CPAP Alternatives

What is CPAP?

CPAP (Continuous Positive Air Pressure) is a relatively small machine that uses air pressure to open the throat at night to prevent snoring, choking, and sleep apnea events. The gold standard for the treatment of obstructive sleep apnea, CPAP is almost always recommended by the Sleep Doctor (and is sometimes required by insurance) for at least a period of 2-3 months. During this time you can try several different types of masks from large full face to small nasal pillows to find which type works best for you.


There have been many advances in the use of CPAP from quieter CPAP machines, to more comfortable masks and hoses that bend easier and are less obtrusive. Many sleep centers or CPAP suppliers provide assistance in the fitting process and make finding the right equipment for you easy and pain free.

CPAP Alternatives

If you have tried CPAP and have not been able to make it work for you, in spite of trying many different masks, then don’t fret, there are other options, and you're in good company! Approximately 83% of CPAP patients quit or are inconsistent in their CPAP therapy for Sleep Apnea.


When a patient cannot tolerate CPAP, they neglect to use it. This non-compliance is referred to as CPAP intolerance or CPAP failure.


CPAP failure is often caused by issues outside your control:


  • Seasonal allergies or ongoing congestion
  • Nasal, sinus or upper palate issues (such as a deviated septum)
  • Skin irritation on face
  • Nasal irritation, dryness or bleeding
  • Claustrophobia or sensation of suffocation
  • Respiratory infections
  • Abdominal bloating & gas
  • Machine disturbs sleep (or partner’s sleep)


These and other issues make CPAP failure common for many obstructive sleep apnea sufferers. Dental sleep appliances are less obtrusive than a CPAP and are often tolerated well after just a couple of days of use. For more information about oral appliance therapy, check out our Oral Appliance Therapy page!

Sleep Apnea is a serious medical concern. Find out how we can help!

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Frequently Asked Questions

  • If I snore, do I have sleep apnea?

    Snoring frequently accompanies sleep apnea but it is not always an indicator of whether this sleep condition is present. However, snoring can indicate that bulky throat tissue could potentially obstruct airways – especially if patients have certain lifestyle factors that contribute to sleep apnea. Fortunately, the treatment we offer for sleep apnea and snoring is the same. By prescribing a custom oral appliance, the diameter of the airway can be widened to prevent the sounds of snoring as well as episodes of apnea. These oral appliances are soft and comfortable to wear. They work by positioning the lower jaw slightly forward so that the airway is no longer obstructed.

  • Is it possible that I have sleep apnea even if I don't snore?

    Anyone of any age can have sleep apnea. Even though snoring can accompany sleep apnea, it is not always a symptom of this sleep disorder. For this reason, it is important to have a sleep study conducted to determine if apnea is occurring. Our practice provides take-home sleep study machinery to detect episodes of apnea during sleep. After usage, the device will be returned to our practice and we will analyze the data collected. If we find that sleep apnea is present or determine if snoring is obstructing one’s quality of life, we will provide treatment recommendations.

  • What causes sleep apnea?

    The exact cause of obstructive sleep apnea (OSA) is different for each person. Anyone can develop it, regardless of age or gender. The most common risk factors include:

    • Being over age 40
    • Having a large neck (over 17 inches in men, 16 inches for women)
    • Being overweight – approximately half of OSA sufferers are overweight
    • Being male – more men than women suffer from OSA
    • Having a large tongue or small jaw
    • Enlarged tonsils and adenoids (particularly in children)
    • Using alcohol or sedatives which relax the muscles in the airway
    • Nasal obstruction due to a deviated septum or sinus and allergy problems

  • What is the difference between a CPAP and an oral appliance?

    While CPAP is very effective in treating sleep apnea, many people cannot tolerate the discomfort of  the mask and the inconvenience and noise of the machine. Therefore a high percentage of users have difficulty or will not wear them.  


    An oral appliance is a popular alternative to the CPAP. This device is small, portable, fits more comfortably and can provide similar treatment benefits.

  • How do you confirm the effectiveness of the oral appliance?

    You will have a follow-up sleep study while using your oral appliance to confirm the effectiveness of the device. A consultation with the sleep medicine physician will be necessary to interpret the results.

  • Does insurance cover sleep apnea treatment?

    Because insurance plans vary widely, our experienced team will work with you to see if your insurance company will cover the oral appliance. If for any reason it isn’t covered, we will let you know and work with you to develop a financial plan if needed.


    If coverage is available for oral appliances, it will come from your medical insurance carrier. Most dental insurance companies do not cover treatment of obstructive sleep apnea.  


    Our patients tell us it is well worth the investment of their time and money to treat their sleep apnea because of the improved quality of life they experience.

  • How long will it take to adapt to the oral appliance? Will it hurt my teeth?

    The majority of patients will adapt to the appliance within 5-10 days. It will take a few days to get used to having a device in your mouth while you sleep. The appliance will not hurt your teeth. If your teeth are sore after initial use, we can easily adjust it for your comfort.

  • How often will the appliance need to be replaced?

    They are made of hard acrylic, which is very durable. They are typically replaced every 3-5 years depending on wear and tear. If you grind your teeth, you may have a more frequent rate of repair or replacement.

  • Will the appliance change my bite?

    A change in your bite is possible. Depending on the position of your teeth and the status of your bone, your teeth may shift. Whith our experience we've minimized the risk of tooth movement dramatically, and the risk can be minimized further with the use of a morning re-positioning device.

  • Are there any side effects of the appliance?

    The most common side effect is morning muscle soreness that usually goes away after a short time. Some patients may experience either dry mouth or excessive salivation. As mentioned above, minor tooth movement occurs in some patients but is rare when the treatment plan and instructions are followed.

  • How long will I have to use the oral appliance?

    Obstructive sleep apnea is unlikely to decrease with age; therefore your oral appliance will probably be a lifelong therapy. However, certain wellness factors such as significant weight loss may improve your symptoms.

  • Can’t I just order a boil and bite device off the internet?

    While there are over-the-counter appliances you can order, keep in mind these are not FDA approved for treating sleep apnea. Additionally, when not fitted properly they may cause unwanted side effects such as jaw problems or excessive tooth movement.