

Health Care Settings

Ambulatory, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Management, Treatment

Diseases/Conditions (MeSH)

D020181 - Sleep Apnea, Obstructive, D009967 - Orthodontic Appliances

Keywords

obstructive sleep apnea, sleep apnea, oral appliance

Methodology

Number of Source Documents
53
Literature Search Start Date
January 1, 2004
Literature Search End Date
February 28, 2013