Sleep Apnea
Tired of Snoring, Daytime Fatigue, or Poor Sleep?
You Could Be Living with Undiagnosed Sleep Apnea..
Sleep apnea is a common but serious sleep disorder where your breathing repeatedly stops during sleep—reducing oxygen to your brain, disrupting rest, and increasing health risks. Left untreated, it can lead to fatigue, TMJ issues, high blood pressure, and more.
The good news? It’s treatable.
Learn About Sleep Apnea
What Are the Different Types of Sleep Apnea?
Sleep apnea is a sleep-related breathing disorder marked by repeated interruptions in airflow during sleep. These pauses can last from a few seconds to over a minute and occur when the airway becomes blocked or the brain fails to send proper signals to breathe.
There are three main types:
-
Obstructive Sleep Apnea (OSA): The most common type, caused by physical blockage due to soft tissue collapse in the throat.
-
Central Sleep Apnea (CSA): Less common; occurs when the brain fails to signal the muscles to breathe.
-
Complex (Mixed) Sleep Apnea: A combination of OSA and CSA, often diagnosed during CPAP therapy.
Understanding the type of apnea is essential for choosing the right treatment approach.
What Causes Obstructive Sleep Apnea?
Obstructive Sleep Apnea (OSA) occurs when the airway becomes partially or completely blocked during sleep, preventing normal airflow. This blockage is often caused by the collapse of soft tissues in the throat and upper airway. Several anatomical, functional, and lifestyle factors can contribute to this airway obstruction.
Common Causes of OSA:
-
Anatomical Airway Narrowing: Enlarged tonsils, a large tongue, a narrow throat, or excess soft tissue in the airway can obstruct breathing during sleep.
-
Obesity: Excess weight around the neck or abdomen increases the risk of airway collapse, especially when lying down.
-
Jaw or Facial Structure: A retruded lower jaw (retrognathia), high-arched palate, or narrow dental arches can restrict space in the airway.
-
Poor Tongue Posture or Tongue Collapse: The tongue may fall back into the airway during sleep, especially when lying on the back.
-
Weak or Poorly Coordinated Airway Muscles: Muscle tone naturally decreases during sleep, and in some individuals, this leads to excessive collapse of the airway walls.
-
Nasal Obstruction: Chronic nasal congestion, deviated septum, or enlarged turbinates can force mouth breathing and increase airway resistance.
-
Aging: As we age, the tissues of the upper airway may become more lax, increasing the risk of airway collapse during sleep.
-
Alcohol, Sedatives, or Muscle Relaxants: These substances reduce muscle tone and can worsen airway collapse.
-
Genetics or Family History: A family history of OSA or certain craniofacial features may increase your risk.
Understanding the root causes of your sleep apnea is the first step toward effective, long-term relief. At Advanced TMJ Maxillofacial Pain & Sleep Center, we perform a comprehensive evaluation of your airway, jaw structure, and oral habits to identify contributing factors unique to you.
Who Is at Risk for Sleep Apnea?
An estimated 22 million Americans suffer from sleep apnea, and according to the American Sleep Apnea Association, approximately 80% of moderate to severe cases remain undiagnosed. Globally, the prevalence of obstructive sleep apnea (OSA) is rising—driven by increasing rates of obesity, sedentary lifestyles, and aging populations.
Sleep apnea is a common yet often underdiagnosed condition that can affect people of all ages and backgrounds. However, certain individuals are at significantly higher risk due to anatomical, lifestyle, and medical factors. Recognizing who is most at risk can help facilitate early detection, proper diagnosis, and timely treatment.
Groups Commonly Affected by Sleep Apnea:
-
Adults aged 30–70 – Prevalence increases with age
-
Men – 2 to 3 times more likely to be diagnosed than women before menopause
-
Postmenopausal women – Risk increases due to hormonal changes
-
Children and adolescents – Often due to enlarged tonsils/adenoids or craniofacial abnormalities
-
Overweight and obese individuals – Excess fat around the airway increases the likelihood of collapse during sleep
-
People with large neck circumference – Greater than 17 inches in men or 16 inches in women
-
Individuals with jaw or airway abnormalities – Such as a recessed chin, large tongue, or narrow palate
-
Those with a family history of sleep apnea or craniofacial traits
-
Users of alcohol, sedatives, or tobacco – These substances reduce airway muscle tone
-
Certain ethnic groups – African American and Asian populations may be at higher risk due to anatomical differences
-
Patients with TMJ disorders, bruxism, chronic facial pain, or fatigue – Sleep apnea may be overlooked in these individuals due to overlapping symptoms
What Are the Common Symptoms of Sleep Apnea?
Sleep apnea often goes unrecognized, especially when symptoms mimic other conditions such as TMJ disorders or chronic fatigue. Understanding the signs is the first step toward effective treatment.
Common signs and symptoms include:
-
Loud, chronic snoring
-
Gasping, choking, or pauses in breathing during sleep
-
Excessive daytime sleepiness or falling asleep unintentionally
-
Morning headaches or dry mouth
-
Difficulty concentrating or memory issues
-
Mood changes, such as irritability or depression
-
Nighttime teeth grinding (bruxism)
-
Jaw pain, facial tightness, or TMJ symptoms
-
Waking with a sore throat or clenched jaw
-
Insomnia or restless sleep
Many patients with undiagnosed sleep apnea also report that no matter how long they sleep, they still wake up tired and unrested. This is a red flag we take seriously.
How Is Sleep Apnea Diagnosed?
Diagnosing Obstructive Sleep Apnea (OSA) involves a combination of clinical evaluation, sleep history, and formal sleep testing. Because many symptoms of OSA such as fatigue, snoring, and morning headaches, can be mistaken for other conditions, a thorough assessment is essential to get an accurate diagnosis and determine the right treatment approach.
1. Clinical Evaluation
The diagnostic process for obstructive sleep apnea begins with a comprehensive clinical evaluation that includes both subjective (patient-reported) and objective (clinician-observed) findings.
Subjective assessment involves a thorough review of your sleep-related symptoms, such as snoring, daytime fatigue, restless sleep, or gasping at night. To aid in screening, standardized tools like the Epworth Sleepiness Scale (ESS) and STOP-BANG questionnaire are commonly used to assess sleepiness, airway risk factors, and the likelihood of apnea.
In addition, a provider trained in Dental Sleep Medicine or Orofacial Pain may perform a detailed evaluation of:
-
Jaw structure and alignment
-
Tongue posture and size
-
Airway space and nasal breathing
-
TMJ function and muscle tension
-
Risk factors such as obesity, neck circumference, or craniofacial structure
These clinical insights are essential for identifying patients at risk and guiding whether sleep testing should be recommended for a definitive diagnosis.
2. Sleep Testing (Polysomnography)
To confirm a diagnosis of OSA, objective sleep testing is required. There are two main types:
-
Home Sleep Apnea Test (HSAT): A portable device you wear at home to monitor breathing, oxygen levels, snoring, and airflow. Suitable for many patients with suspected mild to moderate OSA.
-
In-Lab Sleep Study (Polysomnography): Conducted overnight in a sleep center. This comprehensive test monitors brain waves, heart rate, breathing patterns, oxygen saturation, limb movement, and sleep stages. It is typically recommended for patients with complex symptoms, comorbidities, or suspected severe sleep apnea.
3. Referral to a Sleep Specialist/ ENT
If we suspect you may have sleep apnea based on your symptoms and clinical findings, we will refer you to an ENT or a Sleep physician for formal diagnosis through sleep testing. Once a diagnosis is confirmed, we collaborate with your medical team to determine the most effective treatment such as oral appliance therapy, CPAP, or lifestyle interventions.
What Happens If Sleep Apnea Is Left Untreated?
Obstructive Sleep Apnea is more than just snoring or feeling tired—it’s a serious medical condition that, if left untreated, can have significant consequences for your overall health, quality of life, and safety.
Ignoring OSA increases the risk of multiple short- and long-term complications:
1. Cardiovascular Problems
Repeated drops in oxygen levels during sleep place stress on your heart and blood vessels. Untreated OSA significantly increases the risk of:
-
High blood pressure (hypertension)
-
Irregular heartbeats (arrhythmias)
-
Heart attack
-
Stroke
-
Congestive heart failure
2. Daytime Fatigue and Poor Concentration
Interrupted sleep leads to excessive daytime sleepiness, making it harder to focus, stay alert, or be productive. It can also increase the risk of:
-
Motor vehicle accidents
-
Workplace errors and injuries
-
Memory problems and poor decision-making
3. Metabolic and Hormonal Disorders
OSA is linked to insulin resistance and glucose intolerance, increasing the risk of:
-
Type 2 diabetes
-
Weight gain or difficulty losing weight
-
Metabolic syndrome
4. Mood and Mental Health Issues
Sleep deprivation can affect your emotional regulation and mental well-being, leading to:
-
Irritability or mood swings
-
Depression and anxiety
-
Decreased quality of life
5. Worsening of Other Medical Conditions
If you already have conditions like TMJ disorders, high blood pressure, diabetes, GERD, or fibromyalgia, untreated sleep apnea can make them worse or harder to manage.
6. Reduced Lifespan
Several long-term studies have shown that untreated moderate to severe OSA is associated with a higher risk of early mortality, especially from cardiovascular causes.
The Good News: It’s Treatable!
The risks of OSA are serious, but the condition is highly manageable with the right treatment. Whether through oral appliance therapy, CPAP, or lifestyle changes, early intervention can protect your health, restore restful sleep, and improve your daily functioning.
What Are the Treatment Options for Sleep Apnea?
Obstructive Sleep Apnea is a chronic condition, but with the right treatment, most patients experience significant improvement in sleep quality, daytime function, and overall health. The choice of treatment depends on the severity of the apnea, underlying causes, and patient preferences or tolerances.
1. Lifestyle Modifications
In mild cases, or as a supportive measure alongside other treatments, lifestyle changes can make a significant difference:
-
Weight loss (if overweight or obese)
-
Positional therapy (avoiding sleeping on the back)
-
Avoiding alcohol or sedatives before bedtime
-
Quitting smoking
-
Improving sleep hygiene and maintaining a regular sleep schedule
2. CPAP Therapy (Continuous Positive Airway Pressure)
CPAP is considered the gold standard treatment for moderate to severe OSA. It involves wearing a mask that delivers a steady stream of air to keep the airway open during sleep. While highly effective, some patients find it difficult to tolerate due to discomfort, noise, or dryness.
3. Oral Appliance Therapy (OAT)
For patients with mild to moderate OSA or those who cannot tolerate CPAP, oral appliances offer a highly effective, non-invasive alternative. These custom-made devices reposition the lower jaw and tongue forward to keep the airway open during sleep.
-
Comfortable, portable, and silent
-
Ideal for patients with TMJ issues, bruxism, or CPAP intolerance
-
Must be fitted and monitored by a trained Dental Sleep Medicine provider
The most widely used type of appliance is called a Mandibular Advancement Device (MAD).
A MAD is a custom-made oral device that you wear during sleep. It works by gently repositioning your lower jaw (mandible) forward, which helps keep your airway open throughout the night. By advancing the jaw, the device also pulls the tongue forward and stabilizes the soft tissues at the back of the throat, preventing them from collapsing and blocking airflow.
This simple but effective mechanical adjustment can:
-
Reduce or eliminate snoring
-
Improve oxygen flow during sleep
-
Minimize sleep apnea events
-
Enhance overall sleep quality and daytime alertness
MADs are comfortable, quiet, portable, and easy to use—making them an ideal alternative for patients who cannot tolerate CPAP or prefer a more discreet solution.
4. Surgical Interventions
Surgery may be considered in select cases when anatomical blockages are severe or other therapies have failed. Surgical options include:
-
Uvulopalatopharyngoplasty (UPPP) – Removal of excess tissue from the throat
-
Nasal surgery – To correct structural obstructions (e.g., deviated septum)
-
Tongue or soft palate procedures – To reduce collapsibility
-
Maxillomandibular advancement (MMA) – A corrective jaw surgery to reposition the upper and lower jaws forward, enlarging the airway
-
Hypoglossal nerve stimulation – An implantable device that stimulates the tongue muscles to maintain airway openness during sleep
Surgical options should always be carefully considered in collaboration with an experienced sleep medicine or surgical team
How Can We Help at Advanced TMJ?
At Advanced TMJ Maxillofacial Pain & Sleep Center, our team includes American Academy of Dental Sleep Medicine (AADSM) trained dental specialists with advanced training in Dental Sleep Medicine. We provide custom oral appliance therapy for patients with obstructive sleep apnea (OSA), working in close collaboration with sleep physicians to ensure a coordinated and effective treatment plan. While we aid in screening for OSA, we do not diagnose or manage sleep apnea independently. We play a critical role in delivering oral appliance therapy (MAD) a proven, non-invasive alternative to CPAP for patients with mild to moderate OSA or those who are CPAP-intolerant.
Here’s how we can help:
-
Comprehensive Airway & TMJ Evaluation: We perform a detailed clinical examination of your airway, jaw structure, tongue posture, and TMJ function to screen for sleep-disordered breathing and determine if oral appliance therapy is appropriate.
-
Referral for Diagnostic Sleep Testing: If sleep apnea is suspected, we coordinate with board-certified sleep physicians to facilitate a home sleep test or in-lab sleep study, ensuring an accurate diagnosis and classification of severity.
-
Custom Oral Appliance Therapy: For eligible patients, we offer FDA-approved mandibular advancement devices (MADs), custom-fitted oral appliances that reposition the lower jaw to keep the airway open during sleep. This is a safe and effective alternative to CPAP for patients with mild to moderate OSA.
-
TMJ-Conscious Appliance Design: With specialized expertise in Orofacial Pain and TMJ disorders, we ensure that all oral appliances are designed to protect your jaw joints and muscles, especially in patients with pre-existing TMJ conditions or bruxism.
-
Ongoing Care & Interdisciplinary Collaboration: We monitor your appliance and bite changes with regular follow-up visits and work closely with your sleep physician and medical team to ensure optimal outcomes and long-term success.
-
Specialized Training in Dental Sleep Medicine: Our doctors are AADSM-qualified (American Academy of Dental Sleep Medicine) and have advanced training in oral appliance therapy. Our founder, Dr. Chandrashekhar is actively pursuing board certification in Dental Sleep Medicine, reflecting our commitment to excellence in sleep-related care.
