Mandibular Advancement Device and Changes in Nocturia

Inclusion Criteria:

• English speaker

• >18 y/o

• Obstructive sleep apnea diagnosis with AHI≥5

• ≥ 2 voiding/night at baseline

• Upon clinical examination ≥ 8 teeth per arch, range of mandibular protrusion ≥5 mm

• Consent to participate in the study.

Exclusion Criteria:

• Patients with concomitant diagnosed sleep disorders (i.e. insomnia, narcolepsy,restless legs syndrome, rapid eye movement sleep behavior disorder).

• Prostate/kidney problems (urological disease: (eg overactive bladder, benignprostate hyperplasia)

• Pregnancy

• Heart failure, use of diuretics, diabetes, Parkinson's disease or dementia.

• Patients using combination therapy for the management of obstructive sleep apnea (OSA) (i.e. positive airway pressure (PAP) therapy or positional therapy).

• Upon clinical examination: periodontal disease (>4 mm on periodontal probing, withbleeding on probing, visual signs of periodontal inflammation); tooth horizontalmobility >1 mm, vertical mobility, and unfavorable crown to root ratio; opencavities, loose or fractured restorations, or patient undergoing restorative dentaltreatments.

• Exaggerated gag reflex.

• Lack of coordination or dexterity.

• Inadequate English comprehension.