A Mandibular Advancement Device (MAD) is an oral appliance used to treat sleep-related breathing disorders, including snoring and obstructive sleep apnea (OSA). It is a dental appliance that is custom-made to fit an individual's mouth. The device is typically worn during sleep and works by repositioning the lower jaw (mandible) slightly forward, which helps open the airway and improve airflow.

How does a MAD work?

The primary function of the MAD is to advance the jaw just enough to prevent airway collapse.

1. Mandibular Advancement: These dental appliances work by repositioning the lower jaw (mandible) slightly forward. This forward movement helps to open up the airway by reducing the collapsibility of soft tissues at the back of the throat. By improving the airflow, these appliances can reduce or eliminate snoring and potentially alleviate symptoms of sleep apnea.
2. Tongue Stabilization: Some sleep apnea and snoring dental appliances incorporate features to stabilize the tongue. These devices may include components or design elements that hold the tongue in a forward position. By preventing the tongue from falling back and blocking the airway, these appliances further promote unobstructed breathing.
3. Improved Airflow and Oxygenation: Sleep apnea and snoring dental appliances help improve airflow during sleep, reducing airway resistance and preventing the collapse of soft tissues. This allows for better oxygenation, reduces the occurrence of apnea events, and can lead to improved sleep quality and daytime functioning.

Am I a good candidate for a MAD?

A mandibular advancement device (MAD) may be considered as a treatment option for individuals who meet certain criteria. While a healthcare professional, such as your sleep care team or a dentist specializing in sleep disorders, should make the final determination, here are some factors that can help identify potential candidates for a mandibular advancement device:

1. Mild to Moderate Sleep Apnea: Mandibular advancement devices are often recommended for individuals with mild to moderate obstructive sleep apnea (OSA). If the sleep apnea is severe, other treatment options, such as continuous positive airway pressure (CPAP) therapy, may be more suitable. The severity of OSA is determined through a sleep study.
2. Intolerance to CPAP: Some individuals with sleep apnea may have difficulty tolerating CPAP therapy or find it inconvenient for various reasons. In such cases, a mandibular advancement device can be considered an alternative treatment option.
3. Snoring: Mandibular advancement devices can also be used to address primary snoring, which is snoring without the presence of sleep apnea. If snoring is disruptive or causes distress to the individual or their bed partner, a MAD may help reduce or eliminate snoring.
4. Good Oral Health and Dental Conditions: Candidates for a mandibular advancement device should have sufficient dental and oral health. They should have a proper number of teeth, healthy gums, and a stable jaw structure to support the device. A dental examination is typically conducted to assess the oral health and suitability for the device.

How effective is a MAD?

Mandibular advancement devices (MADs) have been shown to be effective in treating mild to moderate obstructive sleep apnea (OSA) and reducing snoring. The effectiveness of a MAD can vary depending on factors such as the severity of the sleep apnea, individual patient characteristics, and treatment compliance. Here are some key points regarding the effectiveness of mandibular advancement devices:

1. Treatment of Sleep Apnea: MADs have been found to effectively reduce the frequency and severity of apnea events in individuals with mild to moderate sleep apnea. They work by repositioning the lower jaw forward, which helps open the airway and improve airflow during sleep. Studies have shown that MADs can significantly decrease the Apnea-Hypopnea Index (AHI), which measures the number of breathing pauses or reductions in airflow per hour of sleep.
2. Snoring Reduction: MADs are also effective in reducing or eliminating snoring, even in individuals without sleep apnea. By repositioning the jaw and preventing airway obstruction, MADs can help improve airflow and reduce the vibration of soft tissues that causes snoring sounds.
3. Treatment Success: The success of MAD treatment can vary among individuals. Factors that can impact the effectiveness of a MAD include the severity of sleep apnea, the design and fit of the device, patient compliance, and individual anatomical factors. Studies have reported success rates ranging from 60% to 90% in terms of symptom improvement and reduction in AHI.
4. Individual Variability: Every individual responds differently to treatment, and results can vary. Some individuals may experience significant improvement in sleep apnea symptoms and snoring with a MAD, while others may find it less effective. It is important to have realistic expectations and work closely with a healthcare professional to monitor the effectiveness of the device and make any necessary adjustments.
5. Treatment Compliance: The effectiveness of a MAD is closely tied to patient compliance. Consistent and correct usage of the device is essential for optimal results. It is important to wear the device during sleep as prescribed by you Empower Sleep care team and follow any specific instructions for care and maintenance.

How do I track the effectiveness of my MAD?

Tracking the effectiveness of a sleep apnea dental appliance can be done through several methods. Here are a few ways to monitor and assess its effectiveness:

1. Sleep Apnea Symptoms: Pay attention to changes in your sleep apnea symptoms. Record how often you experience daytime sleepiness, snoring, morning headaches, or gasping for breath during sleep. If you notice improvements in these symptoms, it may indicate that the dental appliance is effectively managing your sleep apnea.
2. Sleep Diary: Maintain a sleep diary to track your sleep patterns and any changes in your sleep quality. Note the duration and quality of your sleep, as well as any instances of snoring or interrupted breathing during the night. Compare your sleep diary entries before and after using the dental appliance to evaluate its impact on your sleep.
3. Bed Partner Feedback: If you sleep with a partner, ask for their observations and feedback. They can provide insights into changes in your snoring, and breathing patterns or any other noticeable improvements they observe during your sleep. Their input can help assess the effectiveness of the dental appliance.
4. Follow-up Sleep Study: In some cases, a follow-up sleep study may be conducted to objectively evaluate the effectiveness of the dental appliance. This may involve another overnight sleep study in a sleep laboratory or home sleep testing equipment. The sleep study will measure parameters such as the Apnea-Hypopnea Index (AHI) to determine the severity of sleep apnea and whether it has been adequately reduced with the dental appliance.
5. Professional Follow-up: Regular follow-up appointments with your healthcare professional, such as a sleep specialist or a dentist specializing in sleep disorders, are important. During these visits, the professional can assess the fit and function of the dental appliance, make any necessary adjustments, and evaluate its effectiveness based on your symptoms and any objective measurements.

It's essential to communicate any concerns or issues you experience while using the sleep apnea dental appliance with your healthcare professional. They can provide guidance, make necessary adjustments, or help explore alternative treatment options when needed.

Remember, tracking the effectiveness of a sleep apnea dental appliance is a collaborative process between you and your healthcare professional. Working together and providing regular feedback will help ensure the treatment is optimized for your specific needs and provides the desired outcomes.