INDIVIDUAL GUIDE · SLEEP AND COMFORT

Difficulty Sleeping with an Oral Appliance

ESTIMATED READING TIME · 5 MINUTES

Difficulty falling asleep is common in the first few nights of oral appliance use. Understanding that this is temporary and knowing strategies to adapt helps you establish comfortable use.

SYMPTOMS

What you may experience

  • 01Taking longer than usual to fall asleep
  • 02Awareness of the appliance that keeps you awake
  • 03Waking more frequently during the first few nights
  • 04Feeling that the appliance is distracting or uncomfortable
CAUSES

Why it happens

  • 01The unfamiliar sensation of having an object in the mouth
  • 02Anxiety or concern about the new treatment
  • 03Excess saliva production in the first few days
  • 04Adjustment to sleeping with the jaw in a forward position
PREVENTION

How to prevent it

  • 01Wear the appliance for a few hours while awake to get used to the feeling
  • 02Practice relaxation techniques before bed
  • 03Establish a consistent bedtime routine
  • 04Give yourself several nights to adapt before expecting normal sleep
HOME MANAGEMENT

What you can do at home

  • 01Try wearing the appliance while watching TV or reading to adapt
  • 02Use relaxation or breathing exercises to help fall asleep
  • 03Be patient; most patients adapt within 3 to 5 nights
  • 04Avoid removing the appliance mid-sleep if possible, as this reinforces the habit
WHEN TO CONTACT YOUR PROVIDER

When professional adjustment is needed

  • ▸Sleep difficulty that persists beyond one week
  • ▸Sleep loss that significantly affects daytime functioning
  • ▸Discomfort that prevents you from wearing the appliance at all
  • ▸Anxiety about the appliance that does not improve
FREQUENTLY ASKED QUESTIONS

Guide
FAQs.

EDUCATIONAL CONTENT ONLY · NOT MEDICAL ADVICE · CONSULT YOUR PROVIDER

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Difficulty Inserting or Removing the Appliance

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MEDICAL REVIEW & EDITORIAL STANDARDS
Originally Published
August 5, 2026
Last Updated
August 5, 2026
Last Reviewed
August 5, 2026
Next Scheduled Review
February 5, 2027
Evidence-Based References
  • —Sheats RD, Schell TG, Blanton AO, et al. — Management of Side Effects of Oral Appliance Therapy for Sleep-Disordered Breathing (Journal of Dental Sleep Medicine, 2017;4(4):111–125)
  • —Ramar K, Dort LC, Katz SG, et al. — Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015 (Journal of Dental Sleep Medicine, 2015;2(3))
  • —Levine M, Cantwell M, Postol K, Schwartz DB — Dental Sleep Medicine Standards for Screening, Treatment, and Management of Sleep-Related Breathing Disorders in Adults Using Oral Appliance Therapy: An Update (Journal of Dental Sleep Medicine, 2025;12(2))
  • —Doff MHJ, et al. — Long-term oral appliance therapy in obstructive sleep apnea syndrome: a controlled study on dental side effects (Clinical Oral Investigations, 2013; PubMed PMID 22562077)
  • —Doff MHJ, et al. — Long-term oral appliance therapy in obstructive sleep apnea syndrome: a controlled study on temporomandibular side effects (PubMed PMID 21538074)
  • —Paredes N, Colak O, Gargoum A, et al. — Anteroposterior and Vertical Effects of Mandibular Advancement Devices in Sleep-Disordered Patients: A Systematic Review (Journal of Dental Sleep Medicine, 2021;8(2))
  • —Yu J, et al. — Dental and skeletal changes of long-term mandibular advancement devices for obstructive sleep apnea: systematic review and meta-analysis (2024; PubMed PMID 39174171)