The Science Behind Mandibular Advancement Devices (MADs): How They Work

• Mandibular advancement devices gently move the lower jaw forward to keep the airway open during sleep
• Clinically proven oral devices can effectively treat mild to moderate obstructive sleep apnea
• Custom-fit, doctor-directed devices are very different from store-bought mouthguards
• Daybreak offers a customized, at-home path from diagnosis to treatment

A mandibular advancement device (MAD) is a custom oral appliance worn during sleep to treat obstructive sleep apnea and chronic snoring. It fits over the upper and lower teeth and gently moves the lower jaw forward, helping keep the airway open throughout the night.

This forward positioning prevents the jaw and tongue from collapsing backward, thereby reducing airway obstruction and allowing air to flow more freely. As a result, the device stabilizes breathing, reduces snoring, and decreases sleep disruptions caused by apnea events.

MADs are part of oral appliance therapy, a clinically recognized treatment option prescribed by sleep specialists for certain patients, including those with mild to moderate obstructive sleep apnea or those who cannot tolerate CPAP therapy.

To understand how mandibular advancement devices work, it is helpful to examine what happens to the airway during sleep. As the body relaxes, the muscles in the jaw, tongue, and throat naturally relax. In some individuals, this condition causes the tongue and surrounding soft tissues to fall backward into the airway, resulting in restricted airflow, snoring, and breathing pauses. This mechanism is common in obstructive sleep apnea and is often more pronounced in cases of severe OSA, where airway collapse occurs more frequently.

Mandibular advancement devices counteract this process through gentle mechanical repositioning by:

• Advancing the lower jaw forward, which helps stabilize the airway
• Preventing the tongue from collapsing backward during sleep
• Increasing the space in the upper airway, making it easier for air to flow

This repositioning reduces airway obstruction and minimizes the vibrations that cause snoring. More importantly, it helps prevent repeated breathing interruptions that fragment sleep, resulting in more consistent airflow, fewer apnea events, and deeper, more restorative sleep—without the need for masks, hoses, or external machines.

When properly fitted and adjusted under medical guidance, MADs are designed to strike a balance between effectiveness and comfort, thereby reducing the risk of side effects such as jaw pain during the adaptation period.

Mandibular advancement devices offer several meaningful benefits for people with obstructive sleep apnea or chronic snoring. By reducing breathing interruptions during sleep, many patients experience improved sleep quality and wake up feeling more rested, alert, and less affected by daytime sleepiness.

Additional benefits include:

• Significant reduction in snoring and breathing pauses
• A non-invasive, mask-free alternative to CPAP therapy
• Greater comfort and ease of use for many patients
• More consistent nightly use, as oral devices are often easier to tolerate
• Portable and travel-friendly, with no machines or power source required

Clinical studies also suggest that when obstructive sleep apnea is effectively treated, specific cardiovascular risk markers, such as blood pressure, may improve. While mandibular advancement devices are not a cure for sleep apnea, they are clinically proven to treat specific forms of the condition when properly prescribed and monitored.

Yes, specific mandibular advancement devices are FDA-cleared medical devices for the treatment of obstructive sleep apnea and snoring. FDA clearance indicates that a particular device meets established standards for safety and effectiveness when used as intended; however, it does not apply to oral appliances as a general category.

Because of this, mandibular advancement devices should always be used under the guidance of a qualified healthcare provider. Medical oversight helps ensure the device is appropriate for your condition and properly fitted.

Daybreak’s mandibular advancement device is FDA-cleared and provided as part of a doctor-directed treatment program, offering an added level of safety and confidence.

A mandibular advancement device works best when they are custom molded to the individual’s teeth. While MADs are sometimes mistaken for simple dental devices, they are medical oral appliances that require precise customization and oversight when used for treating OSA.

A properly fitted MAD requires:

• Precise customization to your teeth and jaw structure
• Gradual, personalized jaw advancement
• Monitoring and follow up to ensure comfort and effectiveness

Doctor-directed care helps ensure the device remains comfortable, effective, and safe for long-term nightly use.

Mandibular advancement devices are not appropriate for everyone, but they can be an excellent option for many people.

Good candidates often include:

• Adults with mild to moderate obstructive sleep apnea
• People who snore or experience daytime fatigue
• Patients who cannot tolerate or prefer not to use CPAP therapy
• Individuals seeking a non-invasive, at-home treatment option

Final eligibility is always determined by a sleep professional based on diagnostic results, anatomy, and overall health.

The science behind mandibular advancement devices is well established. By gently repositioning the lower jaw, MADs help prevent airway collapse and support steady breathing throughout the night. Decades of clinical research support their use as a legitimate, doctor-approved option for treating OSA in appropriate patients.

Daybreak applies this proven science in a way that prioritizes comfort, convenience, and clinical oversight. The entire process—from diagnosis to treatment—happens at home and includes:

• A two-night, 98% accurate at-home sleep test
• Test interpreted and Diagnosis by licensed physician (MD)
• A custom-fit, FDA-cleared mandibular advancement device
• Ongoing clinical support and health insurance assistance

There’s no sleep lab, no CPAP equipment, and no guesswork—just a clear, streamlined path to better sleep.

Take Daybreak’s 30-second sleep assessment to see if you’re a good fit.

1. Does insurance cover mandibular advancement devices?

In many cases, mandibular advancement devices are covered by insurance when prescribed to treat obstructive sleep apnea. Coverage varies by plan, which is why providers like Daybreak help patients check benefits and navigate insurance options.

2. How long does it take for a mandibular advancement device to work?

Some people notice improvements in snoring and sleep quality within the first few nights of use. Optimal results typically develop over a few weeks to months as the device is adjusted and the body adapts.

3. What are the potential drawbacks of mandibular advancement devices?

Most side effects are mild and temporary, such as jaw soreness or tooth discomfort, which typically occur during the adjustment period. Teeth shifting or bite changes may occur, but these are often minimized by conservative advancement techniques, jaw exercises, and frequent use of the AM Reposition, or “Rise and Bite” device. Proper fitting and ongoing medical oversight help minimize risks and support long-term comfort and effectiveness.