If you're waking up tired, snoring through the night, or your partner has nudged you about gasping in your sleep, sleep apnea is worth taking seriously. Untreated obstructive sleep apnea is associated with high blood pressure, cardiovascular disease, metabolic dysregulation, cognitive impairment, and daytime dysfunction that compounds over years. Many patients who need treatment cannot sustain CPAP, which is highly effective when worn consistently, but many people cannot or will not wear it night after night. Oral appliance therapy offers a well-tolerated alternative. A custom-fitted appliance worn during sleep repositions the lower jaw slightly forward, which opens the posterior airway, stabilizes the soft tissue, and prevents the obstruction that produces apnea events. FDA-cleared oral appliances are indicated for mild to moderate obstructive sleep apnea and for CPAP-intolerant patients with severe OSA when the alternative is no treatment at all. Dr. Brien Hsu is a Diplomate of the American Board of Dental Sleep Medicine, an original-examination credential that represents rigorous clinical training and case submission across a specialty few dentists pursue. He is the first dentist from the USC School of Dentistry to publish in the Journal of Clinical Sleep Medicine. Sleep medicine is not a secondary service here; it is a clinical specialty. The process begins with a review of your sleep study results. We work in coordination with your sleep physician. Diagnosis is medicine's domain; appliance design and management is ours. The appliance is custom-fitted from a digital or conventional impression of your teeth, calibrated for your anatomy, and adjusted at follow-up visits as needed. Ongoing monitoring ensures the appliance continues to manage your airway effectively. We do not diagnose sleep apnea in the dental chair. A qualified sleep physician performs that evaluation. Our role is the appliance therapy that follows.