Millions of people wear a CPAP machine every night, the standard breathing device prescribed for sleep apnea. They trust the number on the screen to tell them their sleep apnea is under control. I’ve had patients tell me they stopped using theirs because it felt pointless, and it turns out that feeling was often correct.
We dive deeper into this in this episode of Extend with Dr. Sahil Chopra and Sagar Chopra, co-founders of Empower Sleep. We also chat about why palate shape and mouth breathing are driving more sleep apnea in kids, how GLP-1 medications are changing the CPAP conversation, and the truth about lip taping.
Dr. Sahil Chopra is a pulmonary, critical care, and sleep medicine physician trained at UCLA and Loma Linda, with fellowship training in sleep medicine at Harvard. He is co-founder of Empower Sleep, a longitudinal home sleep testing platform used by physicians and patients nationwide. Sagar Chopra holds an MBA from the Wharton School, previously worked on product growth at Uber, and co-founded Empower Sleep alongside his brother, Dr. Sahil Chopra.
What We Discuss:
(8:04) The Landmark Study: 25,000 Nights of Data and the CPAP Discordance Problem
(13:43) Inside the Empower Sleep Device and How It Differs From Wearables
(25:27) Palate Shape, Mouth Breathing, and the Rise of Pediatric Sleep Apnea
(30:31) Menopause, Andropause, and Why Sleep Apnea Shows Up Later in Life
(41:53) Hypoglossal Nerve Stimulators and Central Sleep Apnea
(47:27) How GLP-1 Medications Are Changing Sleep Apnea Treatment
(51:13) The Truth About Lip Taping and Nasal Breathing
Thank You to Our Sponsors:
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Learn more about Dr. Shah:
Website: drshah.com/
Clinic: next-health.com/
Instagram: @darshanshahmd
Learn more about Dr. Sahil Chopra and Sagar Chopra:
Empower Sleep: empowersleep.com/
Sagar Chopra on LinkedIn: choprasagar/
Sagar Chopra on X: schopsss
More Resources:
Quality sleep is the most underestimated longevity accelerator. Download this sleep optimization workbook to transform sleep into a powerful longevity practice: drshah.com/sleep
Comments Off on Is Your Morning Headache Actually Sleep Apnea? 7 Warning Signs You Shouldn’t Ignore
by SadofNE
This article naturally leads readers toward scheduling a consultation because many people don’t realize their symptoms point to sleep apnea rather than stress or aging.
Is Your Morning Headache Actually Sleep Apnea? 7 Warning Signs You Shouldn’t Ignore
Most people assume waking up with a headache is simply part of a stressful life.
Maybe you slept in a strange position. Maybe you’re dehydrated. Maybe you just need another cup of coffee.
But if those morning headaches happen regularly, your body may be trying to tell you something much more important.
One of the most commonly overlooked symptoms of obstructive sleep apnea is waking up with frequent headaches—and it’s far from the only warning sign.
At Sleep Apnea Dentists of New England, we often meet patients who have struggled for years before discovering that poor sleep—not stress—was the real culprit.
Why Does Sleep Apnea Cause Morning Headaches?
Obstructive sleep apnea occurs when your airway repeatedly collapses while you sleep.
These interruptions reduce oxygen levels and force your brain to wake you—sometimes hundreds of times each night—to reopen your airway. Even if you don’t remember waking up, your body does.
Lower oxygen levels combined with disrupted sleep can trigger headaches that are often present immediately upon waking and gradually improve throughout the morning. Sleep apnea is also associated with excessive daytime sleepiness, impaired concentration, and increased cardiovascular risk if left untreated.
Seven Warning Signs You Shouldn’t Ignore
1. Morning Headaches
If your headaches occur several mornings each week and seem to disappear after you’ve been awake for a while, sleep apnea may be contributing.
2. Loud Snoring
Not everyone who snores has sleep apnea.
However, loud, chronic snoring—especially when accompanied by pauses in breathing—is one of the most common indicators of obstructive sleep apnea.
Often, it’s a spouse or family member who notices first.
3. Waking Up Tired Every Day
Have you ever slept eight hours but still felt exhausted?
Quality matters more than quantity.
Repeated breathing interruptions prevent your brain from reaching the restorative stages of sleep needed for true recovery.
4. Difficulty Concentrating
Poor sleep affects memory, focus, decision-making, and productivity.
Many patients mistakenly believe they’re simply getting older or experiencing burnout when fragmented sleep is the real issue.
5. Dry Mouth Every Morning
If you wake with a dry mouth or sore throat, you may be breathing through your mouth during sleep due to airway obstruction.
Dentists often notice signs of mouth breathing and other oral changes that can point toward sleep-disordered breathing.
6. High Blood Pressure
Sleep apnea places significant stress on the cardiovascular system.
Over time, untreated sleep apnea has been linked with hypertension, heart disease, stroke, diabetes, and other serious medical conditions.
7. Your Partner Notices You Stop Breathing
This is perhaps the most important warning sign.
If someone has observed you gasping, choking, or stopping breathing during sleep, it’s time to seek a professional evaluation.
These breathing pauses are not normal and should never be ignored.
Why Many People Go Undiagnosed
Millions of adults live with obstructive sleep apnea without realizing it.
Because the symptoms develop gradually, many people blame aging, stress, work schedules, or poor sleep habits instead of considering an underlying medical condition.
The good news?
Sleep apnea is highly treatable.
What If You Can’t Tolerate CPAP?
While CPAP remains an excellent treatment for many patients, it isn’t the best solution for everyone.
For patients with mild to moderate obstructive sleep apnea—or for those who simply cannot tolerate CPAP—a custom oral appliance may provide an effective, comfortable alternative. These devices gently reposition the jaw to help keep the airway open during sleep and are recognized by the American Dental Association as an appropriate treatment option for selected patients.
When Should You Schedule an Evaluation?
If you experience several of these symptoms on a regular basis, it’s worth discussing them with a healthcare provider.
The earlier sleep apnea is identified, the sooner you can begin improving your sleep, your energy, and your overall health.
Better sleep doesn’t just help you feel more rested—it can improve your quality of life, your relationships, your productivity, and your long-term wellness.
Ready to Find Out if Sleep Apnea Is Affecting Your Health?
At Sleep Apnea Dentists of New England, we have been helping patients find comfortable alternatives to CPAP since 1997. As one of the first dental practices accredited by the Academy of Dental Sleep Medicine, our team is dedicated to providing advanced, evidence-based care for obstructive sleep apnea.
If you’re waking up tired, suffering from morning headaches, or struggling with CPAP, contact our office today to learn whether oral appliance therapy may be the right solution for you.
Comments Off on 7 Warning Signs You May Have Sleep Apnea (And Not Know It)
by SadofNE
Many people assume sleep apnea only affects individuals who snore loudly. While snoring is one of the most common symptoms, sleep apnea often goes undiagnosed because its warning signs can appear unrelated to sleep.
In fact, millions of Americans are living with sleep apnea without realizing it.
If left untreated, sleep apnea can increase the risk of serious health issues, including high blood pressure, heart disease, stroke, diabetes, and chronic fatigue.
Here are seven signs that may indicate it’s time to talk to a sleep specialist.
1. You Wake Up Feeling Exhausted
One of the hallmark symptoms of sleep apnea is waking up tired despite getting what should be a full night’s sleep.
When breathing repeatedly stops during sleep, the brain briefly wakes the body to restore normal breathing. These interruptions can occur dozens—or even hundreds—of times per night, preventing restorative sleep.
2. You Snore Loudly
While not everyone who snores has sleep apnea, loud and persistent snoring is one of the most common indicators.
If your partner regularly complains about your snoring, it may be worth discussing with your healthcare provider.
3. Someone Has Witnessed You Stop Breathing
Many patients first learn they may have sleep apnea because a spouse or family member notices periods where they stop breathing while sleeping.
These pauses are often followed by gasping, choking, or sudden awakenings.
4. Morning Headaches
Frequent morning headaches can occur when oxygen levels drop during sleep.
Poor oxygenation and interrupted sleep patterns can contribute to headaches that persist throughout the morning.
5. Difficulty Concentrating
Sleep apnea affects more than your sleep—it affects your brain.
Untreated sleep apnea can contribute to:
Memory problems
Difficulty concentrating
Brain fog
Reduced productivity
Many patients notice significant improvements in mental clarity once treatment begins.
6. Daytime Sleepiness
Do you find yourself struggling to stay awake during meetings, while watching television, or even while driving?
Excessive daytime sleepiness is one of the most serious symptoms of sleep apnea and should never be ignored.
7. High Blood Pressure
Research has shown a strong connection between sleep apnea and cardiovascular health.
Repeated oxygen deprivation during sleep can place additional strain on the heart and blood vessels, increasing the risk of high blood pressure and other cardiovascular conditions.
When Should You Seek Help?
If you experience several of these symptoms, it may be time to speak with a sleep specialist.
Early diagnosis and treatment can improve sleep quality, increase energy levels, and reduce the risk of long-term health complications.
The Bottom Line
Sleep apnea is more common than many people realize, and it often goes undiagnosed for years. Recognizing the warning signs is the first step toward better sleep and better overall health.
If you suspect you may have sleep apnea, don’t ignore the symptoms. A proper evaluation can help you determine the cause and explore treatment options that may dramatically improve your quality of life.
A new scientific review from researchers at the Marshall University Joan C. Edwards School of Medicine highlights emerging connections between gut health and sleep apnea, pointing to potential new therapeutic approaches for managing this disorder.
The article, published in the journal Sleep Medicine, was led by Marshall medical student Rebecca Hicks, in collaboration with faculty researchers. It explores how gut microbiota—the diverse community of microorganisms living in the digestive tract—may influence the development and severity of sleep-disordered breathing, including obstructive sleep apnea (OSA). Alterations in gut microbiota composition have been consistently observed in individuals with sleep apnea and may induce “leaky gut,” or impaired intestinal barrier integrity, that in turn promotes systemic inflammation that worsens sleep apnea symptoms and facilitates the emergence of end-organ injury.
“Recent studies suggest that changes in gut microbiota diversity and composition may play a role in the onset or progression of sleep apnea,” says Hicks, lead author on the review, in a release. “This connection may be mediated by impaired gut barrier function, inflammation, immune responses, and gut-brain communication pathways.”
The review also highlights the role of extracellular vesicles—tiny particles released by cells that carry molecular signals—as potential messengers between the gut and brain. These extracellular vesicles may affect sleep regulation by modulating immune responses or transporting microbial signals to the brain and could serve as biomarkers or therapeutic targets in modulating the gut-brain axis in sleep apnea.
The authors call for future longitudinal studies to better understand how gut microbiome changes over time may influence the development or consequences of sleep apnea. They also advocate for deeper investigation into the mechanisms by which microbial species and their metabolites affect sleep and for the development of new treatments aimed at improving gut health as a strategy for managing sleep apnea.
“It is exciting to see medical students taking the lead in exploring complex and emerging areas like the gut-sleep connection,” says Abdelnaby Khalyfa, MS, PhD, professor of biomedical sciences at Marshall University, corresponding author on this study, and Rebecca’s mentor, in a release. “This kind of research not only advances our understanding of sleep apnea but also demonstrates the vital role early career trainees can play in shaping the future of medicine in general, and of sleep medicine in particular through innovation and collaboration.”
Ever wake up with a crick in your neck or a pain in your lower back? Are you roused from sleep by heartburn, or a partner complaining that you snore?
If you answered “yes” to any of these questions, your sleep position might be to blame.
There is no one “right” way to sleep, said Dr. Indira Gurubhagavatula, a professor of sleep medicine at the University of Pennsylvania Perelman School of Medicine.
But if you are waking up with discomfort or stiffness or having restless nights, certain adjustments to your sleeping posture may help. Here are some of the most common issues associated with how people sleep, and what to do about them.
On Your Side
Many of us sleep on our sides with no problem. But for some people — especially those with joint issues or who are older — it can put a lot of pressure on the shoulder, hip and knees, said Dr. Rohan Jotwani, a pain medicine specialist at NewYork-Presbyterian/Weill Cornell Medical Center in New York City.
Sleeping on top of a memory foam or gel mattress pad can help by distributing your weight more evenly, he said. Placing a pillow between your knees can also reduce hip, knee and lower back pain by keeping your legs and hips aligned.
When you’re on your side, using a pillow that is either too thick or too thin can force your spine out of alignment, leading to muscle and joint strain. Or it can put pressure on nerves, causing pain, tingling or weakness in your shoulders, arms or upper back, Dr. Gurubhagavatula said.
Those who have a deviated septum may find that sleeping on their side affects how well they breathe, said Dr. Gerald Suh, an ear, nose, throat and sleep specialist in Princeton, N.J. The condition occurs when the thin layer of cartilage and bone that divides the nasal cavity is off-center or crooked. It is common, he said, affecting probably more than 80 percent of people, though only about 30 percent notice an influence on breathing.
For some, it’s easier to breathe when they sleep on the side that the narrower nostril is on, allowing air to flow unimpeded through the wider one, Dr. Suh said.
On Your Back
The goal when sleeping is to maintain the natural curvature of the spine and neck “without creating too many bends and twists and turns,” Dr. Jotwani said. Sleeping on your back is best for maintaining this alignment, he said, but it can also cause or exacerbate other issues.
The symptoms of obstructive sleep apnea, for instance — which occurs when the muscles in the throat relax during sleep and cause snoring and temporary pauses in breathing — can worsen when lying face up, said Azadeh Yadollahi, a scientist who studies sleep and airway disorders at the University Health Network in Toronto.
If you have sleep apnea, sleeping on your side can help keep the airway open and let you breathe more freely, Dr. Gurubhagavatula said.
Sleeping on your back may also worsen acid reflux symptoms by allowing stomach acid to seep into the esophagus. And while any sleeping position can lead to nasal congestion, lying face up can cause you to feel even more stuffy, especially when dealing with a cold or allergies, Dr. Suh said.
Propping up the top half of your body with a pillow or a wedge-shaped bolster helps relieve acid reflux, Dr. Gurubhagavatula said. Or try elevating the head of your bed by putting blocks under the legs of your bed frame, she said. Some research also suggests that sleeping on your left side can help, too.
Pregnant women are often told to avoid sleeping on their backs after about 20 weeks to prevent the uterus from putting pressure on a large vein that carries blood from the lower body to the heart. That could restrict blood flow to vital organs or lower blood pressure, leading to lightheadedness.
When pregnant, it’s safest to sleep on your side, especially the left side, as this moves the weight off the vein, Dr. Gurubhagavatula said. This should help with pregnancy-related acid reflux, too, she added.
On Your Stomach
This is the least common sleeping position, Dr. Gurubhagavatula said. It also tends to be the hardest on your spine.
Having your head turned to one side all night strains the neck, Dr. Jotwani said. And that can be compounded by a thick pillow that angles your neck upward.
The position can also hyperextend your lower back. In a review published in 2025, researchers found that sleeping on the stomach is associated with more lower back pain than sleeping on the back or side.
If you enjoy sleeping on your stomach but wake up with low back pain, it can help to put a small pillow under your pelvis. This prevents your abdomen from sinking into the mattress and putting too much arch in your back, Dr. Jotwani said. But if possible, he added, sleep on your back or side for better alignment.
How to Learn to Sleep in a Different Position
Switching to a new position “can be very daunting,” Dr. Jotwani said. He recommended identifying a new position and then trying to spend at least a little time in it each night. Over time, your body will get used to it.
Strategic placement of pillows, special cushions or devices can help keep you in one position throughout the night, Dr. Gurubhagavatula said. To stay on your side, try placing a body pillow behind you, she suggested. There are also cushions that strap onto your back to keep you on your side, and electronic devices that vibrate when they sense that you’ve rolled onto your back. They’re the technological equivalent of getting elbowed by your bed partner, Dr. Yadollahi said.
If you’re new to sleeping on your back, Dr. Gurubhagavatula said you might be more comfortable with a small pillow under your knees, even if it feels awkward for the first few nights.
Your sleep position is just one of many factors that contributes to your overall sleep quality, Dr. Gurubhagavatula said. Maintaining a consistent sleep schedule, getting adequate exercise and keeping your bedroom dark and cool are all important.
But, she added, if getting a good night’s sleep can be “as simple as turning onto your side, then why not try it?”
A version of this article appears in print on April 7, 2026, Section D, Page 7 of the New York edition with the headline: Your Sleep Position May Cause You Pain. Order Reprints | Today’s Paper | Subscribe
Comments Off on The Silent Struggle: How Sleep Apnea Disrupts More Than Just Your Sleep
by SadofNE
Sleep Apnea: When the Body Interrupts the Unconscious
There are conditions that disturb the body… And then there are those that interrupt something deeper. Sleep apnea is one of them. It does not simply affect sleep—it disrupts the body’s ability to fully surrender, to restore, to return to a state of wholeness. And for many, it goes unnoticed for years, quietly shaping their energy, clarity, and presence in the world.
What Sleep Apnea Actually Is
Sleep apnea is a condition in which breathing repeatedly stops and starts during sleep. But beyond the definition, what matters is this: Your body is being pulled out of rest—again and again—throughout the night.
Not always consciously. Not always dramatically. But consistently enough to prevent true restoration.
There are different forms this can take:
Obstructive patterns, where the airway collapses or becomes restricted
Neurological patterns, where the brain fails to regulate breath rhythm properly
Either way, the result is the same: The body remains in a subtle state of interruption instead of repair.
The Experience Most People Can’t Name
Many people living with sleep apnea don’t realize that what they’re experiencing has a cause. They describe things like:
Waking up tired no matter how long they sleep
A sense of mental heaviness or lack of clarity
Irritability that feels unprovoked
A quiet disconnection from themselves
The feeling of never fully “landing” in rest
This isn’t just fatigue. It’s fragmentation.
Why This Matters More Than Energy
When breath is disrupted, the body is deprived—not just of oxygen, but of rhythm. And rhythm is everything. Over time, this can affect:
Cardiovascular function
Cognitive clarity
Emotional regulation
The nervous system’s ability to settle
But even beyond the physical consequences, there is a deeper cost: You begin to normalize a diminished state of being.
Looking Beneath the Surface
Sleep apnea is often approached as a mechanical issue—and sometimes it is. But it can also reflect a broader imbalance within the system:
Structural patterns in the body
Chronic stress responses
Dysregulation of the nervous system
Long-standing disconnection from natural restorative cycles
This is why quick fixes don’t always create lasting change. The body is not just malfunctioning. It is responding.
Restoration Requires Awareness
Addressing sleep apnea may involve:
Sleep studies and proper diagnosis
Breathing support tools such as CPAP
Structural or positional adjustments
Intentional lifestyle shifts
But none of these are truly effective without awareness.
Because the goal is not simply to “fix sleep.”
The goal is to restore the body’s ability to enter a state of deep, uninterrupted repair.
An Invitation to Pay Attention
If your body is not allowing you to rest, there is a reason. Not one rooted in fear—but one that deserves your attention. There is a difference between pushing through exhaustion…and understanding what is creating it. And that difference changes everything.
You were not designed to live in a constant state of depletion. You were designed to restore, to recalibrate, to wake up clear.
If that hasn’t been your experience, it may be time to look deeper—not just at your sleep, but at what your body has been signaling all along.
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