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Oral Appliance Therapy. The American Academy of Sleep Medicine has concluded that a first line of treatment for mild to moderate sleep apnea is a custom made mandibular repositioning appliance (MRA). MRA's open the airway by moving the jaw and tongue forward, increasing muscle tone in the soft palate. These results are achieved with relatively minor lifestyle adjustments. Additionally, custom made oral appliances have also been shown to be effective in reducing or eliminating snoring.