Midwest Dental Sleep Medicine Institute

10/21/2026

Your brain does its housekeeping while you sleep.

I recently read a wonderful article with images of the brain hemispheres moving slightly apart during sleep. Picture downtown Chicago at rush hour, completely clogged, versus 2 or 3 in the morning, when State Street and Michigan Avenue are wide open. According to the article, during good sleep the brain opens up so cerebrospinal fluid can flow through and clear waste, including amyloid and tau proteins. This happens mostly during REM sleep.

Call (314) 478-8877 to schedule a consultation.

10/20/2026

The goal of treating sleep apnea isn't just a quieter night.

Whether it's CPAP, an oral appliance, or hypoglossal nerve stimulation, the goal is to treat obstructive sleep apnea well enough that you stop snoring, wake up refreshed, and lose the daytime sleepiness. But you are way more complex than a single device. I want to work with regenerative and functional medicine doctors, who look at the body as one unified system. If your treatment isn't giving you the full result, there may be more to uncover, and I'm happy to help look.

Call (314) 478-8877 to schedule a consultation.

10/19/2026

If your sleep device isn't fixing everything, that doesn't mean something is wrong with you. It usually means we need to look wider.

Whether you're on CPAP or an oral appliance, you're still a complex human being.

At my exams I tell patients, "If just using the device isn't helping, let's dig deeper." Work with your primary care doctor or cardiologist to find where your inflammation is coming from. For me, it comes down to sleep, diet, less stress, and movement. Walk for about 30 minutes after dinner and leave about two hours between your last meal and bedtime. Eating at 9 and going to bed at 10:30 is early, but you're still digesting. We all want what we want right now, and that's where processed food comes in. Live intentionally.

Call (314) 478-8877 to schedule a consultation.

10/13/2026

Here’s the chain reaction I walk patients through constantly: when you stop breathing during sleep, your brain registers an arousal, and that arousal doesn’t just fragment your sleep stages, it activates your HPA axis (hypothalamus, pituitary, adrenal gland).

That triggers a cascade: ACTH signals the adrenal gland, which releases cortisol along with epinephrine and norepinephrine. Your body goes into fight-or-flight — increased sympathetic tone — which is exactly why so many patients tell me they’re still exhausted even after what felt like a full night in bed.

And cortisol doesn’t stop there. It also makes you insulin resistant and glucose intolerant, increasing inflammation throughout the body. We know this relationship with type 2 diabetes runs both ways — which is exactly why so many of my patients come in already pre-diabetic, sometimes already on metformin, with no one having connected the dots back to their sleep.

Sleep apnea isn’t just a nighttime problem. It’s a metabolic one too.

I’d love the chance to help your patient sleep better — reach out anytime and let’s get them scheduled. 📞 (314) 478-8877

09/16/2026

Here's something worth understanding about your sleep apnea diagnosis: the number 5 events per hour isn't a magic biological line — it's just where insurance coverage kicks in. If you're stopping breathing 6 times an hour, you're technically over that threshold. But if you're stopping breathing less than 5 times an hour, you can still have real sleep apnea, or at least upper airway resistance syndrome. The number determines paperwork, not whether your airway is actually a problem.

I've made an estimated 4,000-5,000 oral appliances over the last 19 years, and in my experience, a lot of physicians still default straight to CPAP first — even for patients who could be opened easily with an oral appliance — and only "reluctantly" consider the appliance after CPAP fails.

If you're just over that insurance threshold, that doesn't mean CPAP is automatically your best first option. It might just mean you were sent down the more common path, not necessarily the right one for you.

I'd love the chance to help your patient sleep better — reach out anytime and let's get them scheduled.

09/10/2026

"It's just Poiseuille's Law."

That's the physics behind something I see constantly in dental sleep medicine: when a patient's upper airway isn't functioning well, they default to mouth breathing, and mouth breathing makes the airway more likely to collapse. The nose is simply farther from the airway than the mouth, so once nasal breathing breaks down, more air (and more collapse risk) comes through the mouth instead.

But nasal breathing isn't just about airflow. Your turbinates humidify the air on the way in. Your cilia filter it. And your nose produces nitric oxide — a compound that actually helps lower blood pressure. Skip nasal breathing, and you're not just breathing differently; you're losing real physiological benefit.

This is exactly why I don't stop at fitting an oral appliance. I check nasal breathing first, because treating the mouth without treating the nose is only half the job.

I'd love the chance to help your patient sleep better, reach out anytime and let's get them scheduled.

09/09/2026

"How did you sleep as a teenager?"

It's not a question most doctors have time to ask, and that's not a knock on them. I work right here at DePaul Hospital, and I genuinely know that three-quarters of the physicians in St. Louis care deeply about their patients. They just don't have the time to dig that deep.

I do. When a new patient sits down with me, I want to know why they think they have sleep apnea, how long it's been going on, and yes — how they slept as a teenager. It sounds like a small detail, but sleep patterns don't start the day someone gets diagnosed. They tell a longer story, and that story matters for actually understanding what's going on.

Taking the time to ask isn't extra; it's the whole point. It's how I help patients understand exactly what's happening with their sleep, instead of just handing them a device and hoping for the best.

If you've been struggling with sleep and no one's really asked about your history, I'd love the chance to actually listen. Reach out anytime and let's get you scheduled.

09/01/2026

Look at your tongue. See scalloping along the edges? That's often a clear sign of sleep apnea and something I teach other dentists to watch for.

08/31/2026

Here's something that might surprise you: how tired you feel doesn't always match how severe your sleep apnea test results look. I've had patients who stop breathing dozens of times an hour tell me they don't feel that tired, and patients with much lower numbers who are absolutely exhausted.

What often matters more than the raw number is how often you're being pulled out of deep, restorative sleep by tiny arousals you don't even remember. That disruption, not just the number of times breathing stops, is often what's behind persistent daytime fatigue.

If your test results were labeled "mild" but you still feel wiped out every day, that mismatch is worth a real conversation, not a dismissal.

Still tired despite a "mild" diagnosis? Schedule a consultation today.

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08/26/2026

Here's something I tell colleagues honestly: we don't know everything about sleep yet. Why do I have patients who stop breathing 50 times an hour walk in and tell me they're not tired at all? That's a real question I still sit with.

But I do know this...the cardiology connection is one of the clearest signals I see in my practice. I regularly get atrial fibrillation patients referred to me because they're not using their CPAP, and their cardiologist knows exactly what that means: the AFib treatment won't hold long-term if the underlying sleep apnea isn't addressed. Research published in the New England Journal of Medicine confirmed exactly that link.

So even when a patient doesn't feel tired, that doesn't mean nothing's at stake. For AFib patients especially, getting an oral appliance in place isn't just about better sleep; it's often what makes the rest of their cardiac treatment actually work.

I'd love the chance to help your patient sleep better — reach out anytime and let's get them scheduled.