Source: Rutgers UniversitySummary: New research reveals how dental check-ups could be the first line of defense against deadly sleep disorders.

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A patient dozes off in a dental chair despite the anxiety of an impending procedure. A seemingly unremarkable act but — for dentists versed in the latest sleep research — this red flag hints at a life-threatening condition.

In a research review published in the Journal of the American Dental Association, Rutgers Health researchers identified dentists as an unexpected player in the battle against life-threatening sleep disorders.

The review suggests dental professionals have unique opportunities to screen for conditions such as obstructive sleep apnea, a disorder that affects millions of Americans and is linked to serious health risks, including cardiovascular disease and neurodegeneration.

It also challenges dentists to look beyond teeth and gums to the broader landscape of patient health.

“We have a great opportunity to change lives for the better,” said Davis Thomas, a clinical associate professor at the Rutgers School of Dental Medicine and senior author of the review. “Dentists can be the first line of defense in identifying sleep disorders. They often see symptoms long before physicians. Indicators like tooth grinding, tongue scalloping or even a patient dozing off in the chair can be early signs that something more is going on.”

Sleep disorders such as obstructive sleep apnea affect more than half of Americans at some point in their lives. Many cases go undiagnosed, but dentists can play an important role in reducing those numbers.

The review outlines several key indicators that dental clinicians should look for during examinations, including enlarged jaw muscles, scalloped tongue edges, white lines on the cheeks, restricted visibility of the throat, dental wear patterns and tiny cracks on teeth.

These physical signs, combined with patient history and simple screening tools, can help dentists identify at-risk patients with up to 80 percent accuracy.

“It’s not just about looking at teeth anymore,” Thomas said. “We need to observe the whole patient, from their behavior in the waiting room to the subtle signs in their oral cavity.”

Another sign of concern, according to the review authors, is bruxism, commonly known as teeth grinding. Contrary to long-held beliefs, the studies suggest teeth griding is often a symptom of underlying sleep issues rather than a standalone problem caused by dental misalignment.

“We’ve been treating the symptoms without addressing the root cause for far too long,” Thomas said. “By understanding the neuroscience behind sleep disorders, we can provide more comprehensive care and potentially prevent serious health complications.”

This shift in perspective could have far-reaching implications. By identifying patients at risk for sleep disorders, dentists can facilitate early intervention, potentially preventing complications such as hypertension, heart disease and stroke.

To implement these findings, Thomas and his team propose a simple protocol for dental practices: Incorporate sleep-related questions into patient history forms. Other recommendations include training dental staff to recognize physical signs of sleep disorders and using validated screening tools like the STOP-BANG (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck size, gender) questionnaire, which screens for obstructive sleep apnea and establish referral networks with sleep medicine specialists.

“We’re not asking dentists to diagnose sleep disorders,” Thomas said. “We’re asking them to recognize the signs and make appropriate referrals. This simple act can be lifesaving.”

Thomas recommends that dentists looking to incorporate sleep screening into their practices start with education.

“Attend sleep medicine conferences, take continuing education courses, and stay up-to-date with the latest research,” he said. “The more we learn, the more we realize how much we don’t know — and how much we can do to help our patients.”

As the calendar turns and you set intentions for a healthier, more vibrant you, there’s one powerful cornerstone of wellbeing that’s often overlooked: sleep. Deep, uninterrupted rest isn’t just about feeling refreshed in the morning — it supports immune function, cognitive clarity, emotional balance, and long-term health. Yet for millions of adults, truly restorative sleep remains out of reach night after night.

If you find yourself waking up tired despite “sleeping enough,” snoring loudly, feeling fatigued during the day, or gasping for breath at night, there’s a possibility you’re struggling with a common but serious sleep disorder: obstructive sleep apnea (OSA). This condition occurs when muscles in the throat relax and block the airway during sleep, leading to repeated pauses in breathing and fragmented rest. Sleep Apnea Dentists of New England

Why Sleep Apnea Matters

Obstructive sleep apnea doesn’t just interrupt sleep — it can have wide-ranging effects on your health. Frequent breathing pauses reduce oxygen levels and trigger brief awakenings, leaving you less rested and increasing the strain on your cardiovascular system. Long-term untreated sleep apnea is linked with higher risks of high blood pressure, heart disease, stroke, and cognitive challenges. Sleep Apnea Dentists of New England

You Can Sleep Better — and Live Better

The good news is that there are effective, non-invasive treatments that can help restore restful sleep. At Sleep Apnea Dentists of New England, a team with decades of experience helping adults breathe and sleep more easily, you can explore solutions tailored to your needs. Sleep Apnea Dentists of New England

One common option is oral appliance therapy, where a custom-fitted device gently repositions the jaw and tongue to keep the airway open during sleep. These appliances are often more comfortable and easier to use than traditional CPAP machines — and many patients see significant improvement in their symptoms and overall sleep quality. Sleep Apnea Dentists of New England

Make Great Sleep Part of Your Healthy New Year

Good intentions are powerful — but they become transformative when paired with actions that support your body’s rhythms. Prioritizing sleep sets the foundation for better energy, sharper focus, healthier metabolism, and emotional resilience all year long.

If poor sleep has been holding you back, let this be the year you take it seriously. Visit https://sadofne.com to learn more about obstructive sleep apnea and find out how treatment can help you finally enjoy deep, restorative sleep. Your best self begins with a great night’s rest.

Incorporating specific lifestyle habits and breathing exercises into your daily routine can help improve sleep quality and may reduce the frequency of sleep apnea episodes. Here are some effective, evidence-informed options:

Breathing Exercises

1. Diaphragmatic Breathing

• How to do it:
  Lie on your back with your knees bent. Place one hand on your chest and the other on your abdomen.
  Inhale deeply through your nose, feeling your abdomen rise.
  Exhale slowly through your mouth.
• Duration: 5–10 minutes daily.

2. Pursed-Lip Breathing

• How to do it:
  Inhale through your nose for a count of two.
  Purse your lips as if blowing out a candle, then exhale slowly for a count of four.
• Duration: A few minutes each day.

Lifestyle and Physical Activity

3. Cardiovascular (Aerobic) Exercise

• Recommendation: Aim for at least 30 minutes of moderate aerobic activity, such as brisk walking, cycling, or swimming, five days per week.
• Benefits: Improves cardiovascular health and may reduce apnea episode frequency by supporting healthy body weight and respiratory function.

4. Strength Training

• Recommendation: Perform resistance training—using weights, resistance bands, or bodyweight moves like push-ups or squats—twice weekly.
• Benefits: Builds muscle mass, enhances metabolism, and supports overall body composition.

5. Yoga and Respiratory-Focused Practices

• Recommendation: Incorporate yoga, pranayama (yogic breathing), or other mindful breathing practices.
• Benefits: Strengthens respiratory muscles, promotes relaxation, and enhances airflow during sleep.

Important Reminder

Always consult with a healthcare professional before starting any new exercise or breathing routine—especially if you have sleep apnea—to ensure it is safe and tailored to your specific condition.

Sleep trackers can give you valuable insights into your nightly rest — but the colorful graphs and percentages they produce can be confusing. Understanding what those numbers mean can help you make sense of your sleep quality and spot potential concerns.

The Basics of Sleep Stages

Most sleep trackers divide your night into light sleep, deep sleep, and REM (rapid eye movement) sleep.
In healthy adults, the typical sleep pattern breaks down like this:

• Light sleep (N1 + N2): 50–60% of total sleep time
• Deep sleep (N3 or slow-wave sleep): 15–25%
• REM sleep: 20–25%

Light sleep includes two stages: N1 (the transition from wakefulness) and N2 (the bulk of sleep). Deep sleep, or N3, is the most restorative stage — your body repairs tissue, builds bone and muscle, and strengthens the immune system. REM sleep is when most dreaming occurs, and it plays a vital role in memory, mood regulation, and learning.

How Age Affects Sleep Architecture

Sleep patterns naturally change over time. Younger adults tend to have more deep sleep, while older adults experience less deep sleep and more light sleep.
This doesn’t necessarily mean poor-quality sleep — it’s a normal part of aging. However, very low deep sleep percentages can sometimes be linked to sleep disorders, pain, or fragmented sleep.

How Your Night is Structured

A typical night’s sleep follows a repeating cycle of about 90 minutes. Deep sleep dominates the first third of the night, while REM sleep increases toward morning.
So if your tracker shows long REM periods closer to wake-up time, that’s perfectly normal.

Individual Variation is Normal

Everyone’s sleep architecture is slightly different. Factors such as stress, alcohol, medications, and sleep deprivation can shift these percentages. Occasional variations are normal — what matters most is how you feel during the day.
If you’re consistently waking up unrefreshed or your tracker shows large imbalances (for example, very little deep or REM sleep), it may be worth discussing your results with a sleep specialist.

The Takeaway

In general, a healthy adult’s sleep should average:

• 50–60% light sleep
• 15–25% deep sleep
• 20–25% REM sleep

Use your sleep tracker as a guide, not a diagnostic tool. It’s great for spotting trends — such as reduced deep sleep after stress or better REM sleep after regular exercise — but only a formal sleep study can accurately diagnose sleep disorders like sleep apnea.

Dr. Vicki E Cohn, Diplomate, ABDSM Clinical Director Sleep Apnea Dentists of New England, PLLC 70 Wells Ave., Suite 103 Newton, MA 02459 Office:  (617) 964-4028 Fax: (617) 595-4591  Editorial Board, Journal of Dental Sleep Medicine Past Chair, Dental Assembly – American Academy of Sleep Medicine Inaugural Host AADSM Open AirWaves

When most people think of the tongue, they picture the small, flexible muscle they see in the mirror — something that helps with speaking, eating, and tasting. But in reality, the tongue is far more complex, powerful, and larger than it appears on the surface.

The video we’re sharing offers a fascinating visualization of the true size and strength of the human tongue — and it might surprise you.

The Real Size of Your Tongue

What you see when you stick out your tongue is only the front portion. The tongue actually extends far back into the throat, anchored deep within the mouth by a series of muscles and connective tissues. It’s a muscular hydrostat — much like an octopus arm — made up of interwoven muscle fibers that allow it to move in almost any direction.

If you could see the entire structure, you’d realize it’s not just a flat surface but a thick, three-dimensional muscle system that fills much of the lower part of your mouth.

Strength Beyond Its Size

Despite its small appearance, the tongue is remarkably strong. It’s constantly working — pressing, shaping, and moving food as we chew and swallow, and precisely coordinating movements to form speech sounds. The strength of the tongue comes from its versatility rather than brute force: it can apply continuous pressure and fine-tuned control, often performing thousands of movements per minute without fatigue.

Some estimates suggest the tongue’s muscles can generate up to several pounds of force, depending on the task. That’s impressive for an organ that weighs only about 70 grams (2.5 ounces) on average!

Why It Matters

Understanding the tongue’s true size and strength gives us a deeper appreciation for how essential it is to daily life — from communication and eating to maintaining airway health. The video visualization brings this to life, showing just how remarkable this small but mighty muscle really is.

So, the next time you speak, taste, or enjoy a meal, remember — there’s a powerful system of muscles at work behind the scenes, doing far more than meets the eye.

A patient advocate realizes that perfect can become the enemy of good care for OSA patients who fail or refuse CPAP.

By Emma Cooksey | Original Article, SLEEP REVIEW

Years ago, I got into a heated exchange with an Italian dentist on social media. I cringe when I reflect on it now. 

The dentist shared that he had a patient with severe obstructive sleep apnea (OSA) who was unable to use his CPAP machine. Fitting a custom oral appliance, the dentist reduced the man’s apnea-hypopnea index (AHI) from the 70s to only nine events per hour. Instead of applauding a good outcome and the improved quality of life the patient was experiencing, I complained, “Obstructive sleep apnea isn’t properly treated until the AHI is under five events per hour.” 

The exasperated dentist calmly pointed out that the patient had abandoned his CPAP therapy and had left his OSA entirely untreated before he got his oral appliance.

“Isn’t an AHI of nine with an oral appliance better than an AHI in the 70s with no treatment?” he asked.

Since this exchange, I have been ruminating on this question. In that time, I have recorded more than 140 episodes of my podcast, “Sleep Apnea Stories,” interviewing people living with sleep apnea about their treatment choices as well as experts from different specialties. I have learned so much about the broad spectrum of experiences in our sleep apnea community and the reasoning behind individual treatment choices. 

I can understand the frustration of board-certified sleep specialists who prescribe CPAP therapy to their patients, only to see it abandoned. I am a huge advocate of more support and resources for new CPAP users struggling to adapt to their therapy. Early intervention with practical troubleshooting and empathy can be all that’s needed to take someone from giving up on their therapy to successful adherence. This could be a group CPAP therapy clinic for new users to get support in person, or an online coaching model similar to what companies like Lofta and BetterNight provide.

The very best sleep clinics offering superb support to new CPAP users still have a significant number of people who either never start CPAP therapy or abandon it over time. For those people who are leaving their OSA entirely untreated, we need a new attitude of pragmatism. Arguing that CPAP therapy offers the best results in people who use it isn’t helping the group who won’t or can’t use their machine.

The great news for patients is that the range of viable treatment options for OSA is expanding. The GLP-1 tirzepatide is already available as Zepbound, an injectable medication for people with both OSA and obesity. The oral pill version orforglipron has recently reported positive phase 3 trial results. Also in the “coming soon” category is Apnimed’s AD109, a once nightly oral pill that works to maintain upper airway muscle tone during sleep. The successful phase 3 trials for AD109 open up a whole new frontier of using pharmacotherapy to target the cause of OSA. 

The dental sleep medicine community, not to be outdone, has been working hard on appliances with integrated SpO₂ sensors. These oral appliances will enable the sharing of data, including wear time, oxygen desaturation index, pulse rate, and more, not only with patients but also directly with doctors. 

Ear, nose, and throat surgeons have more techniques at their disposal than ever too. Top surgeons continue to refine throat surgeries to include new techniques like transoral robotic surgery. Hypoglossal nerve stimulation implants are evolving with the new Inspire V system with quicker surgery time and a Bluetooth patient remote. Nxyoah’s Genio neurostimulator just earned FDA clearance.

With so many treatment options currently available, and on the horizon, it is time we adopt a more pragmatic approach to considering a person’s OSA “well-treated.” Offering a treatment other than CPAP to lessen the severity of the OSA is far better for quality of life and health outcomes than no treatment at all.

As a patient advocate, I feel strongly that every person with an OSA diagnosis should be educated on and offered all the treatment options that could be useful to them.

I have, in short, changed my tune and now agree with the Italian dentist I argued with. I wish I could remember his name so I could apologize directly. Reducing the severity of obstructive sleep apnea and improving the quality of life for each individual is a worthy goal, even without hitting fewer than five events per hour.