A MAD sleep apnea device is a mouthguard-like device used by dentists to treat sleep apnea and snoring. Because it gently pushes the jaw and tongue forward, it keeps your throat open while you sleep, making it easier to breathe.
Many patients prefer a Mandibular Advancement Device (MAD) to a CPAP machine. Doctors often recommend it for those with mild to moderate sleep apnea, and sometimes even for those with severe cases who can’t use a CPAP machine.
A dentist will always examine your mouth and jaw beforehand to ensure the device will fit and work correctly.
“These aren’t just run-of-the-mill mouthguards, and getting a dentist to personalize one to your mouth can be challenging,” states a report in TIME Magazine. “Most dentists have little background on sleep apnea. It’s necessary to find a dentist trained and certified as an expert in dental sleep medicine.”
A Realistic MAD Sleep Apnea Device Patient Experience
The first week with a MAD sleep apnea device can be challenging as your mouth adjusts to a new, foreign object. The tight, hard plastic often feels uncomfortable, putting pressure on your teeth and gums. Some people even gag or instinctively try to spit it out during the first few nights.
Your body also reacts in other ways, with unpredictable saliva production. The device can make your mouth think you’re chewing, leading to excessive drooling, while others may experience a dry mouth because the new jaw position lets in more air.
You might also wake up with a stiff jaw or a headache from the strain on your jaw muscles, which are contracted for hours at a time. This can be especially true for those who grind their teeth, as the device adds more pressure to the jaw joint.
These early days can feel frustrating or confusing, but for most people, the discomfort and odd sensations fade as their mouth adjusts.
“I noticed an immediate change with the MAD device,” states a patient on Reddit. “It hit me within a few days, if not the first day. Just shifting my jaw like that, I could feel the difference in the air flowing in. But I did have jaw pain the first 2-3 days of using it.”
Adjustment and Your Patient-Provider Partnership
When you first get a MAD sleep apnea device, it’s a good idea to start by wearing it for short periods during the day or during naps to get your mouth used to it. The key is to be consistent; even if you only wear it for an hour or two at first, sticking to the routine will help your body adapt over time.
Morning stiffness in your jaw is a common side effect, but you can alleviate it with simple jaw exercises. Gently moving your jaw from side to side or forward will help wake up and strengthen the muscles.
Additionally, your dentist might provide a Morning Occlusal Guide (MOG). Wearing this small tool for a short time after you wake up helps return your jaw to its normal position, easing stiffness and preventing long-term changes to your bite.
You should also remember to keep both your mouth and the device clean by brushing your teeth and washing the MAD every day. A clean device and mouth not only feel better but also help the device last longer.
For MAD therapy to be successful, it requires a strong partnership between the patient and the provider. Patients need to be patient with themselves and stick to their care plan, especially during the first few weeks when everything feels strange.
In turn, providers must perform a thorough initial assessment to ensure the device is custom-fit for the patient’s mouth. Regular check-ins are also crucial for catching and addressing problems early. Sometimes, even simple adjustments like eating softer foods can relieve stress on the jaw.
Open communication is essential, as patients who share new soreness or tingling sensations help providers find the best solutions, ultimately leading to better sleep and a more restful life.
Life-Changing Benefits of a MAD Sleep Apnea Device
Getting used to a MAD sleep apnea device can feel tough at first, but over time, these devices prove their worth. Studies show that they are highly effective in treating Obstructive Sleep Apnea.
One analysis found that patients experienced over 16 fewer sleep interruptions per hour and saw their daytime sleepiness scores drop by about four points on the ESS scale. Even those with severe symptoms saw significant improvement, with nearly all patients in one study reaching a level that doctors consider successful.
The long-term benefits are equally impressive. Many people stick with the therapy for years, with more than half still seeing positive results after five years. Among those with severe OSA, success rates hold steady for almost two-thirds of users.
Looking past the numbers, patients often report waking up feeling refreshed and clear-headed, sometimes for the first time in decades. Many notice they have more energy and better focus throughout the day, which significantly improves their daily lives.
Partners also benefit from the therapy. In one study, most partners reported that their own sleep improved after their loved one started using a MAD, as the device reduces snoring and other disruptive nighttime noises. These real-life stories highlight why so many people find the treatment to be life-changing.
Practices, Experiences, and Patient Stories
Here’s a rundown of facts about today’s MAD sleep apnea device options.
Reasons and Practices | Details and Experience | Patient Stories |
Common Reasons for Discontinuation | Inability to Adapt: 62%
TMJ Pain: 38% Ineffectiveness: 28% Dry Mouth: 28% |
Patient-reported data indicates that the most common reasons for abandoning therapy are related to an inability to adjust to the device or persistent side effects. |
Initial Adjustment & Side Effects | Duration: 2-4 weeks | The adjustment period can take up to a few weeks as the mouth and jaw adapt to the device. |
Common Side Effects: Jaw/teeth soreness, excess saliva/dry mouth, gag reflex, gum irritation | These temporary side effects are a natural physiological response to the device, but they typically subside as the patient gets used to it. | |
Cost & Longevity | Average Cost: $1,500 – $4,500 | A custom-fitted MAD is considered a medical device, with costs varying based on material and customization. |
Insurance Coverage: Typically medical, not dental | Since sleep apnea is a medical condition, the appliance is often covered under a patient’s medical insurance, though some plans may require a documented history of CPAP intolerance. | |
Expected Lifespan: 2-5 years | With proper care, a custom-fitted MAD is durable and designed to last for several years before needing replacement. | |
Best Practices for New Users | Gradual Adaptation | Begin by wearing the appliance for short periods during the day, such as while watching TV or reading, before attempting to wear it for a full night’s sleep. |
Daily Jaw Exercises | Simple exercises can help alleviate morning stiffness and promote muscle resilience. Examples include Goldfish exercises, as well as gentle side-to-side and forward jaw movements. | |
Use a Morning Occlusal Guide (MOG) | A MOG is a small device worn each morning to help the jaw return to its pre-treatment position, which can prevent long-term dental changes and alleviate soreness. |
MAD Sleep Apnea Device and High Patient Compliance
What sets today’s MAD sleep apnea device apart is how many people actually stick with it. While a significant number of people who get a CPAP machine only end up using it for the long term, nearly 90 percent of those with a MAD use it as directed.
This number shows that a therapy’s success isn’t just about how well it should work, but whether people can consistently use it night after night.
Still, long-term adherence isn’t a guarantee. One study followed veterans and found that while about 72 percent used the device most nights for the first two weeks, that number dropped to 63 percent by three months. This suggests that sticking with the therapy for the long haul can be challenging, even with a promising start.
So why do some people stop? The biggest reason is a failure to get used to the device. Common complaints include jaw pain, dry mouth, or the feeling that the device isn’t helping.
These early struggles are often the key difference between continuing the therapy or giving up.
Long-Term Dental and Occlusal Side Effects
Over time, wearing a MAD sleep apnea device can cause teeth to shift, which might lead to changes in a person’s bite. Even tiny shifts can matter, with studies showing that these changes can add up to about a millimeter over four years.
The space between the upper and lower teeth may shrink, molars might glide forward, or top front teeth might tilt inward. In one study, most people had a new bite pattern after five years.
Strangely, most users don’t notice these gradual dental changes, as their focus is on the more immediate benefits of better sleep and less snoring. Because the dental shifts happen in slow motion, regular check-ups with a dentist are crucial to catching these issues early.
By working together for the long term, dentists and patients can prevent bigger problems down the road.
“MADs are recommended for first line therapy for mild or moderate OSA, alternative therapy for severe OSA or those unable to tolerate PAP Therapy, and patients who have travel, work, or lodging situations that complicate or prevent PAP use,” according to a fact sheet published by Health Mil. “MADs are not recommended for first line therapy for Severe OSA, patients with severe dental disease or inadequate dentition, and patients with severe gag reflexes or that prevent MAD use.”
Practical Considerations for a MAD Sleep Apnea Device
While money is a factor in MAD sleep apnea device therapy, with prices ranging from $1,500 to $4,500, insurance may help. However, coverage varies by plan.
Many insurers require proof that other treatments, like a CPAP machine, have not worked. Paying thousands of dollars with no guarantee of success can feel risky, especially since over a quarter of people stop using their device due to pain or a lack of effectiveness.
Before starting treatment, it’s wise to discuss all the facts with your doctor. You should ask about the device’s lifespan, which is typically two to five years, and whether you can talk or drink while wearing one — which is possible with some newer models. The device is also simple to clean with a soft toothbrush and mild soap every day.
MADs are not for everyone, though. They should be avoided by individuals with central sleep apnea, children (unless a doctor approves), or those with insufficient teeth, gum disease, or severe jaw joint issues.
Wellness and Pain
Find your personalized MAD sleep apnea device by visiting Wellness and Pain. We offer conservative treatments, routine visits, and minimally invasive quick-recovery procedures. We can keep you free of problems by providing lifestyle education and home care advice.
This enables you to avoid and manage issues, quickly relieving your inhibiting lifestyle conditions when complications arise. We personalize patient care plans based on each patient’s condition and unique circumstances. Wellness and Pain can help improve wellness, increase mobility, relieve pain, and enhance your mental space and overall health.