A mandibular advancement device (MAD) is a solution for snoring and sleep apnea. It is also sometimes called a mandibular repositioning device (MRD).

According to the American Sleep Apnea Association, millions of people in the United States snore while sleeping. Snoring is not just an audible nuisance but can also disrupt a person’s sleep and reduce its overall quality.

A mandibular advancement device may be one solution. Keep reading to learn more.

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A MAD may help manage symptoms of sleep apnea.
Image credit: BSIP/Universal Images Group via Getty Images.

About 22 million people in the U.S. have obstructive sleep apnea. As a person’s body relaxes, the throat does, too. This relaxation leads to a narrowing of the airway, which produces distinct snoring sounds when breathing.

Sleep apnea is a condition in which the throat walls close completely, obstructing breathing.

Many individuals do not know that they have sleep apnea. Common symptoms, besides snoring, include:

  • feeling unusually tired during the day
  • waking up suddenly during the night
  • difficulty with focus and memory
  • pauses in breathing while asleep, which a partner will usually notice
  • headaches in the morning

People who think that they may have this condition may wish to consider a sleep study, which can confirm the presence of sleep apnea. Upon diagnosis, a sleep specialist will suggest possible treatment solutions.

Treatments for sleep apnea include:

  • lifestyle changes, such as switching sleep positions, weight loss, and allergy treatments
  • surgery
  • continuous positive airway pressure (CPAP) appliance
  • oral devices, such as a MAD

CPAP is the most common treatment for sleep apnea.

Learn more about obstructive sleep apnea here.

A MAD is an alternative treatment method that people can try. It works by temporarily moving the jaw and tongue forward, which reduces throat constriction and prevents sleep apnea and snoring. Moving the tongue forward increases airway space.

Some MADs are custom or semi-custom and fit a specific person’s mouth. Others, also known as boil-and-bite MADs, are available over the counter (OTC). They feature soft materials that become more pliable under exposure to hot water. Biting down on the flexible mold helps fit the device.

The authors of a 2018 review explain that more research is necessary to determine the effectiveness of each type of MAD.

It is important to note that MADs are not suitable for people who wear dentures or have severe dental issues.

The main benefit of an MA device is that it helps reduce snoring and sleep apnea.

A 2000 study on 22 people’s use of MADs over 12–30 months suggests that these devices are useful for treating sleep apnea and snoring.

All of the study participants wished to continue using the MADs. The sample size, however, was quite small.

According to the Royal Australian College of General Practitioners, people likely to gain the most benefit from MADs include:

  • those with mild-to-moderate sleep apnea
  • young people
  • people with sleep apnea that improves when sleeping on their side
  • females
  • those with a receding jaw structure (also known as a retrognathic mandible)

The following people are less likely to see symptom improvement with MADs:

  • older adults
  • individuals with obesity and those with excess fat tissue around the neck
  • those with a stiff jaw, which makes advancement difficult
  • people with dental conditions, such as gum disease
  • people with central sleep apnea, which is a neurological condition rather than a mechanical one

Learn more about central sleep apnea here.

Although a MAD can help limit sleep apnea symptoms and snoring, there are some side effects. These can include:

  • discomfort around the jaw and mouth area
  • toothache
  • excess drooling
  • dry mouth
  • gum irritation

The side effects of wearing an MA device are usually mild. However, they can sometimes lead people to forego treatment with a MAD.

While CPAP is the gold standard for treating sleep apnea, people do not always keep up with the treatment. About 50% of people using CPAP therapy for sleep apnea eventually abandon treatment.

A review in the Journal of Thoracic Disease suggests that MADs are useful for people who have mild sleep apnea or struggle with CPAP treatment.

CPAP is more effective overall than MADs for treating sleep apnea. However, people tend to use MADs more readily, and this treatment is more cost effective than CPAP.

In comparison with CPAP, MADs are portable, take up almost no physical space in the bedroom, and do not produce noise. They also do not require electricity. However, they are not effective for everyone.

The American Thoracic Society explain that MADs are useful for improving symptoms but not for completely controlling sleep apnea. They note that CPAP is more likely to provide immediate relief from sleep apnea symptoms.

In addition to CPAP and MADs, sleep apnea treatment options include:

  • Surgery: Surgical intervention for sleep apnea usually involves removing any excess tissue from the back of the throat to reduce airway restriction.
  • Weight loss: This long-term solution can help relieve sleep apnea symptoms by reducing fatty tissue around the neck.
  • Quitting smoking and limiting alcohol consumption: Doing both can reduce the risk of airway constriction over time.
  • Allergy medications: Nasal decongestants and other OTC allergy medications can increase airflow and help people breathe through their nose while sleeping.
  • Changing sleep position: People can try switching their sleeping position and resting on their side to see whether symptoms improve. Those with the condition are more likely to experience symptoms when sleeping on their back.

Learn more about natural ways to treat sleep apnea here.

Mandibular advancement devices are a useful tool for treating snoring and obstructive sleep apnea.

They have minimal side effects, are easy to use, and are more cost effective than CPAP.

However, MADs do not work for everyone. People with severe sleep apnea, or central sleep apnea, may not find relief from using these kinds of devices.

People who are worried that they may have sleep apnea should consult their doctor or see a sleep specialist. A sleep study can confirm a diagnosis of sleep apnea. A specialist can then provide treatment options.