PEEP Guard™ by iHeart Sleep
PEEP Guard combines mandibular advancement, an integrated air channel and oral EPAP — expiratory positive airway pressure generated by your own breathing — in one compact appliance worn while you sleep.
This product is delivered under the supervision of medical and dental practitioners and is not available for purchase direct to the public.
From the clinician who developed it — and wears it
Conventional oral appliances work by moving the lower jaw forward. They help many people — but for some, jaw advancement alone doesn't control the problem.
I'm Dr Chris Hart. I'm a dental sleep clinician and researcher — and I'm one of the people this affects. I've spent years asking whether oral appliance therapy could do more than reposition the jaw — whether it could also manage airflow and pressure through the airway. That question is what led to the integrated air channel and to oral EPAP.
I designed it, I ran the clinical trials, I wear it, and I fit it for patients.
PEEP Guard is the result.
video/why-i-built-it.mp4Dr Chris Hart on why he developed the technology
How it works
Most sleep apnoea mouthguards rely on a single mechanism. PEEP Guard combines three.
The lower jaw is gently held forward, helping to maintain space in the airway during sleep — the mechanism conventional oral appliances rely on.
A built-in air channel provides a low-resistance path for airflow past potential sites of obstruction, so you don't have to draw air as hard. Think of drinking through a partly blocked straw: the harder you have to suck, the more the straw wants to collapse in on itself. Moving the jaw forward opens space, but it doesn't change how hard you have to work to pull air through — the channel does.
On exhalation the valve restricts outward airflow, generating expiratory positive airway pressure inside the airway using your own breath. That pressure builds through the oral cavity and pharynx — the same region where the airway is vulnerable to collapse — while the jaw stays advanced and the air channel stays open, so all three mechanisms are working across the night.
Mandibular advancement + iACT + oral EPAP
Four chapters: the appliance in 3D, seating it in the mouth, airflow through the channel, and a cutaway of expiratory back-pressure. Open it full screen →
Two custom trays made from a digital scan or impressions of your own teeth, connected by advancement links, with the PEEP Shield valve sitting at the front.
video/device-in-hand.mp4Dr Chris Hart walks through the components
The PEEP Shield™ — the positive end expiratory valve that generates oral EPAP. It clips to the front of the appliance and is the component doing the pressure work.
A quick self-check
Sleep apnoea is easy to miss, because most of it happens while you are asleep and the daytime signs get blamed on age, stress or a busy life. Tick anything you have noticed in the last few months.
Please act on this one now.
Falling asleep at the wheel is a medical emergency, not an inconvenience, and avoiding driving while you are this sleepy matters more than anything else on this page. Call us on 0458 914 390 — we can arrange a sleep study for you, usually done at home. If you would rather start with your own GP or a sleep physician, do that promptly instead. Either way the assessment comes first, and it is not something to put off.
This self-check is an awareness tool only. It does not provide a diagnosis and no result from it should be relied on as one. Sleep apnoea is diagnosed from a sleep study, not from a questionnaire.
Clinical evidence
Published findings from studies of the oral appliance technologies underlying PEEP Guard. Every figure below is referenced — you can read the sources at the bottom of this page.
In a prospective study of people with severe OSA, EPAP-enhanced oral appliance therapy reduced sleep breathing events by an average of 76% — from 45.4 to 13.4 events per hour. 84% achieved at least a 50% reduction.
Adding oral EPAP to a device already incorporating an integrated air channel reduced the events still remaining by a further 53% — from 12.6 to 5.9 events per hour on average.
EPAP-enhanced mandibular advancement reduced sleep-apnoea-specific hypoxic burden — the oxygen stress caused across the night — by 76% after six months of treatment.
Opening the integrated air channel further reduced events remaining after standard mandibular advancement: ~50% in an initial physiological pilot, ~20% in MAD non-responders in a larger randomised airway-open/airway-closed study.
iACT reduced the negative pressure generated in the throat during breathing by approximately 52% — to levels similar to optimised CPAP.
In the first published clinical study of the air-channel oral appliance, 24 of 29 patients reported no snoring after treatment. All five of the rest reported improvement in frequency and/or intensity.
Efficacy is only part of the story
CPAP reduces sleep apnoea events by approximately 86% while it is being used.7 But how consistently a treatment is worn also decides how much disease is actually treated across the night.
Nightly use in a prospective comparison of 94 patients with moderate-to-severe OSA — mandibular advancement device versus CPAP.8 Measured objectively with an embedded sensor rather than self-reported, oral appliance use averaged 6.6 hours a night.9
Mean Disease Alleviation was non-inferior for the mandibular advancement device compared with CPAP (p = 0.4), despite CPAP reducing breathing events more while worn. The authors note that MDA has not been validated against patient-important outcomes, so this does not establish clinical non-inferiority.8
Conventional oral appliances are worn for longer but generally reduce breathing events less than CPAP. PEEP Guard's technologies are designed to lift the efficacy side of that equation.
Already tried a mouthguard and it didn’t work?
Conventional mandibular advancement addresses airway anatomy through jaw position. An incomplete response isn't unusual — sleep apnoea has more than one driver.
PEEP Guard adds two more mechanisms to the one your previous appliance relied on: an integrated air channel, and oral EPAP.
Can't tolerate CPAP?
CPAP is an effective treatment for obstructive sleep apnoea when it's used consistently. We're not going to tell you otherwise.
But masks, hoses, pressure, noise, travel and simply sleeping comfortably make long-term use difficult for some people. If that's you, there may be another option worth discussing.
| PEEP Guard | CPAP | Conventional MAD | |
|---|---|---|---|
| Mandibular advancement | ✓ | — | ✓ |
| Integrated air channel | ✓ iACT™ | — | — |
| Positive airway pressure | ✓ Oral EPAP | ✓ Continuous | — |
| Mask | — | Required | — |
| Hose | — | Required | — |
| Bedside machine / power | — | Required | — |
| Worn in the mouth | ✓ | — | ✓ |
Suitability
PEEP Guard is a clinical treatment, not a product you buy off a shelf. Whether it's appropriate depends on your sleep study, your OSA severity, what you've already tried and your dental circumstances.
It may be particularly relevant if:
If several of those sound like you, a consultation is the next step. It costs nothing and commits you to nothing.
Every PEEP Guard is individually made and combines mandibular advancement with our integrated air channel and PEEP Shield technology. Choose straightforward treatment, or add objective monitoring, guided optimisation and our 90-Day Results Guarantee.
Essential starts at $13 a week and Complete is $16 a week on an interest-free plan.† If you hold dental extras, your fund may cover up to 70% of the cost.‡ And because Complete carries the 90-Day Results Guarantee — if optimised treatment doesn’t work, we refund what you paid for the device, up to $1,495 — what it costs you to try it can come down to very little, and with good cover close to nothing at all. With cover, the gap left after your fund pays can be spread interest-free over up to 12 months.†
PEEP Guard Essential
Everything you need to commence PEEP Guard therapy, including your custom PEEP Guard and one follow-up consultation.
Get a priceA straightforward option without the additional monitoring and Results Guarantee.
PEEP Guard Complete
Treatment you can measure. Adds objective compliance monitoring, overnight oximetry and a second optimisation consultation, so we can measure how you are responding and optimise during the first 90 days.
Measured — or the device fee comes back. Your oxygen desaturation index is recorded before treatment and again once your appliance is optimised. If it doesn't improve enough, you may qualify for a refund of what you paid for the device. How the guarantee works →
Six quick questions · Weekly cost and what your fund is likely to cover
Compare
| Essential | Complete | |
|---|---|---|
| Initial doctor consultation 015 | ✓ | ✓ |
| Diagnostic models 071 | ✓ | ✓ |
| Clinical occlusal analysis 963 | ✓ | ✓ |
| Mounted diagnostic casts 964 | ✓ | ✓ |
| Custom PEEP Guard 984 | ✓ | ✓ |
| Integrated Air Channel Technology (iACT) | ✓ | ✓ |
| PEEP Shield | ✓ | ✓ |
| Follow-up consultations 014 | 1 included | 2 included |
| Objective compliance monitoring | — | ✓ |
| Overnight oximetry across your optimisation period | — | ✓ |
| Oximetry-guided optimisation | — | ✓ |
| 90-Day Results Guarantee | — | ✓ |
| Device refund if guarantee criteria aren't achieved | — | ✓ |
| Five-year warranty — fit and breakage | ✓ | ✓ |
| Interest-free payment plans† | ✓ | ✓ |
| Health fund rebates may apply‡ | ✓ | ✓ |
The numbers are the dental item codes each part of treatment is billed under — useful if you would rather ring your fund yourself. Item 984 is the one that varies most between funds, so it is the one worth asking about. The monitoring and the guarantee carry no item number, so no fund pays a benefit toward them.
Included with Complete
Two small devices come with PEEP Guard Complete, and between them they answer the only two questions that matter: has your breathing actually improved, and were you actually wearing the appliance when it was measured.
O2 Ring oximeter
A light, comfortable ring worn on your finger that records blood oxygen and heart rate continuously while you sleep — no mask, no leads, nothing taped on.
You wear it before treatment starts and again once your appliance has been optimised. Those recordings give us your oxygen desaturation index, which is the measure the Results Guarantee is judged on, taken the same way both times so the two are genuinely comparable.
Yours to wear at hometheramon® microsensor
A microsensor built into your PEEP Guard that objectively records wear time. It is not a diary and not a guess — it logs the hours the appliance was actually in your mouth.
That matters for two reasons. It means we optimise your treatment against what really happened rather than what either of us remembers, and it gives you documented compliance if an employer, insurer or licensing authority ever asks for it.
There is nothing for you to do. The sensor has no buttons and needs no charging — we read it at your follow-up appointment.
Built into the applianceOvernight oximetry is not a substitute for a diagnostic sleep study. It measures the change in your oxygen desaturation index using a consistent method before and after treatment.
90-Day Results Guarantee
We measure your oxygen desaturation index before treatment and again once your PEEP Guard has been optimised, using the same method both times.
Three consecutive valid nights of overnight oximetry before treatment establish your baseline ODI.
Your PEEP Guard is fitted and advancement optimised across your follow-up consultations.
Another three consecutive valid nights of oximetry. The compliance monitor verifies the recordings correspond with nights your PEEP Guard was actually worn.
We compare the average ODI across the three baseline nights with the average across the three qualifying nights after optimisation.
If your optimised treatment doesn't achieve either a 50% or greater reduction in average ODI or an average ODI below 10 events per hour, you may qualify for a refund of your out-of-pocket cost for the PEEP Guard device component, up to $1,495, with the appliance returned to us. View Results Guarantee Terms & Conditions →
Overnight oximetry used as part of the Results Guarantee measures change in ODI using a consistent pre- and post-treatment methodology. It is not a substitute for a formal diagnostic sleep study. The Results Guarantee is subject to eligibility requirements and Terms & Conditions.
It takes about a minute. What you would actually pay turns on your cover and how much of this year’s limit is left, so your answers are what make this a real estimate rather than a generic number.
Do you have private health insurance with extras (dental) cover?
Roughly how much of this year's extras limit have you used?
This moves your out-of-pocket more than anything else.
Has a sleep study diagnosed you with sleep apnoea?
Would you like a performance guarantee on your treatment?
With PEEP Guard Complete we monitor both how well the device is working and how much you are wearing it. If optimised treatment doesn’t at least halve your average oxygen desaturation index — or bring it under 10 events an hour — we refund what you paid out of pocket for the device, up to $1,495, and the appliance comes back to us. About $3 a week more.
How would you prefer to pay?
Indicative — we confirm the exact figures with you
a week
Rebate figures are a general range, not a quote — what your fund pays depends on your policy and how much of your annual limit is left, and the free insurance check is where we work out your actual number. The guarantee requires PEEP Guard Complete, valid recordings before and after treatment, attendance at your prescribed reviews, and return of the device; full conditions are in the Results Guarantee Terms & Conditions.
These are our fees. What you are actually out of pocket depends on your fund, your level of cover and how much of your annual limit is left — which is what the free call works out, in writing. Your answers stay on this page — nothing here is sent to us, or to anyone else.
Prefer to talk first?
20-minute clinical consultation, online or in clinic
Go through your sleep study, your OSA severity, your CPAP or oral appliance history, whether this approach may be appropriate for you, and which treatment option suits you.
Credited in full toward your treatment if you proceed.
Book a consultation — $49Dr Chris Hart is a registered dentist and dental sleep clinician.
Ask our clinical team about how treatment works, costs, payment options or the impression process.
Talk to our clinical team — free† Payment plans are provided by SmileRight over terms of up to 36 months with no interest, and a deposit payable with your first payment; terms beyond 12 months are available at participating practices. Where a health fund benefit applies, the remaining gap may instead be financed interest-free over up to 12 months; the amount depends on what your fund pays and is confirmed at your insurance check, so no weekly figure for it is quoted on this page. Interest applies if repayments are not made on time. Plan length, repayments, fees and eligibility are determined by them, not by us, and are set out in the offer you receive. We also accept Afterpay, humm, PayPal and Square.
‡ Rebates depend on your insurer, level of cover, annual limits and applicable item numbers. Some patients receive no rebate.
The pathway
Come and see us in person on the Gold Coast or at Tweed Heads, or do the whole thing from home, anywhere in Australia. Either way it's about three weeks from your first assessment to wearing the appliance.
Option 1 — in person
Consultation and a digital intraoral scan — no impression putty. Your fitting and adjustment appointments happen in the chair, which makes optimising advancement faster.
Option 2 — online
Video consultation and a home impression kit with everything you need, plus support from our team while you take them. Fitting and reviews happen by video.
Your treatment journey
A free call to see whether this is worth trying for you.
Review your OSA, sleep study and treatment history.
At home or with us, depending on your treatment pathway.
Your personalised oral EPAP-enhanced appliance is manufactured for you.
Your appliance is fitted and adjusted to your individual needs.
Ongoing clinical appointments and optimisation as required.
Only how we take your records, and where you're fitted, changes. The appliance, the treatment and the price are identical.
Find us
Mermaid Dental Studio
Suite 5B, 2431 Gold Coast Highway
Mermaid Beach QLD 4218
iHeart Smiles at Tweed Dental
47 Kirkwood Road
Tweed Heads NSW 2485
Anywhere in Australia
Video consultation with Dr Hart
Home impression kit posted to you
Prefer to talk it through? Call 0458 914 390
Patient experience
We use published clinical research for treatment outcomes, and patient feedback for what the service itself is like.
“I was able to do the impressions with a doctor to fit my new device from the comfort of my own home. I love that it's virtual!”
Kiera J.Patient“The medical staff at iHeart were fantastic and it was a simple process to get started right away. Thanks to the iHeart team!”
Michael S.Patient“Very clear information given by Dr Hart, backed up by included research studies. I am a nurse and midwife, so I like deep diving into the science, and he could answer all my questions really well. Very impressed!”
Sandra F.Patient“Had my initial call and was comfortable with all the information given.”
Michelle W.Patient“Dr Chris Hart was very knowledgeable and answered all my questions.”
Andrew T.Patient“It was a brilliant experience talking to my doctor online.”
Nicholas G.PatientReviews describe patients' experience of our service. They are not statements about clinical outcomes, which vary between individuals.
Next step
A short call with our clinical team. They will go through your diagnosis, your sleep study and what you have already tried, tell you honestly whether this is worth trying for you, and check what your fund would pay. Nothing is booked in for treatment.
Australia-wide · No cost and no obligation
Questions
Obstructive sleep apnoea has several different drivers, and response to any oral appliance varies between individuals. What we can do is assess your sleep study, your severity, your anatomy and your treatment history, and give you an honest view on whether this approach is worth trying. That is exactly what the free consultation is for.
CPAP uses a bedside pump to deliver continuous positive pressure through a hose and mask, across the whole breathing cycle. PEEP Guard is worn in the mouth and uses your own exhaled breath to generate expiratory positive airway pressure, alongside mandibular advancement and an integrated air channel. They are different treatments that share the principle of positive airway pressure.
EPAP stands for expiratory positive airway pressure. The PEEP Shield valve at the front of the appliance restricts airflow as you breathe out. That resistance generates positive pressure inside your airway during exhalation — pressure that has to be created by a machine in CPAP therapy, but is created by your own breathing here.
Most conventional mandibular advancement devices rely on a single mechanism: moving the lower jaw forward. If that mechanism alone didn't adequately control your sleep apnoea, PEEP Guard adds two more — an integrated air channel that lowers the resistance you breathe against, and oral EPAP. Published studies of these technologies have shown further reductions in events remaining after standard mandibular advancement.2,3
Severe OSA has historically been difficult territory for oral appliances. In a prospective study of 36 patients with severe OSA, EPAP-enhanced oral appliance therapy reduced sleep breathing events from an average of 45.4 to 13.4 per hour, with 84% achieving at least a 50% reduction.5 That said, severity is one of the most important factors in your individual assessment, and it's a conversation to have with a clinician rather than something to decide from a web page.
Yes — a diagnosis matters, and so does a reasonably recent one. If you have a sleep study, have it handy for your consultation. If you don't, or yours is quite old, we'll talk you through your options for getting one.
No. You can be treated entirely from home, anywhere in Australia — video consultation, a home impression kit posted to you with instructions and support from our team, then fitting and reviews by video.
If you can get to us, we have two clinics: Mermaid Beach on the Gold Coast, and Tweed Heads. In person we take a digital intraoral scan instead of impressions — no putty — and your fitting and adjustments happen in the chair, which usually makes optimising the advancement quicker. The prices and the appliance are the same either way.
It's a custom appliance made from a digital scan or impressions of your own teeth, so it fits your mouth rather than being a generic shape. Like any mandibular advancement therapy, some people experience jaw or bite awareness in the early weeks. Your dental circumstances — existing dental work, gum health, jaw joint history — are part of the clinical assessment, which is why an appliance like this should be prescribed rather than bought.
About three weeks end to end, from your first assessment to wearing the appliance — consultation, then your digital scan or impressions, then manufacture, then fitting.
After that, advancement is adjusted over the following weeks based on how you're responding. Getting the appliance is the start of treatment, not the end of it.
Every PEEP Guard is custom made from a scan or impressions of your own teeth, and the therapy is built around your sleep study rather than sold off a shelf. Essential is $1,995 and Complete — which adds the monitoring and the 90-Day Results Guarantee — is $2,495. Through SmileRight that is about $13 and $16 a week over 36 months, interest-free, with a deposit payable with your first payment.
Those are our fees, not what you end up out of pocket. If you hold dental extras, your fund pays a benefit on item 984 and most of your annual limit is still available, out-of-pocket on Essential typically lands somewhere around $600 to $900. Item 984 is the one that varies most between funds, so it is the one worth asking about. Answer a few quick questions and we will show you your weekly cost, then check your fund with you at no charge.
Your $49 consultation with Dr Hart is credited in full toward treatment if you go ahead; if we advise that PEEP Guard is not right for you, the $49 covers the consultation and you leave with a written opinion.
It's included with PEEP Guard Complete. We measure your oxygen desaturation index (ODI) across three consecutive valid nights of overnight oximetry before treatment, then again across three qualifying nights once your PEEP Guard has been fitted and optimised. The compliance monitor lets us verify those recordings correspond with nights the appliance was actually worn.
If your optimised treatment doesn't achieve either a 50% or greater reduction in average ODI or an average ODI below 10 events per hour, you may qualify for a refund of your out-of-pocket cost for the device component of treatment, up to $1,495, and the appliance is returned to us. Where your fund has already paid a benefit toward the device, the refund is reduced by that benefit, so it never exceeds what you have actually paid.
The oximetry used here measures change in ODI with a consistent method before and after — it isn't a substitute for a formal diagnostic sleep study. Eligibility and the full conditions are set out in the Results Guarantee Terms & Conditions.
Many patients with the right level of cover receive a rebate, and with good extras cover it can reach up to 70% of the total cost of treatment. It varies a great deal by insurer, policy, annual limit and item number, though, and some patients receive nothing at all. We give you the item numbers so you can check your own entitlement, and our clinical team will do that check with you at no charge before you commit.
Payment plans are provided by SmileRight over terms of up to 36 months with no interest, and a deposit payable with your first payment. Terms beyond 12 months are available at participating practices — we are one, which is why the 36-month figures on this page are open to you. Interest does apply if repayments are not made on time, and SmileRight may charge fees.
On our fees that is about $13 a week for Essential and $16 a week for Complete over 36 months. Your deposit, and any benefit your fund pays on the day, both reduce the amount financed and so reduce the weekly payment.
If you hold dental extras, there is a second option. Rather than financing the whole fee, book the free insurance check — we work out what your fund pays and what you are actually left out of pocket, and that gap can be spread interest-free over up to 12 months. We do not quote a weekly figure for it here, because the gap depends on your policy and your remaining limit, and we would rather tell you the real number than a likely one.
We also accept Afterpay, humm, PayPal and Square.
Applications are subject to SmileRight’s credit approval. Their terms, fees and eligibility criteria are set by them, not by us, and are set out in the offer you receive when you apply.
This is separate from the 90-Day Results Guarantee above. Your PEEP Guard carries a five-year manufacturer's warranty covering fit and breakage. If the appliance doesn't fit as it should, or it breaks in normal use within five years, it's covered.
That's unusually long for an oral appliance, and it's worth knowing why we can offer it: the appliance is manufactured to your own scan or impressions rather than adapted from a stock size.