Snoring & sleep apnoea treatments
Intra-oral appliances - Mandibular advancement splints (MAS)
The MAS is the most common form of intra-oral appliance used in the management of sleep breathing disorders. Though there are considerable design variations, all MAS posture the mandible forwards with a degree of vertical opening.
Elimination of aggravating factors
It is prudent to eliminate potentially contributing factors: abstinence from alcohol and caffeine during the evening, avoidance of central nervous system depressants and adequate control of co-existing chronic obstructive airway disease (asthma or hypothyroidism).
Research shows that sleeping posture also has implications, with greater frequency when in the supine position (lying on one's back) compared with the lateral recumbent position (one's side). This is likely due to the effect of gravity on the tongue and enlarged soft palate.
Nasal obstructions may also have an impact. External nasal dilating devices have been shown to benefit severe snoring, whilst surgery appears to show little success: short-term results are limited and long-term results show that snoring can return (in addition, side effects such as pain, nasal regurgitation, swallowing problems, etc, are recorded). Despite the unpredictable direct effects on SBD, removal of nasal obstructions as first line care in facilitating other treatment regimes is often suggested.
The most patient-friendly MAS
Sleepwell - a clinically-proven treatment
The most patient-friendly MAS on the market with a success rate of over 80% (in fully apnoeic patients), Sleepwell is also the most technically advanced. Tested in a randomised controlled cross-over trial against CPAP and a placebo, the full clinical trial information can be found below.
Sleepwell is fully patient adjustable - a simple adjustment can modify the degree of mandibular advancement, negating the need for further clinical visits for simple titration.
Sleepwell is also uniquely designed with internal splint fixing, allowing the lips to be closed around the device, preventing dry lips and excess salivation associated with other splints. High levels of patient comfort meant that during clinical trials over 98% of patients found the device acceptable.
Designed and manufactured in the UK, the device is moulded specifically to patient impressions.
- Internal fixings result in high patient comfort
- Full-patient adjustment
- Soft, slim-lined two-piece device meaning full lateral movement
- Mitigates potential TMJ stress
- In-mouth movement reducing likelihood of dislocation
- Clinically proven and effective
Find out more about the Sleepwell on our sponsored 'Snoring - a role for the GDP' with Professor Ama Johal, a doctor with a special interest in snoring.
Download our pre-screening questionnaire for snoring and sleep apnoea
Barnes et al (2004). Efficacy of Positive Airway Pressure and Oral Appliance in Mild to Moderate Obstructive Sleep Apnoea.
Johal et al. (2016). The Efficacy of Mandibular Advancement Appliances as a Treatment Alternative to CPAP in Moderate OSAHS.
Bridget Simpson - GDP in Cornwall
"Mr Wood, my principal’s patient who had destroyed all previous appliances with his nocturnal bruxism, had a Class II malocclusion with his lower incisors closing somewhere back near his upper premolars and was edentulous distal to his lower left canine, for whom snoring had been such a problem since his late teens that he had undergone painful surgery (removal of his uvula and part of the soft palate) which had stopped the problem for exactly 4 nights!
Mr Wood, an intelligent, articulate patient who knew he was my first and who didn’t spare me with his questions (thank you, Mr Johal, I was well briefed). My main concern was that the bite and the short lower arch would mean that it was not possible to construct a satisfactory appliance. However, Matt, S4S’s senior technician, held my hand over the phone, and was consistently encouraging and helpful. Our first attempt was an excellent fit, but Mr Wood couldn’t procline sufficiently to engage the appliance. On the second attempt we were about 1mm off, but I was afraid to push the patient further forward.
Third attempt – bingo and the reassurance from Matt that this had been an exceptionally difficult case. And for Mr Wood – after decades of snoring, he has a new life. A new life that started on the first night that he used his Sleepwell device. A social life that is uninhibited by snoring, a better quality of sleep and, imagine, the difference to his wife and family.
Finally, it has to be said that the Sleepwell appliance is unquestionably a profitable treatment to provide in general practice, as well as, potentially, a great practice builder. However, the satisfaction in making such a difference in someone’s life is incomparable. I now understand, so well, the enthusiasm of Ama Johal and the team and, unusually for me, I have a new technique and I can’t wait for the next one. Attend a S4S seminar and I’m sure you’ll feel the same."
Dr Atherton - GDP in West Yorkshire
“I have put what I learnt into practice already with successful results so I’m pleased” the lab support from S4S and the quality of the appliance itself has helped give him the confidence to help his patients, “The lab gave excellent advice about the impression materials and once I provided treatment myself, I was impressed with the appliance, it was well made and fitted perfectly. S4S also provide help to gauge the severity of the problem, and to ensure that the patient is suitable for this type of appliance.The treatment has been a great success. This patient actually bought two of the devices so he would always have a spare and I think there is greater domestic harmony now that he and his wife are not forced to sleep in separate rooms because of his disruptive snoring.”
David Thompson - Director Anaplastology
"Earlier in 2009 my company started supplying S4S Sleepwell anti snoring devices to patients with a snoring disorder, and it has proven to be wise decision.
Since using the Sleepwell anti snoring devices from S4S, our clinicians say that this device is easier to fit, and that patients report higher levels of satisfaction in using the Sleepwell to solve their snoring problem. Using the Sleepwell has resulted in reducing the clinical time for each patient and improved profitability.
The dedication S4S have to high standards in customer satisfaction through communication and investing in the training of their technical staff has given me confidence in this company and their product. I find that I receive the finished device on time, neatly packed and ready for the clinic. This means that I can make the appointment with the patient to return for the fitting of the Sleepwell with confidence.
Communication with S4S is easy and effective either by telephone or Email. I can talk directly to the technician involved with making a device for a particular patient.
S4S and the Sleepwell anti snoring treatment work efficiently and effectively, and I am delighted with the improvement in patient satisfaction and profitability I have experienced."