Obstructive Sleep Apnea (OSA) is one of the most prevalent sleep disorders, characterized by repeated upper airway collapse during sleep, leading to intermittent hypoxia and sleep fragmentation. Mandibular advancement devices (MADs) are commonly used to treat primary snoring and OSA, particularly in mild to moderate cases.

This case report presents the clinical management of a 47-year-old male diagnosed with moderate OSA, confirmed by polysomnography. Due to the patient’s refusal to undergo Continuous Positive Airway Pressure (CPAP) therapy, a MAD was proposed as an alternative treatment. The device was custom-fabricated and progressively adjusted to optimize mandibular protrusion while ensuring patient comfort. Follow-up assessments, including repeat polysomnography, demonstrated a significant reduction in the apnea-hypopnea index (AHI), which decreased by more than 50% from the initial value but remained above five events per hour—considered a partial therapeutic success. Clinically, the patient reported substantial improvement in daytime symptoms and overall sleep quality.

This case underscores the importance of individualized treatment planning and supports the efficacy of MADs as a non-invasive, patient-compliant solution for managing moderate OSA when CPAP therapy is declined or poorly tolerated.