A normal AHI is the most reassuring number in sleep medicine, and it is hiding apnea in your patients right now. Kevin Goles and I go through four different ways that number lies.

Kevin Goles is an airway-focused dentist, my co-instructor on 3 Days to Airway, and the person I go to when a case doesn't add up. This is the full conversation.

Expect to learn:

→ The 30-second in-chair screening test Kevin has his referring practices running on every patient, and why straight teeth tell you nothing

→ The Journal of Clinical Medicine study on intermolar distance and palatal height, and the 38mm line where obstructive sleep apnea effectively disappears

→ Why the roof of the mouth is the floor of the nose, and how a four-year-old ends up with a moderately deviated septum without ever being hit in the face

→ Why acrylic coverage on a fixed expander stops the palate dropping and caps the width you can create

→ Why young and middle-aged women are the most underdiagnosed population in sleep, precisely because their AHI reads normal

→ How progesterone and estrogen protect the airway, why incidence triples at menopause, and when a hormone complaint is really a breathing problem

→ What happened when I tested a CPAP patient with the machine on and with it off, and why nothing changed but his deep sleep

→ Why the AHI a CPAP reports is estimated by an algorithm rather than measured by oximetry, and the gap that opens against a SleepImage ring

→ How REM sleep regulates the amygdala, and what Matthew Walker's puppy analogy explains about anxiety and depression

STUDY MENTIONED

Correlation Between Severity of Obstructive Sleep Apnea and Dental Arch Form in Adults — Journal of Clinical Medicine, 14(20), 7183

https://www.mdpi.com/2077-0383/14/20/7183

BOOK MENTIONED

Why We Sleep — Matthew Walker

KEVIN GOLES

Instagram: https://www.instagram.com/airway_goles/

TRAIN WITH ME

3 Days to Airway — the hands-on course Kevin and I teach for doctors adding airway to their practice: https://www.3dayairway.com/

WORK WITH ME

Book a 30-minute 1:1 consult: https://tr.ee/Sxn_v17K9G

Book at Saddle Peak Dental: https://saddlepeakdental.com/contact/

Everything else: https://linktr.ee/hilaryfritschdmd

LISTEN INSTEAD

Spotify: https://open.spotify.com/show/033v3dzI7lf95VkfTAzvQC

BUSINESS INQUIRIES

DM me on Instagram: https://instagram.com/hilaryfritschdmd

ABOUT THE SHOW

awAIR Unfiltered — 20 years in dentistry, Diplomate of the International Academy of Sleep, covering airway, sleep and breathing for the clinicians treating it.

This channel is clinical discussion between practitioners. It isn't medical advice, and nothing here is a reason to stop using a device your doctor prescribed.

#airwaydentistry #sleepapnea #dentistry