You’ve probably heard statistics like “6 million Americans are diagnosed with sleep apnea.” But the more accurate current estimates suggest that tens of millions more remain undiagnosed. According to recent data, about 32.2% of U.S. adults may have obstructive sleep apnea (OSA) when assessed properly. Other sources suggest the total may exceed 80 million if milder cases are included.

That discrepancy — between diagnosed and actual cases — has big implications. Many people don’t recognize their own symptoms, and too many remain untreated.

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What Is Sleep Apnea — and Why Does It Matter?

In OSA (the most common form), the soft tissues in your throat collapse partially or completely during sleep. This leads to pauses in breathing (apneas) or shallow breathing (hypopneas). The brain senses the drop in oxygen and briefly arouses you to reopen the airway, fragmenting your sleep.

Common symptoms include:

• Loud, persistent snoring
• Gasping or choking episodes during sleep
• Excessive daytime fatigue or sleepiness
• Difficulty concentrating, memory issues, or “brain fog”
• Irritability, mood changes, or depression

Because the breathing disruptions are happening asleep — and often unconsciously — many people don’t realize they have a problem until a partner or family member observes the snoring or interruptions.

Left untreated, OSA has been linked to a broad spectrum of health risks. Some of the more concerning long-term consequences include:

• Cardiovascular and circulatory: hypertension, atrial fibrillation, heart failure, stroke
• Metabolic/endocrine: insulin resistance, type 2 diabetes, metabolic syndrome
• Respiratory: worsened lung mechanics, increased risk in lung disease
• Neurocognitive & mental health: memory loss, cognitive decline, depression, increased accident risk
• Oral health: chronic mouth breathing, dryness, gum disease, tooth decay
• Reproductive / sexual: reduced libido, erectile dysfunction

Recent studies have also suggested emerging risks. For example, one new study found that rising nighttime temperatures may worsen OSA severity, potentially increasing its societal burden as climates warm.

Moreover, in 2025, a new front opened up: Eli Lilly’s drug Zepbound, originally a weight-loss agent, has been approved for Medicare coverage specifically for sleep apnea, hinting at evolving therapeutic strategies in the field.

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Who Is at Risk?

Although OSA can affect people across ages and body types, some common risk factors include:

• Excess weight / obesity
• Anatomical traits: large neck size, small jaw (retrognathia), crowded airway
• Aging
• Male sex (though women, especially postmenopausal, are increasingly recognized)
• Family history
• Alcohol, sedatives, smoking
• Other conditions: nasal obstruction, hypothyroidism, craniofacial abnormalities

Notably, sleep apnea is likely underdiagnosed in women, since symptoms can be less classic (lower snoring frequency, more daytime fatigue and mood changes) and thus mistaken for other issues.

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Diagnosis & Current Treatment Approaches

Sleep Studies

If you or your partner notice signs of snoring, gasps, pauses in breathing, or daytime fatigue, it’s wise to complete a sleep evaluation. This typically involves an overnight polysomnography (in a sleep lab) or a home sleep apnea test.

Treatment Options

Once OSA is confirmed, treatment is individualized depending on severity, anatomy, comfort, and patient preference. Key modalities include:

• CPAP (Continuous Positive Airway Pressure): This is still the gold standard for moderate to severe OSA. It provides a steady stream of pressurized air to keep the airway open.
• Oral Appliance Therapy (OAT): This includes custom-fit, titratable mandibular advancement devices (MADs) or tongue-retaining devices (TRDs). These hold the lower jaw forward to help keep the airway open.
  • New joint clinical guidelines from the American Academy of Sleep Medicine (AASM) and the American Academy of Dental Sleep Medicine (AADSM) support the use of oral appliances, particularly for mild to moderate OSA or for patients who cannot tolerate CPAP.
  • Meta-analyses show that MADs can significantly reduce the apnea-hypopnea index (AHI) and improve daytime symptoms.
  • That said, OAT is generally less potent than ideal CPAP in reducing respiratory events, so patient selection and follow-up sleep testing are important.
• Positional therapy / combination therapy: For patients whose OSA is worse when lying on their back (positional OSA), combining oral appliances with positional devices or alarms can enhance results.
• Lifestyle modifications: Weight loss, exercise, avoiding alcohol or sedatives before bed, improving nasal breathing, and sleeping on one’s side are always adjunctive therapies.
• Surgery or structural interventions: In select cases, procedures on the airway (e.g. uvulopalatopharyngoplasty, tonsil removal, maxillomandibular advancement) may be recommended.
• Pharmacologic / new approaches: The approval of Zepbound for OSA in certain cases illustrates how weight-centric treatments may find a role in OSA management, especially when obesity is a contributing factor.

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What You Can Expect Visiting Our Office

As a dentist with expertise in sleep medicine, Dr. Abbey J. Lee will work closely with your sleep physician or general provider to optimize your care. Here’s how the process usually goes:

1. Symptom discussion & screening. Be ready to share your sleep history, snoring patterns, daytime energy levels, and other heath issues.
2. Oral / dental evaluation. A careful examination of your teeth, jaw alignment, airway anatomy, and dentition helps us determine whether you’re a good candidate for a custom device.
3. Collaboration with your sleep physician. If you haven’t yet had a sleep study, we can refer you; if you have, we’ll review your results and jointly decide on the best treatment path.
4. Custom appliance design & titration. Unlike over-the-counter “boil-and-bite” options, we use custom, titration-capable devices to optimize your comfort and efficacy.
5. Monitoring & follow-up. Periodic check-ups with both the dentist and sleep physician are essential to detect side effects (e.g. bite changes) and verify ongoing effectiveness (often via a follow-up sleep test).

There is little downside to seeking treatment — your sleep, mood, cardiovascular health, and overall quality of life all stand to gain.

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Take Action Today

If your partner has expressed concerns about your snoring, or if you struggle with fatigue, difficulty concentrating, or other red-flag symptoms of sleep disruption, don’t sit on it. Early diagnosis and treatment are key.

Call us at (404) 328-7177 to schedule a consultation with Dr. Lee. Together, we’ll determine whether an oral appliance is a safe, comfortable, and effective path forward for your health and restful sleep.