A common stereotype in medicine nearly kept me and my family from receiving diagnoses for decades.
Many people picture sleep apnea as an issue affecting an overweight man in his 60s, but that image is misleading.
In my 30s, 40s, and 50s I stayed lean, exercised, and ate well—yet I had undiagnosed sleep apnea.
I didn’t wake up exhausted, but I was more irritable than I should have been. I didn’t even realize what I was missing. The medical system missed it, but dental sleep medicine did not.
Lately I’ve received many questions about snoring, teeth grinding, daytime fatigue, restless sleep, and children who breathe through their mouths. These are all signs of sleep-disordered breathing. This is not just about feeling tired; it affects judgment, mood, creativity, and memory—basically your cognitive life.
There is a strong connection between sleep disorders and anxiety or depression. Yet when people receive a diagnosis for anxiety or depression, they are rarely screened for sleep issues. I envision a future in which that changes, and I believe dentists can lead that change.
Dentists are uniquely positioned to observe the airway directly. We watch how jaws develop, listen to how patients breathe, and notice what happens when patients recline—similar to lying in bed. We see subtle signs up close: grinding, enamel erosion, scalloped tongues, and chronic dry mouth. This places dentists in a strong position to ask better questions and spot breathing problems early.
Sleep is foundational. In my private practice, I observed the same pattern repeatedly: when a patient’s sleep improves, many other health measures improve as well. Blood sugar stabilizes, mood disorders ease, blood pressure often improves, cravings diminish, and the brain gets the time it needs to repair itself.
That was true for my family. After my wife and I addressed our sleep-disordered breathing, many aspects of our lives improved. Our daughters are still working through related issues; two are undergoing MARPE. My four-year-old grandson has a palate expander placed by an airway-focused orthodontist, reflecting the growing emphasis on airway health in dental care.
Sleep isn’t a side project—it’s the project. If you focus on one thing, make it sleep. Not diet. Not exercise. Fix sleep first, and other health goals become more attainable.
Here are the strategies I recommend for improving sleep quality. If you’re ready to prioritize sleep, I also discuss these topics more extensively in my book.
1. Mouth tape + mandibular advancement device
I use a custom oral appliance made by an airway-trained dentist to keep my airway open and tape my mouth to encourage nasal breathing.
2. Vinyl + book
I enjoy listening to a record or reading in bed with my wife. Devices like Oura rings and phones go into airplane mode. No screen time before bed.
3. Walk after dinner
A short walk after dinner helps digestion, supports healthy blood sugar, and reinforces the circadian rhythm. I value these walks with my wife for both health and connection.
4. No food after dinner
Your body needs to finish digestion before it can produce melatonin effectively. Late-night snacks can delay that process.
5. Magnesium + digestive enzymes
I take magnesium about 1–2 hours before bed and digestive enzymes with dinner. Magnesium improves sleep quality, muscle recovery, and calm. Digestive enzymes support full digestion, improving absorption of amino acids needed for melatonin production. If digestion is compromised, your melatonin and sleep may suffer.
6. Brush, floss, tongue scrape, oil pull
My nightly routine includes a stainless steel tongue scraper and an electric toothbrush. I use a nano-hydroxyapatite toothpaste without stimulating essential oils so there’s no unwanted neurostimulant effect before sleep. I also use an oil-pulling mouthwash alternative—an MCT oil blend with CoQ10—that supports gum health and is friendly to the oral microbiome. It’s a modern upgrade to traditional oil pulling and a pleasant ritual I look forward to each night.
Regarding electric toothbrushes: an expensive model is unnecessary. A basic, well-made brush will work fine. The most useful upgrade is a pressure sensor, but if you’re on a budget you can achieve effective brushing with a simpler model. Replace the brush head provided with the device and use a “sensitive” head for gentler cleaning.
If you have questions about your sleep, I want to hear from you. I’ll be writing more about sleep in future newsletters—reply with your questions or experiences.
-Dr. B
P.S. One patient told me that treating her sleep-disordered breathing gave her the courage to leave a dysfunctional relationship. Another said treatment returned his evenings with his children.