CPAP works for most people, but not everyone — and not every case of sleep apnea is the same. If CPAP isn't right for you, the answer isn't to give up on treatment. It's to find out why it isn't working and get matched to what will.

Most CPAP failures get treated as a dead end. You're told to "try harder" with the mask, or you're quietly left untreated. Neither is right.

Sleep apnea has an anatomical and physiological cause specific to you — your airway, your jaw structure, your tongue and throat muscle tone, sometimes your nasal passages. Once we understand your specific cause, there's usually a real alternative, or combination of alternatives, that CPAP alone couldn't offer.

I evaluate what's actually driving your apnea and connect you with the right specialist from a trusted referral network — sometimes one path, sometimes a combination of two or three working together.

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The Options

Oral Appliance Therapy

A custom-fit dental device, worn like a mouthguard, that repositions your jaw or tongue to keep your airway open overnight. No machine, no mask, no power outlet. Best suited for mild obstructive sleep apnea, or as an option for people who are CPAP-intolerant. Fitted and managed by a dentist specializing in dental sleep medicine.

Myofunctional Therapy

Targeted exercises for the tongue and oral-facial muscles that improve muscle tone and airway function over time. It's non-invasive and often used alongside another treatment — an oral appliance or post-surgical recovery, for example — to improve results rather than as a stand-alone fix for moderate-to-severe apnea.

MARPE / MARSE & Airway-Focused Orthodontics

Some sleep apnea, especially in patients with a narrow palate or restricted upper airway, responds to skeletal expansion — techniques like MARPE (Maxillary Skeletal Expansion) that widen the upper jaw and increase airway space. This is coordinated with an orthodontist trained specifically in airway-focused expansion. The orthodontists we work with take into account not just aesthetics but also your airway, bite and function.

HGNS / “Inspire” (ENT surgeon)

Hypoglossal nerve stimulation (HGNS, most commonly known by the brand name Inspire) is a small device — implanted surgically by an ENT surgeon — that stimulates the nerve controlling your tongue, keeping your airway open as you sleep. Activated with a remote, no mask required. It's FDA-approved for moderate-to-severe obstructive sleep apnea in patients who can't tolerate CPAP. Candidacy is confirmed through an ENT surgeon with an exam and a drug-induced sleep endoscopy (DISE) — a outpatient procedure that shows exactly where your airway collapses during sleep.

Upper Airway Surgery (ENT)

An ENT (otolaryngology) surgeon can evaluate your airway to identify anatomical areas of obstruction that may be surgically corrected, including problems involving the nose, tonsils, throat, or soft palate. The evaluation typically includes an in-office airway exam and, when appropriate, drug-induced sleep endoscopy (DISE) to see where and how the airway collapses during sleep and determine which surgical options may be appropriate.

Oral & Maxillofacial Surgery (OMFS)

For more significant anatomical or skeletal causes of airway obstruction, an oral and maxillofacial surgeon can evaluate and perform procedures — including jaw repositioning surgery — that permanently increase airway space. This is a bigger commitment than an appliance or CPAP, and it's typically considered when anatomy is the primary driver, or when less invasive options haven't been enough.

How We Decide What's Right for You

Every path on this page starts the same way: a Sleep Evaluation with me, where we look at your anatomy, your test results. From there, I'll tell you plainly which of these options actually fits your case, refer you to the right specialist in my network, and stay involved through your treatment, not hand you off and disappear.

Pricing for each pathway is set by the specialist providing that treatment (ENT, OMFS, orthodontics), not by me — I'll walk you through what to expect before you're referred anywhere.