I am slim. Can I really have sleep apnea?

Yes, and this is one of the most common reasons it is missed. Airway anatomy, nasal obstruction, tongue position and jaw structure cause apnea at entirely normal weight. Being reassured on the basis of body weight alone is not a substitute for testing.

Does treatment depend on my insurance being medical or dental?

A sleep appliance is billed as a medical device rather than under a dental code, which surprises most people. A dental plan declining it says very little about your actual coverage — the relevant question is what your medical carrier covers.

My child snores loudly. Should I be concerned?

Habitual snoring on most nights is not normal in a child and is worth raising with your paediatrician. In children, sleep-disordered breathing more often presents as restlessness, irritability and difficulty concentrating than as sleepiness, and enlarged tonsils or adenoids are the most common treatable cause.

TMJ and Sleep Apnea Care for Queens

Queens is the most linguistically diverse county in the United States, and that diversity has a specific and under-appreciated clinical consequence for sleep apnea: the textbook picture of who has it is wrong for a large share of the borough's population.

Why the classic picture misses people here

Obstructive sleep apnea is popularly associated with overweight middle-aged men, and that association causes real harm because it is only part of the truth. Craniofacial anatomy contributes at least as much as weight — a narrow maxilla, a retruded mandible, a crowded oropharynx or a large tongue base will compromise an airway at any body weight. Research consistently finds that people of East and South Asian ancestry develop obstructive sleep apnea at substantially lower body mass indices than white populations, largely on craniofacial grounds. In a borough as diverse as Queens, that means a great many people who do not look like the stereotype are never offered testing.

Where testing happens locally

NewYork-Presbyterian Queens in Flushing, Long Island Jewish Medical Center on the Nassau border, Elmhurst Hospital and Jamaica Hospital all serve the borough, alongside independent sleep centres. Home sleep testing has made access considerably easier, and it is a validated first test for straightforward suspected obstructive sleep apnea. Its main limitation is worth knowing: it does not measure brain activity, so it cannot confirm you were asleep and therefore tends to understate severity. A negative home test with convincing symptoms is a reason to escalate, not to stop.

The signs worth acting on

Habitual loud snoring, witnessed pauses or gasping, waking unrefreshed after adequate hours, morning headache, needing to urinate through the night, and daytime sleepiness — particularly falling asleep unintentionally while reading, watching television or as a passenger. Add tooth wear, a scalloped tongue border and morning jaw stiffness, and the case for testing is strong regardless of your build.

How care works from Queens

The first consultation is by video, which removes the travel question from the part of care that needs the most time. Where an appliance is appropriate, records, fitting and titration happen in person, with the location confirmed at booking. Bring any sleep study you already have — an existing diagnosis means treatment can be discussed immediately rather than starting from testing.

Common questions

I am slim. Can I really have sleep apnea?: Yes, and this is one of the most common reasons it is missed. Airway anatomy, nasal obstruction, tongue position and jaw structure cause apnea at entirely normal weight. Being reassured on the basis of body weight alone is not a substitute for testing.
Does treatment depend on my insurance being medical or dental?: A sleep appliance is billed as a medical device rather than under a dental code, which surprises most people. A dental plan declining it says very little about your actual coverage — the relevant question is what your medical carrier covers.
My child snores loudly. Should I be concerned?: Habitual snoring on most nights is not normal in a child and is worth raising with your paediatrician. In children, sleep-disordered breathing more often presents as restlessness, irritability and difficulty concentrating than as sleepiness, and enlarged tonsils or adenoids are the most common treatable cause.

Not sure where to start?

Request a virtual consultation with Dr. Samadian. In-person visits are by appointment in New York.

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