Besides CPAP, oral appliances are another good option for most people with mild to moderate obstructive sleep apnea. Two of the biggest barriers for people to try oral appliances is the unpredictability of insurance overage, and the time that's involved with custom fitting and frequent adjustments. Formal devices can cost anywhere from $1500 to $4000.
A recent study addressed this issue by proposing that patients be fitted in the ENT office with one of the easily available boil-and-bite anti-snoring devices. Rather than having the patient order it and mold it themselves, he had a supply of these products in the office and helped patients mold the devices at the time of their visit, rather than having to come back for the procedure. He compared three types of devices: The Snoreguard, Somnoguard 2.0, and the Somnoguard AP. The first two are not adjustable after the first molding, where the Somnoguard AP is adjustable using a small screw.
Using subjective questionnaires and pre and post-device sleep studies, he reported a 62% objective response rate (> 50% drop in the AHI and the final AHI is less than 20). Overall success was 39% (objective response achieved, and the patient was adherent – using the device more than 5 nights a week). At 2 months, about 58% were still using their devices.
Interestingly, there was no significant difference in the objective response and adherence between the three different devices. However, the AHI and oxygen desaturation level was significantly more improved with the adjustable Somnoguard AP model.
I've had a number of patients that come in for me to help me mold their Somnoguard devices. Perhaps it's time to try the Somnoguard AP model.
Have you tried any of the boil-and-bite models? Was it helpful?