In Search of Better Sleep – Part 2

Tuesday January 18, 2022

Last week I introduced Part 1 of “In Search of Better Sleep”. For this week’s column to make the most sense, I would encourage you to read that column first. It can be found at

In case you don’t have a chance to read it, here is a brief recap: I have been involved in treating patients with sleep apnea for a few years. These are patients who have been diagnosed with sleep apnea by a physician, but were unable or unwilling to use a CPAP machine. The next line of defense to treat this progressive disease is a dental appliance which prevents the lower jaw from falling back during sleep. Despite all my education on this topic, I grew frustrated. Not only was I not treating as many patients as I wanted, I also had way too many patients, who I knew had issues, but would have a “normal” sleep study. I decided I needed more education.

Relatively speaking, the research in this area of medicine is early in its development. There is clear evidence that sleep disordered breathing affects more people in more ways than was thought in the past. As the research continues, more people will be able to be helped to breathe and sleep better.

Although there are many people with obstructive sleep apnea who need treatment, with either CPAP, a dental appliance, or some other form of treatment, there are many more people who have the same signs and symptoms as people with apnea and poor sleep, but they “pass” a sleep study. There is also a diagnosis called Upper Airway Resistance Syndrome (UARS), which is not talked about much. I’ll discuss this is a future column, but if you “passed” a sleep study (especially if you’re on the younger side) and have the symptoms of sleep apnea, UARS should be considered.

In most cases, problems related to the airway start very early in development, and progress throughout life to finally show up in a sleep study as apnea when a person is older. It is an evolutionary/developmental problem. Dentists have an extremely important role to play in helping to identify these issues in all phases of life, especially in children, where most of these problems begin. Identifying them early can allow intervention through orthodontics and other non-invasive therapy, and completely change the course of development, leading to a life of better breathing and better health.

For adults, because they have stopped growing and have signs and symptoms related to breathing issues, but would otherwise “pass” a sleep study, there is help available. Identifying those people, controlling the problems causing these issues, and offering ways to a more permanent resolution is where medicine and dentistry must grow together.

Sleep apnea is the end stage of this breathing disorder. Treatment for those with sleep apnea is typically either the “gold standard” of CPAP, wearing a mask on your face for the rest of your life, or wearing a dental appliance in your mouth for the rest of your life (although it may not work forever), or major surgery to fix the anatomy that is causing this progressive disease. The goal is to not get to the end stage of this disease. 

As I learn and share more about this topic in the future, you will be amazed at some of the things that are related to breathing issues, such as ADHD, developmental issues, memory problems, TMJ pain, poor quality sleep, snoring, and a host of other things. While research in this area is ongoing, there is plenty of scientific evidence already out there to support this information. Breathe well.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have, please email them to him at

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