Abstract: Embodiments herein provide a mandibular positioning appliance that is fully adjustable (adjustable in all planes). The appliance may be used for the management of sleep disordered breathing (SDB). The full spectrum of SDB, from the mildest snoring to severe obstructive sleep apnea (OSA), may be managed by the stabilization and features that this appliance offers. In embodiments, an appliance may be used by itself or may be used in conjunction with other therapies, such as positive airway pressure and/or a tongue retaining device.