--- type: Article title: "Snoring and Sleep Apnea" description: "Custom oral appliance for snoring and sleep apnea, made in our in-house master lab in Cologne. An option for snoring and mild to moderate sleep apnea." resource: https://www.just-kfo.de/en/competencies/snoring-and-sleep-apnea/ language: en tags: [orthodontics, services] timestamp: 2026-09-14T03:17:20+02:00 --- # Snoring and Sleep Apnea Expertise · Snoring & sleep apnea Mandibular Advancement Device in Cologne – Cost, Insurance & Procedure for Snoring and Sleep Apnea Loud snoring or nighttime breathing pauses? A custom-fitted mandibular advancement device gently holds the lower jaw forward during sleep and widens the airway – gentle, quiet, and completely mask-free. Book an appointment onlineHow the appliance helps ★5,0 · 228 Google reviews At a glance Snoring occurs when the soft tissue in the throat relaxes during sleep and the flow of air narrows the airway. In mild to moderate obstructive sleep apnea, an individually measured mandibular advancement device gently holds the lower jaw forward – so the airway stays open. Symptom: loud snoring, pauses in breathing, daytime fatigueTreatment: custom-fitted mandibular advancement deviceBenefit: quiet, no mask, from our in-house master dental laboratoryCost: custom-fabricated approx. 1.000–2.200 eurosInsurance: when sleep apnea is medically confirmed and CPAP cannot be successfully used (since 2021)Adjustment: first nights to a few weeks, checkup every 6–12 months 5,0228 Google reviews No maskquiet appliance instead of a CPAP machine 50 weeksopen per year In-house master dental laboratoryAppliances made in Cologne 1 Consultation2 3D Scan3 Appliance Book an appointment online How It WorksWho It's ForProcedureCost & InsuranceFAQ A mandibular advancement device (oral appliance for snoring) gently holds the lower jaw forward during sleep, keeping the airway open – effective against snoring and for mild to moderate obstructive sleep apnea. Custom-made devices typically cost around 1.000–2.200 euros; statutory health insurance may cover the cost for medically confirmed sleep apnea under certain conditions. Whether sleep apnea underlies your snoring must be clarified by sleep medicine beforehand – not in the dental chair. How a Mandibular Advancement Device Works Snoring occurs when the muscles relax during sleep, the lower jaw and tongue sink backward, and the soft tissues in the narrowed throat begin to vibrate. The device works mechanically: it holds the lower jaw in a stable, slightly advanced position, the tongue does not fall back, and the airway remains open. A custom-fabricated device consists of two parts – one for the upper jaw, one for the lower jaw – connected by a mechanism and adjustable in small increments. This is exactly what distinguishes it from a boil-and-bite appliance: it fits more precisely, does not press on individual teeth, and can be adjusted if the effect is lacking. We fabricate it after digital scanning in our in-house master dental laboratory using 3D printing; more details in the article on 3D-printed mandibular advancement devices. Who the Device Is Suitable For – and Who It Is Not For disruptive snoring without breathing pauses and for mild to moderate obstructive sleep apnea, the mandibular advancement device is a guideline-supported treatment.1 In severe sleep apnea, positive airway pressure therapy with a mask (CPAP) remains the standard; the device is considered there only when CPAP cannot be successfully used. Sleep apnea is measured by the Apnea-Hypopnea Index (AHI), the number of breathing pauses per hour: up to 5 unremarkable, 5–15 mild, 15–30 moderate, over 30 severe. How strongly the device works varies from person to person and is monitored by sleep medicine – and it works only if it is worn throughout every night. Good to know: Men snore about twice as often as women (evaluation of 63 studies with around 215,000 participants)7; snoring increases with age and the difference becomes smaller. Those affected often do not notice it themselves – the partner does. When Snoring Is Dangerous Snoring can be more than just disruptive. Obstructive sleep apnea is a risk factor for high blood pressure, cardiac arrhythmias, heart attack and stroke, for microsleep while driving, and for depression. Watch for these signs – in yourself or in the person next to you: Pauses in breathing during sleep, often followed by loud snoring or gasping for air Pronounced daytime sleepiness, falling asleep while reading or watching TV Difficulty concentrating Headaches and dry mouth in the morning When you should have it checked: if you have one or more of these signs – through your primary care practice, an ENT practice, or a sleep lab. An oral appliance that masks untreated sleep apnea obscures the actual problem. Diagnosis comes before the device Whether sleep apnea lies behind the snoring cannot be determined in the treatment chair. If you already have a sleep medicine report, bring it to the initial consultation – then we can plan directly. Without a report, we'll tell you what the shortest path is. About 95 percent of people with obstructive sleep apnea snore; that's why, before fitting any oral appliance, we work together with a physician qualified in sleep medicine to clarify what's behind your snoring. How the fitting works at our practice Consultation and diagnosis Digital scan instead of impression Fabrication in our in-house master dental laboratory Adjustment and follow-up Step 1: Consultation and diagnosis We discuss your symptoms and the sleep medicine report, and we examine your teeth, jaw joints and bite – not every dentition is suited for a mandibular advancement device. Step 2: Digital scan instead of impression The basis for the appliance is a 3D scan of both jaws – without impression material and without gagging. Step 3: Fabrication in our in-house master dental laboratory The appliance is fabricated in-house by 3D printing – repairs and adjustments are done without mailing delays. Step 4: Adjustment and follow-up The amount of protrusion is adjusted in small increments; many people notice a change in the first few nights, but it can take several weeks to reach the right setting. After that, we check the fit and condition every six to twelve months. Book an initial consultation now What does a mandibular advancement device cost – and will health insurance pay? The costs for a mandibular advancement device vary depending on the model, material and individual fitting. Typically, prices range between 1.000 and 2.200 euros. Additional costs may arise for regular follow-up appointments and adjustments. For a comparison of the costs of all types of oral appliances – from aligners to retainers – see the article What does an oral appliance cost? When statutory health insurance covers the cost The Federal Joint Committee (G-BA) added the mandibular advancement device to the benefit catalog on November 20, 2020; the resolution took effect in February 2021,4 and the dental regulations followed on May 6, 2021.3 Three conditions must be met: There is a medically confirmed obstructive sleep apnea in an adult person. The positive airway pressure therapy with a breathing mask (CPAP) cannot be used successfully. The prescription comes from a practicing physician with qualifications in sleep medicine. Fabrication, adjustment, and follow-up are then carried out by a dentist or orthodontist.5 If the conditions are not met For snoring alone without sleep apnea, the device is a private service. We clarify what applies in your case before treatment begins — you receive the costs in writing in advance, not only with the invoice. Legal status: September 13, 2026. We review this information once a year. Appliance from the drugstore or from an orthodontist? Prefabricated anti-snoring devices from pharmacies, drugstores, or online retailers are heated at home in a water bath and adapted to one's own teeth by biting down. For occasional snoring without other complaints, this can be worth a try. A mandibular advancement device fabricated in the laboratory, on the other hand, is custom-made from a digital scan and adjusted in small increments. This is more complex, but it fits more accurately, does not press on individual teeth, and can be modified if it does not work. In a randomized comparison study, a laboratory-fabricated device was successful in 60 percent of participants, a prefabricated device from a water bath in 31 percent.6 A custom-fabricated device also fits securely on both arches — swallowing it during sleep is therefore very unlikely, unlike models that can come loose. Risks and side effects Two things must be considered separately. In the short term, mild jaw pain or tension, increased saliva, or dry mouth are common; these usually subside after the adjustment period. In the long term, the occlusion changes in some wearers. A systematic review of 14 studies with at least four years of follow-up finds measurable changes: the upper front teeth tip backward, the lower ones tip forward, overbite and overjet become smaller.2 This is neither rare nor always minor. This is precisely why a mandibular advancement device requires regular orthodontic monitoring — such changes are detected early there, and the device can be adjusted. Anyone who wears the device for years should know this and be able to participate in the decision. Frequently asked questions about oral appliances for snoring Tap a question to open the answer. Where can I get a mandibular advancement device in Cologne? +You can get a custom-made mandibular advancement device (an appliance that holds the lower jaw forward) at JUST KFO – Dr. Steinmaier & Kollegen in Köln (Hauptstraße 50). The appliance is custom-made in our in-house master dental laboratory after a digital 3D scan and is used in coordination with sleep physicians and ENT doctors – effective against snoring and mild to moderate obstructive sleep apnea. Unlike standard appliances from the drugstore, the custom-made device fits precisely and is fine-tuned to your individual degree of advancement. You can book a consultation appointment online. How much does a mandibular advancement device cost? + Costs depend on type, material, and manufacturer. An individually fitted mandibular advancement device usually costs between 1,000 and 2,200 euros in Germany. In cases of medically confirmed obstructive sleep apnea, statutory health insurance covers the device if continuous positive airway pressure therapy (CPAP) cannot be used successfully — details in the section Costs and Insurance. How well do mandibular advancement devices work? + Mandibular advancement devices are an established option for snoring and for mild to moderate obstructive sleep apnea. A custom-fitted device moves the lower jaw slightly forward and thereby helps keep the airway open – the soft palate and tongue are less likely to fall back. This reduces snoring and pauses in breathing. Compared with CPAPtherapy or surgery, it is less invasive and easier to use. When it fits well, it can noticeably improve sleep quality. In a randomized study using custom-made devices, 84 percent of bed partners reported quieter snoring and 76 percent reported snoring on fewer nights per week. Who prescribes a mandibular advancement device? + A mandibular advancement device can be prescribed by a dentist, an orthodontist or a sleep physician. Orthodontists have particular experience in making and fitting these devices, since snoring is often related to jaw or tooth misalignment. Before a device is fitted, the underlying causes should be carefully investigated. Since 2021 the following applies in Germany: if a physician has diagnosed obstructive sleep apnea, statutory health insurance may cover a mandibular advancement device under certain conditions. What helps against snoring right away? + A few measures can reduce snoring quickly: Sleeping position: sleeping on your side or with your head slightly raised improves airflow. Relaxing the jaw muscles: targeted exercises can help. Nasal strips or nasal dilators: these improve breathing through the nose. Avoiding alcohol and sedatives: they relax the muscles of the throat and make snoring worse. Mandibular advancement device: a custom-fitted device often reduces snoring considerably. Which option suits you best is something we clarify after a diagnosis. Avoid alcohol in the evening – in an analysis of 13 sleep laboratory studies, there were on average around four more pauses in breathing per hour with alcohol than without. Can a dentist help with snoring? + Yes – a dentist can improve your oral health and fit a mandibular advancement device. An orthodontist additionally brings experience with jaw misalignment and airway problems, which are often behind snoring. The orthodontist investigates the cause and offers a suitable therapy – for example a mandibular advancement device, jaw correction or exercises for the jaw muscles. Around 95 percent of people with obstructive sleep apnea snore – which is why, before any device is fitted, we work together with a physician qualified in sleep medicine to find out what lies behind your snoring. Can an ENT doctor help with snoring? + Yes – an ENT doctor examines the airways and may recommend, for example, nasal surgery or CPAP therapy. If the snoring is related to the jaw or the teeth, the orthodontist adds a mandibular advancement device or jaw correction. The two often work together in order to cover both cause and treatment comprehensively. In a randomized study, the number of nighttime breathing pauses after palate-and-throat surgery fell below 20 per hour in 59 percent of those who had the operation, compared with 6 percent in the untreated control group – whether such a procedure is an option is decided by the ENT doctor. How effective are mandibular advancement devices? + They are effective for snoring and mild to moderate sleep apnea.1 The device advances the lower jaw slightly forward and keeps the airway open, reducing snoring and breathing interruptions. For most patients, snoring can be successfully reduced or eliminated this way. It is less invasive than CPAP or surgery; what matters are precise, individual fitting and correct positioning. For mild to moderate obstructive sleep apnea, mandibular advancement devices are a guideline-supported alternative to CPAP therapy.1 Which mandibular advancement device is best? + The best appliance depends on your individual needs—in most cases, a custom-made device from an orthodontist is the right choice. It should fit comfortably, not disturb your sleep, and be made of high-quality, hygienic material. Because it is tailored to your anatomy, it usually fits more comfortably than a prefabricated appliance. In a randomized comparison study, a custom-made appliance fabricated in the laboratory was successful in 60 percent of participants, while a prefabricated appliance from a boil-and-bite kit was successful in only 31 percent. How long does a mandibular advancement device last? + How long a device lasts depends on the material, how it is used and how it is cared for. A high-quality, custom-fitted device normally lasts a long time. Over time, however, it can wear down – have it checked regularly and readjusted if needed so that it remains effective. We will also give you tips on caring for it. In one observational study, the average time a device was worn before being replaced was just under three years; independently of this, the condition of the device should be checked every six to twelve months, depending on your individual risk profile. How do you stop someone from snoring? + Snoring is best stopped by addressing its cause. To do this, the orthodontist determines what lies behind it – for example a narrowed airway or a jaw or tooth misalignment – and recommends a suitable treatment: a mandibular advancement device (it moves the lower jaw forward and helps keep the airway open), a jaw correction, or specific exercises for the jaw muscles. In most people, snoring can be reduced or eliminated this way. In around 62 percent of those affected, the nighttime pauses in breathing occur mainly when lying on the back, and aids that prevent sleeping on the back reduced their number in studies by an average of about 43 percent. Can you train yourself out of snoring? + Partly – certain exercises can strengthen or relax the jaw and throat muscles and reduce snoring; however, they have to be done in a targeted way and regularly. Often a treatment tailored to the cause is more effective: after a diagnosis, options include a mandibular advancement device, a jaw correction or additional exercises. This combination usually gives more lasting results. In a review of nine studies, targeted exercises for the tongue, palate and throat reduced the proportion of sleep time spent snoring from around 14 to about 4 percent on average – but only with regular practice over several months. How quickly does a mandibular advancement device work? + Many notice improvement within the first few nights. It may take several weeks for the lower jaw to adjust to the advanced position and for the optimal setting to be found; readjustment is normal. How do I properly care for my mandibular advancement device? + Clean daily with lukewarm water and a soft toothbrush. Hot water will warp the material. During follow-up appointments, we check fit and condition. When does snoring require medical attention instead of a device? + If you experience breathing interruptions, severe daytime fatigue, or morning headaches, the first step is a sleep medicine evaluation. Only after a confirmed diagnosis can it be determined whether a mandibular advancement device is the appropriate therapy. +Sources & studies on snoring & sleep apnea Sources: Chan, C., Wong, B.M., Tang, J., & Ng, D.K., 2012. Gender difference in snoring and how it changes with age: systematic review and meta-regression. Sleep and Breathing, 16(4), 977–986. https://doi.org/10.1007/s11325-011-0596-8 Ramar, K., Dort, L.C., Katz, S.G. et al., 2015. Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy. Journal of Clinical Sleep Medicine, 11(7), S.773–827. https://doi.org/10.5664/jcsm.4858 Marklund, M., Persson, M. und Franklin, K.A., 1998. Treatment success with a mandibular advancement device is related to supine-dependent sleep apnea. Chest, 114(6), S.1630-5. https://doi.org/10.1378/chest.114.6.1630 Vanderveken, O.M., Devolder, A., Marklund, M., Boudewyns, A.N., Braem, M.J., Okkerse, W., Verbraecken, J.A., Franklin, K.A., De Backer, W.A. und Van de Heyning, P.H., 2008. Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. Am J Respir Crit Care Med, 178(2), S.197-202. https://doi.org/10.1164/rccm.200701-114OC Sutherland, K., Vanderveken, O.M., Tsuda, H., Marklund, M., Gagnadoux, F., Kushida, C.A. und Cistulli, P.A., 2014. Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med, 10(2), S.215-27. https://doi.org/10.5664/jcsm.3460 Lettieri, C.J., Paolino, N., Eliasson, A.H., Shah, A.A. und Holley, A.B., 2011. Comparison of adjustable and fixed oral appliances for the treatment of obstructive sleep apnea. J Clin Sleep Med, 7(5), S.439-445. https://doi.org/10.5664/JCSM.1300 Okuno, K., Sato, K., Arisaka, T., Hosohama, K., Gotoh, M., Taga, H., Sasao, Y., & Hamada, S. (2014). The effect of oral appliances that advanced the mandible forward and limited mouth opening in patients with obstructive sleep apnea: a systematic review and meta-analysis of randomised controlled trials. Journal of oral rehabilitation, 41(7), 542–554. https://doi.org/10.1111/joor.12162 Petit, F.X., Pépin, J.L., Bettega, G., Sadek, H., Raphaël, B. und Lévy, P., 2002. Mandibular advancement devices: rate of contraindications in 100 consecutive obstructive sleep apnea patients. Am J Respir Crit Care Med, 166(3), S.274-278. https://doi.org/10.1164/rccm.2008167 Gagnadoux, F., Fleury, B., Vielle, B., Pételle, B., Meslier, N., N’Guyen, X.L., Trzepizur, W. und Racineux, J.L., 2009. Titrated mandibular advancement versus positive airway pressure for sleep apnoea. Eur Respir J, 34(4), S.914-920. https://doi.org/10.1183/09031936.00148208 Zhu, Y., Long, H., Jian, F., Lin, J., Zhu, J., Gao, M., & Lai, W. (2015). The effectiveness of oral appliances for obstructive sleep apnea syndrome: A meta-analysis. Journal of dentistry, 43(12), 1394–1402. https://doi.org/10.1016/j.jdent.2015.10.008 Chan, A.S.L., Lee, R.W.W., & Cistulli, P.A.C., 2007. Dental appliance treatment for obstructive sleep apnea. Chest, 132(2), S.693-699. https://doi.org/10.1378/chest.06-2038 Bartolucci, M. L., Bortolotti, F., Corazza, G., Incerti Parenti, S., Paganelli, C., & Alessandri Bonetti, G. (2021). Effectiveness of different mandibular advancement device designs in obstructive sleep apnoea therapy: A systematic review of randomised controlled trials with meta-analysis. Journal of oral rehabilitation, 48(4), 469–486. https://doi.org/10.1111/joor.13077 Okuno, K., Sasao, Y., Nohara, K., Sakai, T., Pliska, B.T., Lowe, A.A., Ryan, C.F., & Almeida, F.R., 2016. Endoscopy evaluation to predict oral appliance outcomes in obstructive sleep apnoea. Eur Respir J, 47(5), S.1410-1419. https://doi.org/10.1183/13993003.01088-2015 Randerath, W.J., Heise, M., Hinz, R., & Ruehle, K.H., 2002. An individually adjustable oral appliance vs continuous positive airway pressure in mild-to-moderate obstructive sleep apnea syndrome. Chest, 122(2), S.569-575. https://doi.org/10.1378/chest.122.2.569 Lam, B., Sam, K., Mok, W.Y.W., Cheung, M.T., Fong, D.Y.T., Lam, J.C.M., Lam, D.C.L., Yam, L.Y.C., & Ip, M.S.M., 2007. Randomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea. Thorax, 62(4), S.354-359. https://doi.org/10.1136/thx.2006.063644 Takaesu, Y., Tsuiki, S., Kobayashi, M., Komada, Y., Nakayama, H., & Inoue, Y. (2016). Mandibular Advancement Device as a Comparable Treatment to Nasal Continuous Positive Airway Pressure for Positional Obstructive Sleep Apnea. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 12(8), 1113–1119. https://doi.org/10.5664/jcsm.6048 Mathur, A. (2023). The Occlusal Side Effects of Mandibular Advancement Device Therapy in Adult Sleep Apnea Patients: A Systematic Review. Cureus, 15(11). https://doi.org/10.7759/cureus.48682 Gemeinsamer Bundesausschuss. Behandlungsrichtlinie: Unterkieferprotrusionsschiene bei obstruktiver Schlafapnoe, Beschluss vom 06.05.2021. g-ba.de/beschluesse/4813 Gemeinsamer Bundesausschuss. Richtlinie Methoden vertragsärztliche Versorgung: Unterkieferprotrusionsschiene bei obstruktiver Schlafapnoe, Beschluss vom 20.11.2020. g-ba.de/beschluesse/4576 Kassenzahnärztliche Bundesvereinigung. BEMA – Einheitlicher Bewertungsmaßstab für zahnärztliche Leistungen, Stand 01.01.2026 (Positionen UP1–UP3). kzbv.de – Gebührenverzeichnisse Schnarchschiene in Köln – so finden Sie zu uns Sie interessieren sich für Schnarchschiene in Köln? Unsere Fachpraxis liegt im Kölner Süden – gut erreichbar aus der ganzen Stadt, mit eigenem Meisterlabor im selben Haus. Fachpraxis für KieferorthopädieHauptstraße 50 · 50996 KölnÖffnungszeiten werden geladen … Termin online buchen0221 – 93 53 02 0 Mit dem AutoKostenfreie Parkplätze im Innenhof – an der Schranke einfach klingeln. Über die Rheinuferstraße aus der Innenstadt, über die A555 aus Richtung Bonn, über die Rodenkirchener Brücke vom rechten Rheinufer. Mit Bahn und BusZwei Haltestellen in Gehweite: Bahnhof Rodenkirchen (Linien 16 und 17, Bus 130, 131, 134, 135) und Heinrich-Lübke-Ufer (Linien 16 und 17, Bus 130, 134). Jugendliche kommen so allein zum Kontrolltermin. Aus ganz Köln erreichbarKurze Wege aus Rodenkirchen, Sürth, Weiß, Hahnwald, Marienburg, Bayenthal, Raderthal, Zollstock, Rondorf und der Südstadt – über die Rodenkirchener Brücke auch aus Porz und dem rechtsrheinischen Köln, aus dem übrigen Stadtgebiet über Rheinuferstraße und Militärring. SprechzeitenMo–Do 8:00–12:30 und 13:30–18:00 Uhr, Fr 8:00–12:30 und 13:30–16:00 Uhr. Geöffnet an rund 50 Wochen im Jahr, Termine auch online rund um die Uhr. Sleeping quietly again? Schedule your no-obligation initial consultation about snoring at JUST KFO – Dr. Steinmaier & Kollegen in Cologne. 0221 – 93 53 02 0 Mon–Thu 8:00–12:30 & 13:30–18:00 · Fri 8:00–12:30 & 13:30–16:00 Book an appointment online