A consultation and screening

Your journey starts with an extensive consultation with Dr. Lynch. It is a paid visit, and it is thorough on purpose: we ask how you sleep, how you feel during the day, and what you have already tried. If you share a bed, what your partner notices matters too: snoring, pauses in breathing, or gasping.

Signs we ask about

Waking up tired even after a full night in bed
Daytime sleepiness, fogginess or trouble concentrating
Snoring, or pauses in breathing followed by a gasp
Dry mouth or sore throat in the morning
Morning headaches
Night sweats not explained by another condition
High blood pressure
Jaw pain, clenching or grinding

A short sleep questionnaire

A short questionnaire about your sleep and daytime energy, including your body mass index (BMI), helps us see where to begin. You can work out your BMI before your visit. Check your BMI.

Your first examination

Dr. Lynch looks at more than your teeth. The exam includes X-rays when needed, a check of the soft tissues in your mouth and an oral cancer screening, an exam of your jaw joints (TMJ), and a look at the wear on your teeth. Grinding that moves the jaw forward leaves a different wear pattern from side-to-side grinding, and it can be a sign that your body is working to open your airway at night. What to expect at your first visit.

Bea Salvanera, NP, explains how we screen for sleep apnea

Sleep testing and measurement

We measure your sleep so your plan is built on numbers, not guesses.

A home sleep test

Instead of a night in a sleep lab, most patients can test at home in their own bed. Our nurse practitioner orders the test during a telehealth visit, and you wear the SleepImage ring, a small ring on your finger, while you sleep. Pick the ring up the same day as your telehealth visit, or we ship it to your home within three to five business days.

When a sleep lab is the better choice

A home test is a good starting point, but it is not right for everyone. If your symptoms suggest central sleep apnea or another sleep disorder, we will refer you for an overnight study (polysomnography) in a sleep lab.

What the numbers mean

The key number is the apnea-hypopnea index (AHI): how many times an hour your breathing stops or becomes shallow for 10 seconds or longer.

5 to 15 mild
15 to 30 moderate
30 or more severe

An airway evaluation

We also look at the things that shape your airway: your jaw, tongue, tonsils, nose and bite. How airway shape affects sleep.

Your personal plan

Once your results are in, Dr. Lynch walks you through them and through your options. Your plan addresses everything we found, not only one piece.

Lifestyle and daily habits: weight, alcohol, smoking, medications and sleep position
Oral appliance therapy, when it is right for you
Care for jaw pain and grinding, so treatment stays comfortable
Coordination with your physician, ENT or cardiologist when your care calls for it

If an oral appliance is part of your plan

Getting a custom appliance usually takes two visits. At the first, we take impressions or a digital scan of your teeth and send them to a dental lab. At the second, we check the fit, make sure it is comfortable, and show you how to wear it and clean it.

We then adjust the appliance in small steps over time, following American Academy of Sleep Medicine guidance (opens in a new tab). Going slowly keeps your jaw comfortable while your airway opens.

If CPAP is the better treatment for you, we will tell you. If you have tried CPAP and could not stay with it, an appliance may be the option that works. Read about CPAP intolerance.

Follow-up testing and ongoing care

Feeling better is a good sign, but we want proof. Once your treatment is in place, we test your sleep again to confirm it is working, and we adjust if the numbers say we should.

A follow-up sleep test with your treatment in place
Adjustments to your appliance until your results and comfort are where they should be
Ongoing checks of fit and wear
Updates to your physician, so everyone caring for you sees the same results

Your sleep journey, step by step