If you are waking up exhausted, struggling with chronic fatigue, or dealing with a bed partner’s loud snoring, you are likely searching to understand what is sleep apnea and how it affects your long term health. Sleep apnea is a common, potentially serious clinical disorder where a patient’s breathing repeatedly stops and restarts during sleep [F001]. Fortunately, once diagnosed, there are highly successful sleep apnea treatment options available to help you restore deep sleep and protect your cardiovascular health.

To schedule a clinical sleep consultation in Encino with Dr. Michael Simmons, please call our office at (818) 300-0070 or contact our team through our New Patients portal.

What Exactly Is Sleep Apnea?

Sleep apnea is a common, potentially serious clinical disorder where a patient’s breathing repeatedly stops and restarts during sleep [F001]. These pauses can last from a few seconds to several minutes, and in severe cases, they may occur dozens of times per hour [F011]. When breathing stops, the body’s blood oxygen levels drop, which disrupts deep sleep and triggers a survival response that causes the patient to wake up briefly to gasping or choking [F004].

Because these brief awakenings are extremely short, most patients do not remember them. Instead, they wake up feeling unrefreshed, experiencing chronic fatigue, and wondering why they are exhausted despite spending a full night in bed. It is estimated that up to 80% of moderate to severe sleep apnea cases remain undiagnosed, making patient education and proactive clinical screening essential first steps.

Types of Sleep Apnea: Obstructive, Central, and Complex

Sleep apnea is not a single, uniform medical condition. It is categorized into three primary types based on the underlying anatomical or neurological mechanism causing the breathing interruption:

• Obstructive Sleep Apnea (OSA): This is the most common form of the disorder, accounting for the vast majority of all clinical diagnoses [F002]. Obstructive sleep apnea occurs when the muscles in the back of the throat relax excessively during sleep, causing the soft tissues to collapse and physically block the upper airway [F012]. As the body attempts to draw breath against this physical obstruction, normal breathing is disrupted until a brief arousal triggers the throat muscles to tighten, often marked by a loud snort, gasp, or choking sound [F013].
• Central Sleep Apnea (CSA): Unlike OSA, central sleep apnea is not caused by a physical blockage of the throat. Instead, it is a neurological concern that occurs when the brain fails to send the proper signals to the muscles that control breathing [F003]. Patients with CSA may stop breathing for prolonged periods without making an effort to breathe, which requires specialized neurological and medical evaluation to determine the root cause.
• Complex (or Mixed) Sleep Apnea: This condition occurs when a patient exhibits signs of both obstructive sleep apnea and central sleep apnea during a sleep evaluation. Often, the central sleep apnea component becomes apparent only after the physical airway obstruction has been treated.

Key Differences and Mechanisms

To help patients and referring physicians understand how these types compare, the table below outlines the primary mechanisms, symptoms, and clinical considerations for each form of sleep apnea:

Apnea Type	Primary Mechanism	Common Symptoms	Clinical Considerations
Obstructive (OSA)	Physical collapse of soft tissue in the upper airway blocking airflow [F012]	Loud, chronic snoring; gasping or choking; morning headaches; daytime sleepiness [F013, F014]	Most common form; highly responsive to custom oral appliance therapy or CPAP [F009]
Central (CSA)	Neurological failure of the brain to signal breathing muscles [F003]	Quiet pauses in breathing; frequent nighttime awakenings; shortness of breath	Often linked to underlying medical conditions; requires medical sleep specialist care
Complex (Mixed)	Combination of physical airway collapse and neurological signal failure	Overlapping symptoms of both OSA and CSA; complex breathing patterns	Requires advanced diagnostics and individualized multidisciplinary management

How Sleep Apnea Severity Is Measured (The AHI Scale)

To determine the appropriate clinical treatment pathway, sleep clinicians use a standardized metric known as the Apnea-Hypopnea Index (AHI). The AHI measures the average number of apnea (complete breathing pauses) and hypopnea (partial breathing reductions) events that occur per hour of sleep during a diagnostic sleep study.

Based on the AHI score, sleep apnea severity is classified into three distinct categories:

• Mild Sleep Apnea (AHI of 5 to 15 events per hour): The patient experiences 5 to 15 breathing pauses per hour. While this is the lowest clinical threshold, patients with mild sleep apnea can still suffer from significant daytime fatigue, morning headaches, and elevated long term health risks.
• Moderate Sleep Apnea (AHI of 15 to 30 events per hour): The patient averages 15 to 30 breathing events per hour. At this level, daytime sleepiness is often more pronounced, and the physiological strain on the cardiovascular system increases.
• Severe Sleep Apnea (AHI of more than 30 events per hour): The patient stops breathing 30 or more times every hour [F011]. This means the airway collapses at least once every two minutes throughout the entire night, causing extreme oxygen desaturation, severe sleep fragmentation, and critical medical risks.

If you suspect your snoring is a sign of sleep apnea, do not wait to seek medical guidance. Contact the Encino Center for Sleep and TMJ Disorders at (818) 300-0070 to learn more about our specialized clinical evaluation process.

How Is Sleep Apnea Diagnosed: From Clinical Signs to Sleep Study

An accurate diagnosis is the essential foundation of any successful sleep therapy plan. The diagnostic process begins with a clinical evaluation of symptoms and physical risk factors, and is confirmed using objective diagnostic sleep testing [F008].

Recognizing the Clinical Signs and Risk Factors

Patients are often prompted to seek an evaluation because of visible symptoms or key risk factors. The most common indicators of sleep apnea include:

• Chronic, loud snoring or snorting sounds that disrupt a bed partner’s sleep [F013]
• Observed episodes of gasping, choking, or silent breathing pauses during the night
• Excessive daytime drowsiness, persistent fatigue, and morning headaches [F005]
• Waking up with a dry mouth, sore throat, or a feeling of gasping for air
• Difficulty concentrating, brain fog, mood changes, and memory difficulties [F007]

Certain anatomical and physical factors can also increase a patient’s risk of developing sleep apnea. These include being overweight, being male, having a family history of sleep disorders, having a naturally narrow airway, or presenting with a small lower jaw [F014]. In children, sleep apnea is frequently associated with enlarged tonsils or adenoids, which physically obstruct the airway during sleep [F015].

The Role of Objective Sleep Testing

While clinical signs can indicate a high probability of sleep-disordered breathing, sleep apnea cannot be diagnosed by symptoms alone. Confirming the diagnosis requires objective testing, which typically takes one of two forms:

1. Polysomnography (PSG): This is an overnight sleep study conducted in a dedicated laboratory setting. A polysomnogram monitors a wide range of physiological signals, including brain waves, eye movements, heart rate, breathing effort, airflow, and blood oxygen levels. PSG remains the gold standard for comprehensive sleep diagnostics, particularly when central sleep apnea or complex comorbid conditions are suspected.
2. Home Sleep Testing (HST): For many patients with a high likelihood of moderate to severe obstructive sleep apnea, a home sleep study is a convenient, reliable diagnostic option. Using a portable monitoring device worn in the comfort of the patient’s home, an HST records essential breathing parameters, airflow, and oxygen saturation.

It is important to note that the Encino Center for Sleep and TMJ Disorders does not perform diagnostic sleep studies in-office. Instead, we work within a collaborative, multidisciplinary medical-dental care model. Dr. Michael Simmons and our clinical team coordinate closely with qualified board-certified sleep physicians who interpret the diagnostic testing, establishing a medically sound foundation before initiating custom dental sleep therapy.

What Happens If Sleep Apnea Goes Untreated?

Leaving sleep apnea unmanaged is far more than a convenience or noise issue. Because every breathing pause deprives the body of essential oxygen and subjects the cardiovascular system to intense, repeated stress, untreated sleep apnea carries severe, documented health consequences [F004].

Cardiovascular and Metabolic Risks

Each time the airway collapses, the body’s oxygen levels drop, triggering a sudden release of stress hormones like adrenaline. This causes blood pressure and heart rate to spike, putting tremendous strain on the cardiovascular system. Over time, this chronic stress leads to a massive increase in serious medical risks, including:

• High Blood Pressure: Untreated sleep apnea is a leading cause of resistant hypertension.
• Heart Disease and Heart Attack: The repeated drops in blood oxygen increase the risk of coronary artery disease, heart failure, and myocardial infarction [F006].
• Stroke: The combination of vascular strain, oxygen desaturation, and inflammation significantly elevates stroke risk [F006].
• Type 2 Diabetes: Sleep apnea alters metabolic function, leading to increased insulin resistance and poor blood sugar control.

Cognitive and Safety Implications

The severe sleep fragmentation caused by sleep apnea prevents patients from reaching the deep, restorative stages of sleep. This chronic sleep deprivation impacts daily cognitive functioning, causing persistent brain fog, memory issues, difficulty concentrating, and impaired decision-making [F007].

Furthermore, the resulting daytime drowsiness creates immediate physical safety hazards. Studies show that individuals with untreated sleep apnea are at a significantly higher risk of experiencing work-related injuries and serious motor vehicle crashes due to microsleeps and slow reaction times [F016].

Are you looking for a highly credible alternative to CPAP? Call the Encino Center for Sleep and TMJ Disorders at (818) 300-0070 to schedule your custom oral appliance therapy evaluation with Dr. Michael Simmons today.

Highly Credible Clinical Alternatives for Sleep Apnea Care

For patients diagnosed with obstructive sleep apnea, continuous positive airway pressure (CPAP) is widely recognized as a gold-standard treatment, delivering a steady stream of air to keep the airway open [F009]. However, compliance remains a major clinical challenge. Many patients find the mask, hose, and pressure uncomfortable, leading them to discontinue therapy and leave their health at risk.

Fortunately, custom Oral Appliance Therapy (OAT) provides an evidence-based, highly credible alternative for patients with simple snoring, mild to moderate OSA, and severe OSA patients who are CPAP-intolerant. These compact, custom-fit devices are designed by a trained dental sleep medicine specialist to gently support the lower jaw in a forward position, preventing the tongue and soft tissues from collapsing into the airway.

In complex cases, co-therapy, the combined use of a custom oral appliance alongside CPAP, can also be highly effective, allowing the CPAP pressure to be lowered to a more comfortable, tolerable level.

Dr. Michael Simmons, DMD, MS, is a dual-board certified specialist in Orofacial Pain and Dental Sleep Medicine with decades of academic, teaching, and clinical experience. As the first practicing dentist worldwide to receive Fellowship in the American Academy of Sleep Medicine (FAASM), Dr. Simmons provides the rare level of specialist authority needed to design, fit, and gradually adjust custom oral appliances, ensuring optimal clinical efficacy and long term jaw comfort.

Frequently Asked Questions About Sleep Apnea

Is sleep apnea a serious condition?

Yes, sleep apnea is a potentially serious medical condition. Beyond chronic fatigue and loud snoring, untreated sleep apnea causes frequent blood oxygen drops and sleep fragmentation. This significantly increases the risk of high blood pressure, heart disease, stroke, type 2 diabetes, and severe motor vehicle or workplace accidents [F006, F016].

Can sleep apnea be treated without a CPAP machine?

Yes. While CPAP is a highly effective treatment, custom Oral Appliance Therapy (OAT) is an evidence-based, FDA-approved treatment option for patients with snoring, mild to moderate obstructive sleep apnea, and severe sleep apnea patients who cannot tolerate or prefer not to use CPAP. It is essential to work with a qualified dental sleep medicine specialist to ensure the device is custom-fit and clinically effective.

How do I know if I have sleep apnea or just snore?

While simple snoring involves the vibration of soft tissues in the throat, sleep apnea involves actual breathing pauses where airflow is completely or partially blocked [F011]. If your snoring is accompanied by gasping or choking sounds, morning headaches, chronic daytime fatigue, or observed breathing pauses, you should seek a professional sleep evaluation [F013]. You can learn more about the differences between snoring and sleep apnea on our snoring and sleep apnea clinical page.

What is the process to get a custom oral appliance?

The process begins with a comprehensive clinical evaluation of your airway, teeth, gums, and jaw-joint health, which is highly relevant because sleep disorders and TMJ disorders frequently co-occur. After verifying your diagnostic sleep study findings in collaboration with a sleep physician, custom impressions or digital scans are taken of your mouth. A specialized dental laboratory fabricates your custom appliance, which is then carefully fitted and gradually adjusted by Dr. Michael Simmons to ensure safety and effectiveness.

If you or a loved one is experiencing snoring, gasping during sleep, or unrestful rest, contact the Encino Center for Sleep and TMJ Disorders at (818) 300-0070 to schedule your comprehensive consultation with Dr. Michael Simmons.