CPAP Alternatives


If you've been diagnosed with obstructive sleep apnea, it is likely that you've discussed or have already tried CPAP (Continuous Positive Air Pressure) treatment with your physician. While CPAP is the gold standard of treament, many patients are CPAP intolerant and almost 50% of patients who are prescribed a CPAP are non-compliant, stopping using the mask in under a year. The health risks of obstructive sleep apnea are severe, so treatment is vital. The good news is that there are CPAP alternatives which have proven to be highly effective in treating mild to moderate sleep apnea.

  • Oral Appliances
  • Lifestyle Modifications


Many patients with sleep breathing disorders who have difficulty tolerating a CPAP machine are successfully treated with dental sleep appliances. Custom-made oral appliances are highly effective for many of our patients for several reasons:

  • They open up the airway for unrestricted breathing
  • They’re quite comfortable appliances, with no head gear or straps around your face.
  • They’re silent, whereas the CPAP makes noise.
  • Small and convenient, they travel well.
  • For people with mild to moderate obstructive sleep apnea, they’re equally effective as CPAP.
  • Additionally, they can be used effectively for snoring and upper air resistance syndrome, even if you don’t have obstructive sleep apnea.

Dr. Picard specializes in working with patients with sleep breathing disorders or snoring, customizing these devices to give you healthy, restful sleep that is life-changing. We partner closely with sleep doctors and accredited sleep disorder centers to collaborate on your treatment plan.



Oral sleep apnea appliances look much like a mouth guard, but have some important differences. There are over a hundred FDA-approved oral appliances available, and we select and customize the right device for each patient's needs, depending on several factors. They are surprisingly comfortable and easy to get used to wearing during sleep. Note that over-the-counter boil-and-bite appliances are not FDA approved and some can ultimately lead to dental or jaw problems.

During sleep, when muscles relax, the lower jaw tends to move slightly backward toward the neck, which can collapse the airway. While CPAP opens the air passage through continuous air pressure, oral appliances move the lower jaw forward slightly to open the airway, creating the same effect far less intrusively. This makes it a very effective CPAP alternative for most patients with mild to moderate obstructive sleep apnea, particularly those who cannot tolerate CPAP. This eliminates apneic episodes and substantially reduces snoring.

Whether you choose CPAP or an oral appliance to treat sleep apnea, the results will be evident by whether or not your symptoms subside. Symptoms like snoring, waking with snorts or coughs through the night, waking with a sore throat or dry mouth, severe daytime drowsiness or fatigue, morning headaches, earaches, and irritability (of you and your partner, if applicable) should go away with effective treatment. You will have follow-up appointments iwth Dr. Picard to review your symptoms, make any adjustments necessary to ensure optimum comfort and success with treatment, and you will have a follow-up evaluation with your physician to determine if treatment is working.


Lifestyle changes are effective ways of mitigating symptoms of sleep apnea. Here are some tips that may help reduce apnea severity:

  • Lose weight. If you are overweight, this is the most important thing you can do to treat your sleep apnea.
  • Abstain from alcohol. Drinking causes frequent nighttime awakenings and makes the breathing muscles of the upper airway relax.
  • Quit smoking. Cigarette smoking worsens swelling in the upper airway, exacerbating apnea and snoring.
  • Lie on your sides instead of your back for sleeping. This can help alleviate breathing problems and snoring.