I can't tolerate CPAP. What else can I do?
Many people find CPAP hard to live with, and it does not mean you have failed. CPAP works well when it is used every night, but the mask, the noise, dry mouth or the air pressure make that hard for a lot of people.
For many patients, a custom oral appliance is the answer. It holds your lower jaw slightly forward while you sleep so your airway stays open, and it is small, quiet and easy to travel with. The American Academy of Sleep Medicine supports oral appliances for mild to moderate obstructive sleep apnea, and for severe sleep apnea when CPAP cannot be tolerated (AASM: oral appliance therapy (opens in a new tab)).
An appliance is not right for everyone, so we start with your sleep test results and an exam of your teeth, jaw and airway. Once it is adjusted, we test again so we know it is working. Bring your last sleep study and your CPAP details to your first visit.
Oral appliance therapyCPAP intolerance
Will Medicare cover my oral appliance?
In many cases, yes. Sleep apnea is a medical condition, and a custom oral appliance is considered durable medical equipment, so it goes through Medicare or your medical plan rather than dental insurance. We accept major medical insurance and Medicare.
Coverage depends on your plan, and it usually requires a sleep apnea diagnosis from a sleep test, so testing comes first. Call us and we will check your benefits before your first visit.
How Medicare and medical insurance work at AZ Sleep
Does snoring always mean sleep apnea?
No. Plenty of people snore without having sleep apnea. But loud, regular snoring is one of the most common signs of it, especially when it comes with pauses in breathing, gasping or choking at night, or waking up tired after a full night in bed.
That is why we screen for sleep apnea before treating snoring on its own. A sleep test gives the answer. If it turns out to be snoring alone, an appliance can often help with that too.
Signs of sleep apneaYour sleep questionnaire
How long until I feel better?
It is different for everyone, so we would rather be honest than promise a date. An appliance is usually fitted over two visits, and then we move it forward in small steps until your breathing and comfort are where they should be. Some patients notice a difference early; for others it takes longer while we fine-tune the fit.
What matters most is that we measure it. Once your appliance is adjusted, we test your sleep again with it in place, so we know it is working instead of guessing.
Step 4: follow-up testing and ongoing care
Can an appliance help my jaw pain too?
It can be part of the answer, and Dr. Lynch pays close attention to it. Clenching and grinding at night often go along with sleep apnea; sometimes the jaw is working to keep the airway open. At your first visit, she examines your jaw joints and looks at the wear on your teeth.
If you have jaw pain, we fit the appliance carefully and move it forward gradually so your jaw stays comfortable. It also protects your teeth from grinding, which CPAP cannot do. Jaw pain has many causes, though, so Dr. Lynch will tell you what she finds and whether other care makes sense.
TMJ, jaw pain and grindingHow we treat jaw pain alongside sleep apnea
Why do you look at lifestyle as well as the appliance?
Because sleep apnea rarely has one cause. Your weight, alcohol, smoking, some medications, your sleep position, stress and other health conditions can all affect how you breathe at night. An appliance is an important part of the plan, and the other pieces matter too.
That is why AZ Sleep is a complete program: we measure, we address every piece that affects your sleep, and we measure again. When something needs another specialist, Dr. Lynch works with your physicians, ENTs and cardiologists.
Comprehensive treatmentStep 3: your personal plan
Do I need a sleep study before I come in?
No. You do not need to have everything figured out before you call. If you already have a sleep study, bring it. If you do not, that is where your journey starts: after your consultation and screening, our nurse practitioner can order a home sleep test during a telehealth visit, and you sleep with the SleepImage ring on your finger in your own bed. Pick the ring up the same day as your telehealth visit, or we ship it to your home within three to five business days. If a sleep lab is the better test for you, we will refer you.
Some insurance plans have their own referral rules, and we will help you check yours.
Step 2: sleep testingRequest a consultation
These answers are general information and are not medical advice. Talk with your own doctor about your health. If you think you have a medical emergency, call 911.
More answers in the sleep apnea FAQRead: Do I have sleep apnea?About Dr. Lynch