Patient Journey — What To Expect

Your path to better sleep, step by step.

No guessing. No surprises.

The path from “I think I might have sleep apnea” to “I’m sleeping through the night again” has more steps than most patients expect, but each step is straightforward. Here’s the whole journey laid out, so you know what’s ahead before you call.

Most patients move from their first consultation to their custom appliance in four to six weeks. Long-term care continues from there.

Step 1. The screening consultation

You don’t need a referral, a diagnosis, or a sleep study to schedule. Call us, or fill out the consultation form, and we’ll set a time.

The first visit runs 30 to 45 minutes. We review your symptoms, your medical history, your current medications, and any sleep concerns. If you already have a sleep study, bring it. If you’ve been prescribed a CPAP, bring that information too. We’ll also do a brief oral exam to confirm you’re a candidate for an oral appliance.

By the end of this visit, you’ll know whether oral appliance therapy makes sense for you, whether you need a sleep study first, and what the next steps look like.

Step 2. The sleep study, if you need one

If you haven’t been diagnosed with sleep apnea, the next step is a sleep study. We coordinate with partner sleep physicians in the Dallas-Fort Worth area to arrange one.

Most sleep studies today are done at home. You wear a small device in your own bed for one or two nights and then return it for analysis. Lab-based studies are still used in some cases, but home tests are now the most common way to diagnose obstructive sleep apnea.

A sleep physician interprets the results and makes the diagnosis. From there, you come back to us.

Step 3. The diagnosis and the prescription

Once a sleep physician has confirmed obstructive sleep apnea, you have treatment options. CPAP is one. An oral appliance is another. For patients who choose the appliance, the sleep physician provides the prescription, and we take over from there.

If you’ve already been diagnosed and are coming to us because CPAP didn’t work, we skip ahead to the fitting once we have your records.

Step 4. The fitting appointment

This is when we take precise digital impressions of your teeth. The impressions go to the lab that fabricates your custom appliance. From impression to finished appliance typically takes two to four weeks.

The fitting itself takes about an hour. We test the appliance for fit, make small adjustments, and show you how to insert, remove, and care for it. You wear it home that night.

Step 5. Titration and adjustment

A sleep appliance has to be adjusted to find the right setting for you. The process is called titration.

Most patients return for two or three short visits over six to eight weeks. We adjust the appliance gradually; you sleep with each new setting for a few nights, and we work together to find the position that opens your airway without straining your jaw. This is the most patient-specific part of the process, and the most important.

Step 6. Verification

The American Academy of Sleep Medicine recommends a follow-up sleep study once your appliance is dialed in to confirm it’s working. We coordinate that with your sleep physician. If you’re responding well, we move into long-term care. If we need to adjust further, we do.

Step 7. Long-term care

A sleep appliance is a treatment, not a one-time procedure. We see you for an annual check-up, examine the appliance for wear, and verify it still fits correctly. Most appliances last three to five years before they need to be replaced.

If your sleep changes, your weight changes, or symptoms come back, come in sooner. We adjust or remake the appliance as needed, and stay in touch with your sleep physician about any changes that might call for a new sleep study.

Typical timeline

  • Week 1: Initial consultation
  • Weeks 2 to 4: Sleep study, if needed, and physician diagnosis
  • Weeks 4 to 6: Fitting appointment, appliance fabricated
  • Weeks 6 to 12: Titration and adjustment
  • Month 3 or 4: Follow-up sleep study, if recommended
  • Annually thereafter: Check-up and appliance evaluation

Ready to start?

The first step is a 30-minute conversation. Most patients leave that conversation with a clear sense of what’s next and a much shorter list of unknowns. That alone is worth the visit.

Treatment that fits your life.

Oral appliance therapy is the modern alternative to CPAP for many patients. Each treatment plan starts with a sleep physician's diagnosis, then Dr. Holt builds a custom device shaped to your mouth.

Oral Appliance Therapy

A small, custom-fit device worn at night. It holds the lower jaw slightly forward to keep your airway open. No mask, no hose, no machine noise. The standard of care for mild to moderate sleep apnea and a strong option for severe cases when CPAP fails.

CPAP Alternatives

If you've been diagnosed with sleep apnea and your CPAP is collecting dust, you're not alone. Roughly half of patients abandon their machines within a year. An oral appliance is often the next step.

Snoring Treatment

Loud, persistent snoring is more than a nuisance. It can signal an underlying airway issue, and it costs the person next to you their sleep too. A custom appliance can quiet most snoring overnight.

Sleep Apnea Treatment

Untreated sleep apnea raises your risk of high blood pressure, heart disease, stroke, and accidents. Treating it well can change how you feel every day. Dr. Holt's approach is co-managed with your sleep physician, from start to finish.

Stop wrestling with sleep apnea
If you snore loudly, wake up exhausted, or can't stand your CPAP, an oral appliance may be the answer. The first step is a conversation.