Do Patients prefer CPAP or an Oral Appliance to treat Sleep Apnea?

Realizing that no therapy will satisfy absolutely every patient; the simplest way to answer this question is by considering the following:

Medical Guidelines established by the AASM state that oral appliances are considered First Line Therapy for the management of Snoring, Mild & Moderate Sleep Apnea. The reason for this is NOT that they are more effective in eliminating apnea than the “Gold Standard” we know as CPAP (in fact CPAP has a higher success rate at any level of apnea); it is because literature data demonstrates that patients are far more likely to comply with an oral appliance than with CPAP.  Sleep 2006:29:2

By the way, the literature data established this very early in the game:

One of the earliest studies evaluating patient preference established that ten out of eleven prefer an oral appliance over nCPAP for their long term therapy. Thorax 1997, 52:362-368

Finally, many studies have demonstrated the success we have with long-term oral appliance compliance; especially when the patients are followed up with regularity:

A 256 patient study demonstrated a 90% patient compliance after 2 ½ years of wear. CRANIO 2000:18:2

It is very important to point out that I am not expressing a personal opinion, all of the above is derived from peer-reviewed literature; the closest thing to fact we have to work with.

So, if 10 out of 11 prefer an oral appliance over CPAP when given a choice...


John Viviano BSc DDS D ABDSM


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