Combined Therapy for Sleep Apnea

While oral appliance therapy and CPAP therapy are both effective ways of treating sleep apnea, many patients are not able to receive complete relief from just one. Thankfully, Dr. David Schwartz and our team at Dental Professionals can also offer combined therapy for sleep apnea. This approach allows us to tailor our treatment to the exact needs of our patients and provide them the ultimate solution to their sleep problems. 


Continuous positive airway pressure (CPAP) therapy is currently the most common approach physicians use to treat sleep apnea. It involves a patient wearing a facemask that is connected to an air pump. This pump forces air into a patient’s throat in order to prevent breathing obstruction related to sleep apnea. While it has been shown to be extremely effective for those suffering from severe obstructive sleep apnea (OSA) and central sleep apnea (CSA), many patients have difficulty falling asleep because of the machine itself. The sensation of the air going into their throat can be very uncomfortable, and the mask often creates feelings of claustrophobia. Also, the machine can create quite of bit of noise, which can be disturbing to both the patient and their bed partner. These issues and more are why nearly 50% of CPAP patients stop using it within one year.


A major alternative to CPAP therapy is oral appliance therapy. These custom-made mouthguards are ideal for patients with mild OSA, who snore or have problems sleeping with their CPAP. They work by gently shifting the jaw forward to prevent the soft tissues in the throat and the tongue from obstructing the airway. They are fabricated using high-quality materials to assure they are comfortable, flexible, and durable. They are easy to use, maintain, and travel with, which is why patients typically have a much higher compliance rate with them. They are often able to get the same results without the discomfort of a CPAP machine, which is why The American Academy of Sleep Medicine and The American Academy of Dental Sleep Medicine often recommend them as the primary form of treatment for many patients.


Combined therapy allows a patient to benefit from the best qualities of each treatment method at once. By using a CPAP machine in conjunction with an oral appliance, more patients are able to get a solution tailored to their particular needs. It allows patients who suffer from severe OSA or CSA to benefit from the comfort and ease of oral appliance therapy without having to give up the reliability of their CPAP.  When a patient uses combined therapy, they’ll be able to wear just a nasal mask rather than a full facemask. This makes it much easier for people to sleep with their CPAP because they don’t feel so constricted. Also, because the oral appliance is shifting their jaw slightly forward, they can set the CPAP to a lower setting. This helps cut down on the noise as well as the sensation of air being pumped into the throat. The end result is a patient who is finally able to sleep comfortably and healthily throughout the entire night.


Of course, while combined therapy is excellent for some patients, it is not a “one-size-fits-all” kind of treatment. Combined therapy is often best for patients who:

  • Are CPAP intolerant or have difficulty using their CPAP regularly
  • Do not achieve relief from their sleep apnea with just oral appliance therapy
  • Do not achieve relief from their sleep apnea with only CPAP therapy


Combined therapy offers a multitude of benefits for those patients who can’t find relief using just one treatment method:

  • More Comfort – Combined therapy allows a patient to wear a small nasal mask with their CPAP as opposed to the constricting face mask. Also, thanks to the help of the oral appliance, the CPAP can be put on a lower setting, which minimizes the sensation of air being pushed into the throat and even reduces noise.
  • Easier Compliance – The biggest problem with a CPAP machine is that so many patients do not consistently use it because it is uncomfortable. With combined therapy, they are able to rest more peacefully and easily, which makes it much easier for patients to reliably use it. This will enable them to get the correct amount of sleep each night, which will have dramatic benefits for their overall health.
  • Increased Effectiveness –According to a number of studies conducted by The American Academy of Dental Sleep Medicine, combined therapy is able to significantly reduce the number of apnea events (times where a person’s breathing has stopped for more than 10 seconds) people experience throughout the night.  One study found that patients with no treatment experienced about 6 apnea events per hour, while those with CPAP therapy had about 4. With combined therapy, that number dropped to 2. These results have been replicated in multiple studies, showing that combined therapy is able to maximize the effectiveness of both CPAP therapy and oral appliance therapy.
  • Increased Convenience – A CPAP machine is extremely hard to travel with, so for business people on the go, they usually just leave it at home. For patients using combined therapy, they can simply bring their oral appliance with them. They’re small, easy to pack, and can assure that they’ll always get the rest they need no matter where they are.



If you are dealing with sleep apnea but can’t get the rest you need with your CPAP machine or oral appliance, combined therapy might finally be your answer. When you come to visit Dental Professionals for your consultation, Dr. Schwartz and our team will review past treatment plans, sleep study results, and several other diagnostics. Using this information, we’ll be able to determine if combined therapy is right for you. No matter what treatment plan we recommend, the end result will always be a full night’s sleep and an energetic morning. If you’d like to know more about combined therapy, be sure to contact our Chicago, IL, or Skokie, IL office today. We’re also proud to serve patients in the Evanston, Chicago, Wilmette, and Cook County areas.

Call Chicago Office Phone Number 312-938-3999 our Chicago Office with questions or to make an appointment.

Call Skokie Office Phone Number 847-676-1432 our Skokie Office with questions or to make an appointment.

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