The CPAP Alternative: Custom Oral Appliance Therapy in Westchester
Can’t Stand CPAP?
| Feature | Custom Oral Appliance | Standard CPAP |
| Comfort | Small, custom-molded, mask-free | Bulky masks and restrictive headgear |
| Noise | Completely silent | Constant motor noise and air leaks |
| Travel | Fits in your pocket; no power needed | Large case; requires distilled water & power |
| Partner Approval | Eliminates snoring quietly | Often disrupts the partner’s sleep |
Does Insurance Cover Oral Appliance Therapy?
In many cases, your health insurance coverage will pay for all or most of the cost of your treatment. If you have Cigna, United Healthcare, Oxford, or The Empire Plan, you likely have full coverage for this.
Learn More About Getting a Custom-Made Oral Appliance
Some obstructive sleep apnea (OSA, for short) sufferers are looking for a non-invasive (non-surgical) solution to control their sleep apnea symptoms and heavy snoring. Often, they are told to use CPAP (continuous positive airway pressure, also known as the “sleep mask” or “sleep machine”). But not everyone who needs treatment for sleep apnea can tolerate CPAP, or is willing to strap a mask to their face in order to get a good night’s sleep. CPAP can be uncomfortable, noisy, and is difficult to take with you if you travel. For individuals with CPAP failure and CPAP intolerance, there is another solution. An oral appliance, known as a mandibular advancement device, can often help.
Mandibular Advancement Device
An oral appliance is a device that you put in your mouth before going to sleep, and you wear it all night long, like a retainer. The oral appliance is an alterantive to CPAP, designed to treat and reduce symptoms of sleep apnea and snoring. It is custom-molded to fit on your upper and lower teeth, with an adjustable connector between the two parts. You can fine-tune the setting of the device until your snoring and sleep apnea reduces to an acceptable level. You can see an example of what one appliance looks like by checking the photos below. (There are other options that have a slightly different appearance).
Why Choose Oral Appliance Therapy?
If you have been diagnosed with Sleep Apnea and find the CPAP mask uncomfortable, restrictive, or impossible to sleep with, you aren’t alone. Unlike CPAP machines, oral appliances do not require masks or hoses, so you can sleep in any position you like. The device is silent and unintrusive. Oral appliances are travel-friendly; they can fit inside your luggage without extra bags or power cords. And oral appliances are highly effective. At Westchester ENT, we follow American Academy of Sleep Medicine (AASM) guidelines to ensure your oral appliance therapy is a medically-validated first-line treatment for your OSA. A Mandibular Advancement Device is the AASM-recommended treatment for Mild-to-Moderate OSA.
Dr. Spingarn at Westchester ENT specializes in making Mandibular Advancement Devices for sleep apnea sufferers. After an appropriate diagnostic evaluation and sleep testing has been performed, Dr. Spingarn will let you know if you are a good candidate for a mandibular advancement device. If so, he will take impressions of your teeth, which will be sent to a device-making laboratory, and then you will come back to the office to receive your device. If you live far away from the office, we are now offering a remote treatment option, where you take your own dental impressions with a kit and receive your appliance in the mail.*
Does Insurance Cover Oral Appliance Therapy?
In many cases, your health insurance coverage will pay for all or most of the cost of your treatment. If you have Cigna, United Healthcare, Oxford, or The Empire Plan, you likely have full coverage for this. With other commercial insurances, such as Aetna, you may have partial coverage. Blue Cross offers partial coverage if you have out-of-network benefits. Government-sponsored plans, such as Medicare and Medicaid, and union plans, such as Local 1199, do not offer coverage, but we do offer a self-pay option.
In order to use a mandibular advancement device, your teeth should be in good shape, without active dental disease. You also should have no history of jaw pain or the jaw-joint disorder known as temporomandibular dysfunction (often abbreviated as TMJ pain or TMD). If you have bruxism, or teeth grinding, it’s not a problem, because oral appliance therapy actually protects your teeth.
If you are coming to the office for an oral appliance consultation, you can save yourself time and energy by preparing in advance. For instance, if you already have a diagnosis of obstructive sleep apnea, then try to bring a copy of your sleep test results with you. It’s best if the sleep test was performed less than one year ago, or else you might need us to order you a new test. If you do not have a diagnosis yet, call our office before your visit so we can arrange for a sleep test to be authorized by your insurance company. Sometimes, we can arrange for you to have the test performed on the same day that you come for your consultation.
*If you want an oral appliance but live far away and cannot come to the office for an in-person consultation, you have a remote option. This option applies to patients insured by Cigna, Oxford, United Healthcare, and Empire Plan, as well as private-pay patients. You can potentially obtain an appliance by taking your own dental impressions (with a kit that we send to you) and receiving your appliance via a delivery service. If this interests you, you are welcome to start the process by requesting a telehealth consultation with Dr. Spingarn.
