In adults with mild-to-moderate obstructive sleep apnea, what is the primary treatment modality?

• A. CPAP therapy
• B. Oral appliance therapy
• C. Surgical uvulopalatopharyngoplasty
• D. No therapy

Answer: (B)

For mild-to-moderate obstructive sleep apnea, using an oral appliance to advance the mandible is a common first-line option because it directly helps keep the airway open during sleep by moving the jaw forward. This mechanical effect reduces airway collapsibility and lowers the number of breathing interruptions, which translates into better sleep quality and daytime functioning for many patients.

The appeal lies in real-world practicality: many adults tolerate and adhere to an oral appliance better than a CPAP mask, so the net effect is often greater daily functioning and quality of life. While CPAP is highly effective when worn, its adherence challenges mean oral appliances can be the more successful choice for achieving consistent relief in mild-to-moderate cases. Surgery is more invasive and reserved for specific anatomical issues or when non-surgical options have failed, and doing nothing is not appropriate for symptomatic OSA. Note that oral appliances may be less effective than CPAP in more severe disease and require a dental evaluation to ensure fit and to monitor for dental or TMJ issues.