CPAP is the gold standard for sleep apnea — but only when you actually wear it. Studies show that a significant portion of CPAP patients stop using their machine within months. For patients who can’t tolerate CPAP, oral appliance therapy is the recommended alternative by the American Academy of Sleep Medicine — small, silent, mask-free, and covered by medical insurance.
Estimates suggest that 30–50% of CPAP-prescribed patients are non-compliant within the first year. If you've abandoned your CPAP — or are struggling to use it consistently — the issue is almost never willpower. These are the most common reasons patients stop:
We review your existing sleep study, AHI score, CPAP prescription, and compliance history. Bring your sleep study results if you have them — or we can request records from your sleep physician.
We communicate with your prescribing sleep physician or pulmonologist — sharing our treatment plan, getting a referral if needed, and ensuring the transition is medically coordinated and covered by insurance.
Digital scans taken and a precision-fit mandibular advancement device fabricated. The appliance is gradually adjusted over follow-up appointments to find the optimal jaw position that controls apnea events and remains comfortable.
A follow-up sleep test — home sleep test or in-lab — confirms the oral appliance is adequately controlling apnea events. Results are shared with your sleep physician. Annual monitoring and appliance replacement as needed.
I was prescribed CPAP and lasted three weeks before I gave up. My sleep physician referred me to Dr. Giannelli for an oral appliance. I've worn it every night for two years without a problem. My follow-up sleep study showed my AHI dropped from 28 to 3. I wish I'd known this was an option from the start.
I travel for work three weeks a month. Bringing a CPAP was a nightmare — forgotten distilled water, adapters, TSA checks. The oral appliance fits in my toiletry bag. I use it every single night now, which I never did with the CPAP. My energy levels are completely different
For mild to moderate OSA, clinical studies show oral appliance therapy achieves comparable outcomes to CPAP in most patients — and meaningfully better real-world outcomes when compliance is accounted for. An appliance worn every night at 85% efficacy outperforms a CPAP machine worn three nights a week at 100% efficacy. For severe OSA, CPAP remains the gold standard when tolerated — but OAT is still recommended when CPAP compliance has genuinely failed.
We recommend coordinating the switch with your sleep physician rather than stopping CPAP on your own — both for clinical safety and insurance coverage. Dr. Giannelli works directly with your prescribing physician to document the CPAP intolerance, establish the OAT referral, and ensure treatment continuity. Most sleep physicians actively support the switch for non-compliant patients.
Your existing sleep study and diagnosis typically satisfies the requirement for fabricating an oral appliance — you don’t need to be re-diagnosed. However, a follow-up sleep study after fitting is important and recommended to confirm the oral appliance is adequately controlling apnea events. This follow-up test is also typically covered by medical insurance.
Yes — most medical insurance plans, including Medicare, cover oral appliance therapy for diagnosed sleep apnea regardless of prior CPAP prescription. Coverage typically requires documentation of the diagnosis, a physician referral, and pre-authorization. We manage the entire insurance process on your behalf and verify your coverage before treatment begins.
The full clinical picture — how oral appliances work, who they're right for, and what the treatment process looks like.
The same custom oral appliance that treats sleep apnea is also highly effective for primary snoring — with sleep apnea screening built in.
TMJ disorders and sleep-disordered breathing frequently coexist — both are assessed and addressed together in our practice.
Schedule your CPAP alternative consultation at Bluffside Smiles Dental in La Crosse — and find out if an oral appliance is right for you.