Sleep Apnea

  | slēp | 'apnēə, ap'nēə |
  1. Cessation of breathing that recurs during sleep and is caused especially by obstruction of the airway or a disturbance in the brain's respiratory center.
    First known use: 1975

Sleep apnea - brief periods during sleep when breathing stops - affects 12 million people in the United States. It's often associated with noisy snoring, but it's far more serious than that: Sleep apnea can also be tied to an increased risk of heart disease, stroke, high blood pressure and other life-threatening conditions.

Sleep apnea should be diagnosed by a physician trained in sleep medicine, who may prescribe use of a CPAP, a mask-like device worn during sleep that gets oxygen to the person. CPAPs are highly effective. Unfortunately, some people find them cumbersome and uncomfortable and decide not to use them, putting themselves at risk. For them, an oral appliance made by a dentist can be an effective alternative.

Thomas M. Cleary, D.M.D., provides oral appliance therapy to sleep apnea patients in western Massachusetts. A general dentist with a practice in Easthampton, Mass., he has completed extensive training in oral appliance therapy and has achieved excellent results with patients suffering from sleep apnea.

Take this simple self-test to see if you have a tendency toward sleep apnea. Then click on the links below to learn more about how an oral appliance can help.

what patients are saying

"My sleep apnea appliance has allowed me to sleep through the night uninterrupted. With the CPAP I would wake up several times during the night. Now I wake up in the morning, more rested. In addition, my wife can now sleep in the same bed without being disturbed by my snoring. My blood pressure has also come down since I have been using my oral appliance. I am very pleased with the positive changes this appliance has made."

Sleep apnea is marked by one or more of these symptoms
  • Loud, chronic snoring
  • Intermittent pauses in breathing during sleep, sometimes as many as 30 per hour
  • Snorting or gasping for breath during sleep
  • Insomnia or restless sleep
  • Morning headaches
  • Morning sore throat or dry mouth
  • A persistent tired feeling during waking hours
  • Daytime drowsiness, including while driving

If you have any of these symptoms, you should discuss them with your primary care provider or your dentist, who can then refer you to a sleep physician. Once you have been evaluated by a sleep physician, you can consider treatment options. Among those options is an oral appliance made by a dentist trained in sleep medicine treatment.

Epworth Sleepiness Scale
  • 0

    would never doze
  • 1

    slight chance of dozing
  • 2

    moderate chance of dozing
  • 3

    high chance of dozing
How likely are you to doze off or fall asleep in the following situations, in contrast to just feeling tired?

If your score is 10 or higher, you should consider being evaluated for sleep apnea.

Your results indicate you should be evaluated for sleep apnea. Click here to send an email requesting an appointment or additional information.

Here is what you can expect if you have found that a CPAP isn't a good option for treating your sleep apnea, and decide that you want Dr. Cleary to make an oral appliance for you.

Before treatment begins:

Dr. Cleary will administer the Epworth Sleepiness Scale test, a simple written questionnaire that can determine if you are at risk for sleep apnea.

If the Epworth test indicates potential sleep apnea, he will advise you to have a sleep test (polysomnogram) if you have not already had one. You need to receive a diagnosis of sleep apnea from your primary care physician or a physician who specializes in sleep medicine.

If treatment is indicated and you choose an oral appliance, you’ll need to provide the following:

  • A copy of your polysomnogram from the sleep physician
  • A prescription for an oral appliance from your primary care physician or sleep physician
  • Two x-rays - a lateral jaw/cephalometric x-ray to evaluate any air obstructions and a panoramic x-ray to evaluate your jaw joint. Dr. Cleary will provide you with a referral to a specialist who can take these x-rays.
First visit (approximately 2 hours):

Dr. Cleary will review your sleep test and x-rays. He will take a health history and do an examination of your mouth and neck. He will also take impressions of your teeth and photograph your teeth and jaw.

Second visit, three weeks later (approximately 1 hour):

Your oral appliance will be ready. Dr. Cleary will fit it to your mouth and make any needed adjustments. He will also make a morning repositioner that will allow your jaw to resume its most comfortable position. He will take follow-up photos, and explain how to care for your oral appliance.

Third visit, two weeks later (approximately 30 minutes):

You will get a monitor that you can use at home to see how the oral appliance is improving the quality of your sleep, and to determine whether any additional adjustments are needed. Dr. Cleary will continue to make any necessary adjustments until the results of the sleep test are optimal.


You should schedule annual follow-up visits to monitor the continuing effectiveness of your oral appliance.

resources green-arrow
in the news black-arrow
  • YouTube video Shaquille O’NealYouTube video Shaquille O’Neal
  • Shape MagazineShape Magazine
  • USA TodayUSA Today
  • CBS NewsCBS News
  • Journal of Clinical Sleep MedicineJournal of Clinical Sleep Medicine
  • The New York TimesThe New York Times
  • My Daddy SnoresMy Daddy Snores
  • American Academy of Dental Sleep MedicineAmerican Academy of Dental Sleep Medicine
  • Division of Sleep Medicine, Harvard Medical SchoolDivision of Sleep Medicine, Harvard Medical School
  • National Institutes of HealthNational Institutes of Health
  • Centers for Disease Control and PreventionCenters for Disease Control and Prevention