What we treat
How and what we diagnose and treat: home sleep testing, sleep apnea, and insomnia.
Snoring is very common and is often associated with sleep apnea, especially if you snore very loudly for much of the night and can be heard outside of the bedroom. If friends or family complain about your snoring, take it seriously - we can help!
We can’t guarantee your snoring will stop after treatment, but the vast majority of our patients have had either complete elimination of their snoring or significant reduction in their snoring.
Snoring alone without sleep apnea has been found to be associated with decreased attention and performance during the day. Sleep apnea is also associated with attention deficits, memory problems, brain fog, but also associated with high blood pressure, stroke, heart attacks, mood disorders, and many other chronic diseases. Treatment of sleep apnea with custom-made medical mouth guards, or CPAP (for very severe cases), can help prevent the development of many of these conditions.
We offer oral appliance therapy for patients with mild and moderate sleep apnea, and for patients with severe sleep apnea if their AHI is under 50 or don’t want to use CPAP. We test the effectiveness of treatment with home sleep testing over several nights if necessary. We’ve found that most patients prefer a treatment other than CPAP. Based on our research and results of our clinical trials, custom-made oral appliances for sleep apnea are as effective as CPAP, but patients are more likely to continue with the treatment long term. All of our treatments are FDA approved and follow current treatment guidelines.
Yes, in most cases. We’ve treated over 20,000 sleep patients with medical sleep apnea mouth guards, surgery and/or CPAP. Medical mouth guards, custom made by our medical team, are covered by medical insurance when the providers are in network with medical (not dental) insurance and when medically necessary (as long as you have sleep apnea and are symptomatic). In case you’ve chosen to be treated with a mouth guard, and it is not working or causing discomfort, then we’ll discuss alternative treatments. Our expertise is based on the large volume of patients we’ve treated and clinical research we’ve conducted on home sleep testing; and the efficacy of oral appliances for sleep apnea - all presented at medical meetings and or published in the medical literature.
Oral appliance therapy for sleep apnea works by preventing the lower jaw and tongue from falling back in your throat when asleep. The deep part of the throat is referred to as the “airway” in medical terms, and is generally narrow. Being overweight, having a narrow jaw, a large tongue, large tonsils, or other anatomic variants that narrow the throat is a risk for developing obstructive sleep apnea. Oral appliances fit on the upper and lower jaw and keep the lower jaw in a favorable position that allows the airway to remain open when asleep, especially during deep sleep and REM sleep. This is a very effective treatment for sleep apnea. The effectiveness is confirmed with home sleep testing when the appliance is in place at night.
We recommend CPAP if you have already tried an oral appliance, and didn't get used to it, or it was ineffective. We also recommend CPAP if you have ongoing dental treatment such as braces, aligners, or dental implants. Your teeth and gums must be in good shape when using an oral appliance, and we recommend you have visited your dentist in the past year, and have no active dental issues. If that is NOT the case, then we recommend CPAP. If your sleep apnea is extremely severe, we also suggest you try CPAP first, unless you are opposed to it, or have claustrophobia, or have failed CPAP treatment in the past.
Before getting a CPAP you’ll need a home sleep test since CPAP is a medical treatment for sleep apnea. We need to know whether or not you have sleep apnea, and how severe it is. Insurance won't cover treatment for sleep apnea unless you have a sleep test confirming that you have sleep apnea.
Side effects of snoring include poor sleep quality - which leads to poor daytime function. Snoring can also cause relationship and marital problems due to the disruption caused to your bed partner. Snoring is a common cause of insomnia in bed partners of snorers.
Primary insomnia (not associated with sleep apnea or other sleep disorders) is best treated with cognitive behavioral therapy provided by therapists. We don’t provide this service, but will refer you to an online program that’s very effective. Insomnias related to sleep apnea or other sleep disorders respond very well to online CBTi programs, and we refer our patients for this service.
Read this article from the National Library of Medicine. Bottom line - in person CBTi is very difficult to obtain and is very expensive. Online CBTi is available and affordable.
When treating patients with insomnias associated with sleep apnea, we use medications when indicated. Our providers are licensed and prescribe medications as part of their treatment when appropriate.
Home Sleep Tests
Home sleep apnea testing technology has existed for close to 30 years. We’ve conducted our own medical research on home sleep testing devices. Our research, as well as many others', has shown that home sleep testing is very reliable and in many cases is more likely to provide realistic information about your sleep than a one night sleep study done in a hospital or other type of facility.
No. In most cases, a home sleep test is sufficient. Lab sleep studies (Polysomnography or PSG for short) are useful for diagnosing non-sleep apnea sleep disorders such as narcolepsy; REM behavior disorders, and less common sleep disorders. The wait time to get a sleep study done in a hospital or sleep lab can be up to one year.
Our providers recommend doing home sleep testing for a minimum of 3 nights in most cases. The home sleep testing device we use can do many nights of home sleep testing, and transmits the sleep data directly to BlueSleep for review and interpretation before your next visit.
Once the sleep test has been scored and interpreted, our providers will review the results of the test with you and explain the meaning of the test. Once that visit has occurred, a copy of your test will be available on your BlueSleep portal.
We don’t perform sleep or snoring surgeries, but given our past experience in sleep surgery, including clinical trials evaluating novel surgical treatments for sleep apnea and snoring, we will refer you to a sleep surgeon in our area as needed.
Sleep surgery is performed by Otolaryngologists (Ear Nose and Throat Surgeons).