What is Combination Therapy for Sleep Apnea?



Combination therapy involves using both a CPAP machine and a custom oral appliance at the same time. The goal is to maximize the benefits of each treatment while minimizing their individual drawbacks.

Think of it this way: a CPAP machine delivers a steady stream of air to keep your airway open during sleep. An oral appliance, on the other hand, works by gently repositioning your lower jaw and tongue to prevent your airway from collapsing. When used together, they can create a powerful synergy, often allowing for a lower, more comfortable CPAP pressure setting, or making the oral appliance even more effective.

Why Consider Combining Treatments?

You might be wondering why someone would use both a CPAP and an oral appliance. There are several reasons why this approach can be beneficial:

• Increased Comfort: Many people find CPAP difficult to tolerate due to the pressure settings, mask discomfort, or noise. By using an oral appliance, the required CPAP pressure can often be significantly reduced, making the CPAP much more comfortable and easier to wear consistently.
• Enhanced Effectiveness: For individuals with more severe obstructive sleep apnea, or those who haven't achieved full relief with a single therapy, combining treatments can offer a more robust solution to keep the airway open throughout the night.
• Better Adherence: When treatment is more comfortable, you're more likely to use it every night. This leads to better health outcomes and a higher quality of life.
• Addressing Complex Cases: Sometimes, a person's airway anatomy or the severity of their sleep apnea requires a multi-faceted approach. Combination therapy can be particularly helpful in these situations.



If you're struggling to consistently use your CPAP or feel that your current treatment isn't quite enough, discussing combination therapy could be your next step toward better sleep.

How Your Custom Oral Appliance Works in Combination Therapy

At Great Sleep Dental, we focus on providing custom-fitted oral appliances that are comfortable and effective. These aren't one-size-fits-all devices; they are precisely made for your mouth, much like a custom suit or dress is tailored to fit you perfectly.

Our oral appliances work by gently holding your lower jaw forward, preventing your tongue and the soft tissues in your throat from collapsing and blocking your airway while you sleep. They anchor securely to your upper jaw, which is a stable part of your skull, ensuring the lower jaw stays in the correct position.

When used with CPAP, the oral appliance acts as a first line of defense, opening your airway even before the CPAP machine delivers air. This means the CPAP doesn't have to work as hard, allowing for lower pressure settings. This often results in less air leakage, less mask pressure on your face, and a quieter experience, making your CPAP therapy much more tolerable. Our FDA-approved oral appliances for sleep apnea are designed with your comfort and effective treatment in mind.

What to Expect with Combination Therapy

If you're considering combination therapy, your journey will typically begin with a thorough evaluation. We'll discuss your sleep history, any challenges you've faced with previous treatments, and your overall health. We understand that no one wakes up wishing for a piece of plastic in their mouth; you're looking for the outcome, which is better sleep and improved health.

After a detailed assessment, we'll take precise measurements to create your custom oral appliance. When you receive your appliance, we'll ensure it fits comfortably. We'll check for any rough spots and make immediate adjustments. It's normal for it to take a few weeks to fully adjust to wearing the appliance nightly. We'll guide you through this process, offering tips like wearing it for an hour before bed to get used to it.



Once you're comfortable with your oral appliance, we'll work with your sleep physician to adjust your CPAP settings. The goal is to find the lowest effective pressure that, combined with your oral appliance, keeps your airway open and allows you to sleep soundly. Regular follow-up appointments will ensure your treatment remains effective and comfortable. We'll ask about your snoring, how you're feeling, and if you're still experiencing daytime sleepiness. Your feedback is crucial to fine-tuning your therapy.