CPAP is an effective treatment option for obstructive sleep apnea when used consistently. The right treatment depends on your medical needs, treatment response, preferences, and what you can use night after night. If PAP is not working for you, there are options to discuss with your medical provider.
When CPAP is hard to use
Mask discomfort, pressure, dryness, noise, a hose, travel, or removing the mask during sleep can make nightly use difficult. Your medical team may be able to improve PAP comfort by adjusting the mask, settings, or support.
A custom oral appliance
For an appropriate adult with diagnosed OSA who cannot tolerate CPAP or prefers an alternative, a custom, titratable oral appliance can be considered. It is compact, quiet, mask-free, and does not require electricity.
Does adherence change the picture?
CPAP generally reduces breathing events more than an oral appliance while it is being worn. Clinical guidance reports that oral appliances may have higher adherence overall, although older studies often measured use by patient report. The best choice considers both treatment response and what you can use consistently.
What about severe OSA?
Severe OSA needs particular medical attention. If PAP cannot be used, a medical provider may consider an oral appliance or another option, with appropriate follow-up to assess the response. An appliance is not automatically right for every patient.
How we know treatment is working
Dr. Dawson fits, adjusts, and monitors the dental side of treatment. Your medical provider directs the medical plan and coordinates an appropriate efficacy assessment; symptom improvement alone does not confirm adequate control.
Take the next step
Tell us what has been difficult about CPAP, and we can help you explore whether a dental evaluation makes sense.
Check candidacy · How oral appliance therapy works · Getting started
Clinical guidance: AASM and AADSM oral appliance therapy guideline.