Sleep Apnea & Snoring · Daly City, CA · Bay Area

Sleep Apnea Treatment

Without the CPAP Machine.

A custom oral appliance may be the CPAP alternative you have been looking for — comfortable, compact, and worn while you sleep. Take-home WatchPAT sleep testing with MD-read results. HRPO monitoring to confirm effectiveness. Accurate diagnosis. A treatment that actually gets used.
Sleep Apnea & Snoring Treatment in Daly City, CA

If CPAP Isn’t Working for You, A Dental Appliance Might Be the Answer.

Obstructive sleep apnea (OSA) is a serious sleep disorder in which the airway collapses repeatedly during sleep — interrupting breathing, dropping oxygen levels, and disrupting sleep architecture dozens or hundreds of times per night. The health consequences of untreated sleep apnea extend well beyond tiredness: cardiovascular disease, hypertension, stroke, metabolic disorders, and cognitive impairment are all associated with chronic OSA.

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CPAP (Continuous Positive Airway Pressure) is effective when worn correctly and consistently. The problem is compliance. Many patients cannot tolerate the mask, the noise, or the feeling of forced air — and an appliance that is not worn does nothing. The American Academy of Sleep Medicine (AASM) recognises oral appliance therapy as an effective first-line treatment for mild to moderate OSA, and as an appropriate alternative to CPAP for moderate to severe OSA patients who cannot tolerate CPAP therapy.

An important clarification: this practice does not diagnose sleep apnea. Diagnosis must be made by a physician (MD). Our role is to facilitate appropriate testing using the WatchPAT take-home sleep test — results read by an MD — and to provide custom oral appliance therapy once a medical diagnosis is established. HRPO (High Resolution Pulse Oximetry) is used both to assess initial oxygen levels and to monitor the effectiveness of treatment. 3D imaging may be used to assess the airway.

Sleep Apnea Treatment at a Glance

What to expect at this practice

Diagnosis

MD required — we facilitate WatchPAT take-home testing, MD reads all results

Testing

WatchPAT take-home sleep test + HRPO oxygen monitoring + 3D airway imaging

Treatment

Custom oral appliance — AASM-recognised CPAP alternative for mild to moderate OSA

Monitoring

HRPO confirms the appliance is controlling apnea events effectively

7 Factors

Severity, soft palate, jaw motion, bite, jaw structure, bruxism, dental health — all assessed

Investment

Financing available — medical insurance may cover oral appliance as OSA treatment

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WatchPAT Take-Home Sleep Test

FDA-approved — MD reads all results

HRPO Monitoring

High Resolution Pulse Oximetry — baseline & effectiveness tracking

Custom Oral Appliances

AASM-recognised CPAP alternative — highly tolerated

AACD Accredited Fellow

1 of 80 worldwide — Kois occlusal training

Financing Available

Mon–Thu 8:00 AM – 5:00 PM · Daly City

Sleep Apnea & Snoring Treatment in Daly City, CA

If CPAP Isn’t Working for You, A Dental Appliance Might Be the Answer.

Obstructive sleep apnea (OSA) is a serious sleep disorder in which the airway collapses repeatedly during sleep — interrupting breathing, dropping oxygen levels, and disrupting sleep architecture dozens or hundreds of times per night. The health consequences of untreated sleep apnea extend well beyond tiredness: cardiovascular disease, hypertension, stroke, metabolic disorders, and cognitive impairment are all associated with chronic OSA.

CPAP (Continuous Positive Airway Pressure) is effective when worn correctly and consistently. The problem is compliance. Many patients cannot tolerate the mask, the noise, or the feeling of forced air — and an appliance that is not worn does nothing. The American Academy of Sleep Medicine (AASM) recognises oral appliance therapy as an effective first-line treatment for mild to moderate OSA, and as an appropriate alternative to CPAP for moderate to severe OSA patients who cannot tolerate CPAP therapy.

An important clarification: this practice does not diagnose sleep apnea. Diagnosis must be made by a physician (MD). Our role is to facilitate appropriate testing using the WatchPAT take-home sleep test — results read by an MD — and to provide custom oral appliance therapy once a medical diagnosis is established. HRPO (High Resolution Pulse Oximetry) is used both to assess initial oxygen levels and to monitor the effectiveness of treatment. 3D imaging may be used to assess the airway.

Book Your Consultation
Understanding Sleep Apnea

What Is Obstructive Sleep Apnea — and Why Does It Matter?

Obstructive sleep apnea occurs when the soft tissues of the throat — the tongue, soft palate, and pharyngeal walls — collapse backward during sleep and block the airway. The blockage causes breathing to stop (an apnea event). The brain detects falling oxygen levels and triggers a partial awakening to restore breathing — preventing the restorative sleep stages that the body needs.

This cycle can happen 5 to hundreds of times per hour. Each event drops blood oxygen levels, triggers a stress response, and fragments sleep. Most people with OSA have no memory of these events and do not know they have the condition. Sleep apnea can go undetected for years while silently damaging cardiovascular, metabolic, and cognitive health.

Snoring is the most common presenting sign — the sound of air forcing through a partially obstructed airway. But not all snorers have OSA, and not all people with OSA snore loudly. A proper sleep study is the only reliable way to confirm the diagnosis and its severity.

  • Cardiovascular Disease & Hypertension | The repeated oxygen drops and arousal responses of OSA activate the sympathetic nervous system and raise blood pressure chronically. Untreated sleep apnea significantly increases the risk of hypertension, heart attack, arrhythmia, and stroke.
  • Metabolic Disruption | Sleep apnea disrupts glucose regulation and is strongly associated with insulin resistance and type 2 diabetes. Sleep deprivation also affects appetite-regulating hormones, increasing the likelihood of weight gain — which in turn worsens the OSA.
  • Cognitive & Mental Health Effects | Chronic sleep fragmentation impairs memory consolidation, concentration, and executive function. Depression and anxiety are significantly more common in people with untreated OSA. Many patients describe a dramatic improvement in cognitive clarity and mood following effective treatment.
  • Daytime Impairment & Safety | Excessive daytime sleepiness — a hallmark of OSA — significantly increases the risk of motor vehicle accidents, workplace errors, and impaired performance. Many patients have normalised this fatigue over years and do not connect it to their sleep quality.
  • Relationship Impact | Snoring affects sleep quality for partners and household members, not just the person with OSA. Addressing sleep apnea often improves sleep and quality of life for the entire household — a benefit that patients frequently mention as transformative.
Do You Have Sleep Apnea?

Sleep Apnea Symptoms — Many Go Unrecognised for Years.

Because most events occur during sleep, many people with OSA are completely unaware of the problem. These are the most common signs — recognised either by the patient or by those around them.

Loud or Chronic Snoring

Often the first sign noticed by a partner. Loud, persistent snoring — especially with gasping or choking sounds — strongly suggests airway obstruction. Not all snorers have OSA, but regular heavy snoring warrants evaluation, particularly when other symptoms are present.

Observed Pauses in Breathing

A bed partner or family member observing the sleeper stop breathing — followed by a gasp or snort as breathing resumes — is one of the most reliable signs of OSA. If this has been observed, evaluation is strongly recommended.

Excessive Daytime Sleepiness

Feeling excessively tired or sleepy during the day despite a full night in bed — falling asleep while reading, watching television, or in other passive situations — is a hallmark of OSA. Many patients have normalised this level of fatigue and do not recognise it as abnormal.

Morning Headaches

Headaches upon waking — particularly at the top or back of the head — can result from oxygen desaturation and carbon dioxide buildup during apnea events. Morning headaches that resolve within an hour of waking are a classic OSA sign.

Difficulty Concentrating & Memory Problems

Cognitive impairment from sleep fragmentation affects memory consolidation, attention, and decision-making. Patients often describe a persistent mental “fog” that lifts dramatically with effective treatment — frequently one of the most appreciated outcomes of sleep apnea care.

Waking Unrefreshed & Insomnia

Sleeping for a full night and still waking feeling exhausted is a hallmark of OSA — the quantity of sleep appears adequate, but the quality is severely impaired by repeated arousal events. Some patients also experience difficulty staying asleep or waking repeatedly through the night.

Recognise any of these? Call 650-755-6000 to arrange a consultation. We will discuss your symptoms, arrange WatchPAT take-home sleep testing (with MD-read results), and HRPO monitoring — and determine whether oral appliance therapy is appropriate for your situation.

CPAP vs Oral Appliance

The Most Effective Treatment Is the One You Will Actually Use Every Night.

CPAP therapy is effective when worn. The challenge is that many patients cannot tolerate the mask, the noise, the hose, and the feeling of pressurised air — particularly when travelling or sleeping in a different position. CPAP compliance rates are considerably lower than those for oral appliances. For the patients who cannot use CPAP consistently, the treatment provides no benefit.

The American Academy of Sleep Medicine recognises oral appliance therapy as an effective first-line treatment for mild to moderate obstructive sleep apnea — and as an appropriate alternative to CPAP for moderate to severe OSA patients who cannot tolerate CPAP. Nine in ten oral appliance patients wear the device every night. Treatment compliance is the most important factor in treatment effectiveness.

Oral appliances are custom-fitted to the individual patient’s teeth and jaw anatomy — not generic over-the-counter devices. They are calibrated using the seven clinical factors assessed at this practice, and their effectiveness is monitored with HRPO — not assumed based on symptom reporting alone.

Oral Appliance Therapy

  • No mask, no machine, no power source required
  • Compact and portable — travels easily
  • Silent during wear
  • Custom-fitted to your bite and jaw anatomy
  • Calibrated to 7 specific clinical factors
  • Effectiveness confirmed by HRPO monitoring
  • 9 in 10 patients wear it every night
  • AASM first-line for mild-moderate OSA
  • Appropriate alternative to CPAP when not tolerated

CPAP Therapy

  • Highly effective when worn correctly and consistently
  • First-line recommendation for severe OSA
  • Mask, hose, and machine required every night
  • Difficult to transport when travelling
  • Many patients experience intolerance: nasal dryness, skin irritation, noise
  • Compliance rates significantly lower than oral appliances
  • No benefit when not worn
Our Diagnostic & Treatment Protocol

Testing That Produces Accurate Answers — Read by the Right People.

We do not diagnose sleep apnea — diagnosis is a medical responsibility. Our role is to facilitate the right testing, collaborate with your physician, and provide precisely calibrated oral appliance therapy once the diagnosis is established.

WatchPAT — Take-Home Sleep Test

The WatchPAT is an FDA-approved take-home sleep testing device worn on the wrist during a normal night’s sleep in your own home. It monitors multiple physiological signals — including oxygen saturation, heart rate, and peripheral arterial tone — to assess for obstructive sleep apnea. All WatchPAT results are read by a physician (MD), not by this dental practice. This collaborative medical-dental approach is the correct model for sleep apnea care. The WatchPAT is used both for initial diagnosis (facilitated by our practice) and to assess the effectiveness of oral appliance therapy once treatment is established.

HRPO — High Resolution Pulse Oximetry

HRPO (High Resolution Pulse Oximetry) continuously measures blood oxygen saturation and pulse rate during sleep. In dental sleep medicine, HRPO serves two critical functions: first, it provides an objective baseline assessment of overnight oxygen levels before treatment begins — helping identify the presence and severity of oxygen desaturation. Second, it monitors the effectiveness of oral appliance therapy after the appliance is fitted and calibrated. If oxygen levels are still dropping significantly, the appliance requires further adjustment. HRPO means treatment effectiveness is confirmed by objective data — not assumed based on symptom improvement alone.

3D Airway Imaging

3D CBCT (cone beam CT) imaging may be used to assess airway anatomy — visualizing the size and shape of the airway at different levels, identifying areas of narrowing, and assessing the nasal passage, soft palate, and tongue base. Airway imaging provides information that guides the design and calibration of the oral appliance, and can identify anatomical factors that affect treatment planning and prognosis.

Important: We Do Not Diagnose Sleep Apnea

The diagnosis of sleep apnea must be made by a physician (MD). This practice facilitates appropriate sleep testing — including the WatchPAT take-home study — and ensures the results are reviewed by a qualified physician. Once a medical diagnosis has been established, we provide custom oral appliance therapy and monitoring. This is the medically and ethically correct model for dental sleep medicine, and it is the model we follow without exception.

Our collaborative approach — dental expertise for oral appliance design and monitoring, medical oversight for diagnosis and results — ensures patients receive accurate diagnosis, appropriate treatment, and objective confirmation that the treatment is working.

Custom Appliance Design

7 Clinical Factors That Determine the Right Appliance for You.

No two patients have the same anatomy, bite, or sleep apnea profile. The oral appliance that works best for one patient may not be appropriate for another. Dr. Hovden evaluates seven specific clinical factors to determine the most appropriate appliance design and starting position for each individual patient — and then monitors effectiveness with HRPO to confirm the calibration is adequate.

This individualized approach — grounded in the Kois Center’s systematic framework for occlusal evaluation and Dr. Hovden’s extensive training in dental sleep medicine — produces oral appliances that are both comfortable to wear and clinically effective at controlling apnea events.

After the appliance is delivered, regular follow-up appointments allow fine-tuning based on HRPO monitoring results and patient feedback. The goal is not simply an appliance that is worn — it is an appliance that works, confirmed by objective monitoring data.

  • Severity of Sleep Apnea
    The AHI (Apnea-Hypopnea Index) from the physician-read sleep study determines whether oral appliance therapy is appropriate as a first-line or alternative treatment, and informs the degree of jaw advancement needed.
  • Size of Soft Palate & Tongue
    Larger tongue base and soft palate increase the tendency for airway collapse during sleep. These anatomical factors affect appliance design and the degree of jaw repositioning needed to maintain an open airway.
  • Jaw Range of Motion
    The range of motion of the lower jaw determines how far the jaw can be advanced without discomfort. Patients with limited jaw opening or temporomandibular joint issues require careful assessment before appliance fabrication.
  • Bite (Occlusion)
    The relationship between the upper and lower teeth determines how the appliance positions the jaw and what occlusal loads are generated during wear. Kois-trained occlusal analysis ensures the appliance does not create or worsen bite problems.
  • Jaw Structure & Anatomy
    The skeletal relationship of the jaws — including retrognathia (a recessed lower jaw) — affects the anatomical basis of the airway collapse and informs the target position for the oral appliance.
  • Teeth Clenching or Grinding (Bruxism)
    Bruxism affects appliance material selection and design, and may influence the level of jaw repositioning that is comfortable to tolerate during sleep. Some oral appliances can also reduce bruxism simultaneously.
  • Health of Teeth & Gums
    The oral appliance is supported by the teeth — adequate dental health is required to provide the necessary retention and support. Active decay, significant periodontal disease, or insufficient teeth may need to be addressed before an appliance can be fabricated.
Oral Appliance Advantages

Why Oral Appliances Work When Other Treatments Don’t.

Effective treatment of sleep apnea changes everything — sleep, energy, health, relationships. Here is what patients consistently report.

High Compliance

Nine in ten patients wear the oral appliance every night. Compliance is the decisive factor in treatment effectiveness — and the compact, mask-free nature of an oral appliance makes nightly compliance significantly easier to sustain than CPAP.

No Machine or Mask

No CPAP machine, no hose, no mask, no power source. The oral appliance fits in your nightstand, travels in a carry-on, and is worn silently while you sleep — eliminating all the barriers that make CPAP compliance difficult for many patients.

Immediate Results

Many patients experience significantly reduced snoring from the very first night the appliance is worn. Sleep quality and daytime energy typically improve within the first few weeks as the jaw position is optimised through progressive adjustment.

Adjustable & Titrated

Oral appliances are adjustable. The jaw position is progressively advanced over multiple appointments until HRPO monitoring confirms adequate control of apnea events. If symptoms change over time, the appliance can be recalibrated without replacement.

Objectively Monitored

HRPO monitoring provides objective data confirming the appliance is controlling oxygen desaturation events — not just subjective symptom improvement. This means treatment can be adjusted to a level of effectiveness confirmed by data, not assumption.

Partner’s Sleep Restored

Eliminating or significantly reducing snoring restores sleep quality for bed partners and household members. Patients frequently describe the impact on their relationship and their partner’s quality of life as one of the most significant benefits of treatment.

Why This Practice for Sleep Apnea Treatment

Oral Appliance Therapy Backed by AACD-Level Precision and Kois Occlusal Training.

An oral appliance must not only hold the jaw forward — it must do so without creating new problems. Poorly designed appliances can worsen bite function, cause or exacerbate TMJ problems, and produce tooth movement over time. The design and calibration of a sleep appliance requires the same occlusal awareness as any other dental restoration.

Dr. Hovden is a Clinical Instructor at the Kois Center — one of the world’s leading institutions for evidence-based occlusal analysis. His AACD Accredited Fellowship and Spear Institute training ensure that every oral appliance is designed with the patient’s full bite and jaw health considered — not just the immediate goal of opening the airway.

He completes well over 200 hours of continuing education per year since 2020. He is also a Former UOP Faculty Member for 39 years and the founder of the Bay Area Aesthetic Masters study club — committed to raising the level of care of local dentists for over 20 years.

  • Kois Center Clinical Instructor — Occlusal Analysis | Every oral appliance designed at this practice is assessed through the lens of Kois-based occlusal evaluation — ensuring the appliance opens the airway without compromising bite health, joint health, or long-term dental stability.
  • AACD Accredited Fellow — 1 of 80 Worldwide | The highest credential in cosmetic dentistry — reflecting a standard of clinical precision that applies to every procedure at this practice, including dental sleep medicine.
  • Visiting Faculty — Spear Institute | Advanced restorative and occlusal expertise at a teaching level. The functional evaluation that precedes every oral appliance reflects Spear-level understanding of how the teeth, joints, and muscles interact.
  • Well Over 200 CE Hours Per Year Since 2020 | Including current training in dental sleep medicine, WatchPAT interpretation, HRPO monitoring, and the latest oral appliance technologies and protocols.
  • Former UOP Faculty Member — 39 Years | Arthur A. Dugoni School of Dentistry, University of the Pacific. The depth of clinical expertise that 39 years of university faculty membership reflects underpins every treatment decision at this practice.
Sleep Apnea FAQs

Your Questions, Answered Honestly.

Something not covered? Call 650-755-6000 or book your consultation.

A dentist does not diagnose sleep apnea — that must be done by a physician. However, a trained dentist plays a critical role by providing oral appliance therapy — a custom-fitted device worn during sleep that holds the lower jaw forward to keep the airway open. The AASM recognises oral appliance therapy as an effective first-line treatment for mild to moderate OSA and as an alternative to CPAP for those who cannot tolerate it. We facilitate WatchPAT take-home testing with MD-read results to ensure diagnosis is handled correctly before treatment begins.

An oral appliance for sleep apnea is a custom-fitted device worn during sleep that holds the lower jaw in a slightly forward position, keeping the tongue and soft tissues from collapsing into the airway. Unlike CPAP, it requires no mask, no machine, and no power source — it is compact, silent, and tolerated by the vast majority of patients who try it. Effectiveness is confirmed by HRPO monitoring after fitting.

For mild to moderate OSA, oral appliance therapy is recognised as equally effective to CPAP — and typically better tolerated. Nine in ten oral appliance patients wear the device every night; CPAP compliance rates are considerably lower. For severe OSA, CPAP remains the first-line recommendation, though oral appliances may be appropriate when CPAP cannot be tolerated. Effectiveness is monitored with HRPO — High Resolution Pulse Oximetry — to confirm the appliance is controlling breathing events adequately.

The WatchPAT is an FDA-approved take-home sleep testing device worn on the wrist during a normal night’s sleep at home. It monitors oxygen saturation, heart rate, and peripheral arterial tone to assess for OSA. All WatchPAT results are read by a physician (MD), not by this dental practice. This ensures diagnosis is always made by a qualified physician — which is medically and ethically correct. The WatchPAT is used both for initial assessment and to evaluate the effectiveness of oral appliance therapy.

HRPO stands for High Resolution Pulse Oximetry. It measures blood oxygen saturation and pulse rate continuously during sleep. In dental sleep medicine, HRPO serves two functions: assessing baseline oxygen levels before treatment begins, and monitoring the effectiveness of oral appliance therapy after fitting. If oxygen levels are still dropping significantly, the appliance needs further adjustment. HRPO means treatment effectiveness is confirmed by objective data — not assumed based on symptom improvement alone.

The best candidates are adults with a physician diagnosis of mild to moderate OSA, or those with more severe OSA who cannot tolerate CPAP. Seven specific factors are evaluated: severity of sleep apnea, size of soft palate and tongue, jaw range of motion, bite, jaw structure, teeth clenching or grinding, and health of teeth and gums. Good dental health and sufficient teeth to support the appliance are important. Patients with active TMJ problems may need those addressed first.

No. Sleep apnea must be diagnosed by a physician (MD). Dr. Hovden’s role is to identify potential signs of sleep disordered breathing, facilitate appropriate testing (WatchPAT take-home sleep test, results read by an MD), and provide custom oral appliance therapy once a diagnosis has been established by a qualified physician. This collaborative medical-dental approach is the correct model for sleep apnea care.

Most patients adapt within one to two weeks. Initial jaw and tooth soreness is normal and resolves. The appliance is adjustable — gradually advanced to achieve optimal jaw position and airway opening. Regular follow-up appointments allow fine-tuning based on HRPO monitoring and symptom feedback. Compared to CPAP, the majority of oral appliance patients find compliance significantly easier to maintain.

Yes — financing is available at Dr. Hovden’s practice. Depending on your insurance coverage, some or all of the oral appliance cost may be covered under your medical insurance plan, as sleep apnea is a medical condition. Your team will help you understand what your plan covers. Call 650-755-6000 to discuss your options.

Stop Tolerating Poor Sleep. There Is a Better Way.

If CPAP hasn’t worked for you — or if you suspect you may have sleep apnea — a consultation with Dr. Hovden is the right starting point. WatchPAT take-home testing, HRPO monitoring, and a custom oral appliance calibrated to your specific anatomy. Real answers. Objective monitoring. Effective treatment.

Book Your Consultation Call 650-755-6000

901 Campus Dr, Suite 202, Daly City, CA 94015 · Mon–Thu 8:00 AM – 5:00 PM · Financing Available