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Titratable oral appliances for the treatment of snoring and obstructive sleep apnea.

The American Sleep Disorders Association recommends that oral appliances (OAs) be used in patients with primary snoring or mild obstructive sleep apnea (OSA) and in patients with moderate to severe OSA1,2 who are intolerant of or refuse treatment with nasal continuous positive airway pressure (nCPAP). Because of the life-threatening implications of a number of sleep disorders, it is imperative that OA therapy commences only after a complete medical assessment. For some patients, combination therapy with other treatments such as weight loss, surgery and nCPAP may be indicated, and such combination therapy must be coordinated by the attending sleep physician.