Combination OSA Therapy

For patients who struggle with CPAP alone, combining CPAP with a custom mandibular advancement splint (MAS) can dramatically reduce required pressures, improve comfort, and achieve superior treatment outcomes.

The only clinic in Canberra to offer this service in-house

Book a Consultation Download Patient Guide

What Is Combination Therapy?

Obstructive sleep apnoea (OSA) is most commonly treated with continuous positive airway pressure (CPAP). While highly effective, many patients find CPAP difficult to tolerate — particularly at higher pressures — leading to poor adherence and ongoing symptoms.

Combination therapy pairs CPAP with a custom-fitted mandibular advancement splint (MAS). The MAS repositions the lower jaw forward during sleep, physically opening the upper airway. This reduces the pressure CPAP needs to deliver to keep the airway patent — often by several cmH₂O.

The result is a more comfortable, quieter, and better-tolerated treatment experience, with equivalent or superior control of apnoea events compared to either therapy alone.

Who Is a Good Candidate?

Patients on CPAP with residual AHI > 5 despite good adherence
Patients requiring high CPAP pressures (≥ 10–12 cmH₂O)
Patients with CPAP intolerance due to pressure, mask leak, or discomfort
Patients who have failed CPAP monotherapy but are not suitable for surgery
Patients seeking to reduce CPAP pressure for travel or comfort reasons
Patients with moderate-to-severe OSA who partially responded to MAS alone

Why Combination Therapy

Key Benefits

Reduced CPAP Pressure

Combining a mandibular advancement splint with CPAP allows the required therapeutic pressure to be significantly reduced, improving comfort and tolerability.

Improved Adherence

Lower pressure means less mask leak, less noise, and a more comfortable experience — leading to better nightly usage and improved treatment outcomes.

Better Symptom Control

Patients who remain symptomatic on CPAP alone often achieve superior AHI reduction and daytime symptom relief with combination therapy.

Suitable for CPAP-Intolerant Patients

For patients who struggle to tolerate standard CPAP pressures, combination therapy offers a pathway to effective treatment without abandoning CPAP entirely.

What to Expect

Our Treatment Process

Initial Assessment

A comprehensive evaluation of your sleep study results, CPAP data, and symptom history to determine suitability for combination therapy.

Custom MAS Fabrication

A precision-fitted mandibular advancement splint is designed and fabricated to your anatomy, optimised to work alongside your CPAP device.

CPAP Pressure Titration

Your CPAP pressure is retitrated — either via auto-CPAP or in-lab study — to find the lowest effective pressure when used with the MAS.

Ongoing Review

Regular follow-up to monitor treatment response, adjust the MAS as needed, and ensure sustained symptom control and adherence.

Learn More or Book a Consultation

Download our patient guide for more information on combination therapy, or contact our clinic to discuss whether this approach is right for you.

Download Patient Guide Book an Appointment