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An Alternative to Inspire Sleep Apnea Treatment

A Modern Solution for OSA and TMD

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    Our TMJ Holistic Healing Methods Vs. Inspire Sleep Apnea Device

    A side-by-side comparison of Holistic TMJ-Aware Oral Appliance Therapy and the Inspire® Hypoglossal Nerve Stimulation (HNS) device, highlighting the key differences in invasiveness, candidacy, clinical outcomes, risks, and total costs. This breakdown is designed to help patients explore effective alternatives to Inspire for sleep apnea—especially those who may have concerns about surgical options, long-term device use, or who have encountered Inspire sleep apnea horror stories.

    • Holistic TMJ-Aware Pathway

      OAT-Anchored

      Non-invasive oral appliance therapy with comprehensive TMJ management


    • Inspire® HNS

      Surgical

      Hypoglossal nerve stimulation implant device

    Treatment Approach
    • Invasiveness
    • Non-surgical, reversible, adjustable
    • Surgical implant (generator + leads)
    • Candidacy
    • Broad; works across mild, moderate, and many severe OSA cases; can combine with PAP
    • Adults with AHI 15–100, PAP-intolerant, BMI ≤ 40, no complete concentric collapse (DISE)
    Clinical Outcomes
    • Effectiveness
    • Comparable to CPAP in real-world outcomes (thanks to higher adherence); supports combination therapy
    • STAR trial: durable benefits up to 5 years; ~75% responder rate
    • Adverse Effects
    • Mostly dental/TMJ effects (jaw soreness, bite changes) managed with follow-up
    • Surgical/device risks: tongue weakness, stimulation discomfort, infection, revisions, rare explants
    Technical Considerations
    • MRI / Imaging
    • No restrictions
    • MR Conditional only (specific conditions/protocols required)
    • TMJ & Bruxism
    • Directly addressed in appliance design + adjunctive therapy
    • Not addressed; may need separate TMJ management
    Financial & Guidelines
    • Cost
    • Lower up-front; routine follow-up; broad insurance coverage for OAT
    • $30k–$40k typical up-front (device + surgery + facility); ongoing battery/revision costs
    • Guideline Alignment
    • AADSM 2025: Oral appliances viable across severities; reversible therapies first
    • AASM 2021: surgical referral discussed for PAP-intolerant adults with BMI < 40
    Dr. David Shirazi

    About Dr. Shirazi

    Dr. Shirazi developed TMJ-Aware Oral Appliance Therapy out of a commitment to offering a truly comprehensive, non-invasive solution for sleep apnea that respects the interconnectedness of the jaw, airway, and overall health. Many patients struggle with CPAP intolerance or experiencing jaw pain from conventional oral appliances. Others are hesitant to pursue surgical options like the Inspire® sleep apnea device due to concerns over invasiveness, high costs, or unfavorable outcomes they’ve read about.

    Our treatment is different. It’s fully reversible, adjustable, and carefully designed to support both airway function and TMJ health. We prioritize comfort, functionality, and long-term wellness—integrating dental, orthopedic, and airway science to deliver effective outcomes without the risks of surgery. This holistic pathway is ideal for those seeking alternatives to Inspire for sleep apnea, especially patients who are looking for a gentler yet highly effective way to breathe and sleep better without sacrificing jaw stability.

    TMJ & SLEEP THERAPY CENTRE OF Los Angeles and Conejo Valley

    Success Stories

    The Shirazi Hybrid represents a leap in oral appliance technology—combining custom 3D-printing, dual-axis titration, and CPAP-friendly design to meet the nuanced needs of both sleep apnea and TMJ patients

    EXCELLENT Based on 73 reviews Suzanne P 2024-06-03 Trustindex verifies that the original source of the review is Google. I received excellent care from Dr. Shirazi and his staff. Dr Shirazi listens to his patients and has a holistic approach.   Michael Whalen 2023-07-26 Trustindex verifies that the original source of the review is Google. Came in for evaluation for severe headaches, ear pressure/pain and jaw pain. Dr. Shirazi was able to identify my TMJ misalignment and clenching as a probable source - 6 weeks into treatment and nearly all the clinical signs have resolved.Staff is always friendly and has been supportive along the way. Highly recommend for management of TMJ disorders. Read more Jessica Luna 2023-06-28 Trustindex verifies that the original source of the review is Google. Dr Shirazi and his staff are the most loving and educated people around. I went in with severe jaw pain and Dr. did a full check up to determine the root of my issues. He explained everything so well and detailed, at that time I knew I had chosen the perfect office for my needs. I now sleep and eat everyday without my jaw pains because of his perfect structured treatment plan. I will continue to recommend this office to everyone with similar issues because I know him and his staff will go above and beyond to treat all patients. Read more Margaret Franz 2023-06-21 Trustindex verifies that the original source of the review is Google. Very friendly staff!   hunter klotz 2023-06-07 Trustindex verifies that the original source of the review is Google. Very helpful staff, and Dr. Shirazi is extremely knowledgeable and willing to share details of his field   Shandor Batoczki 2023-06-07 Trustindex verifies that the original source of the review is Google. This place is the best if you are looking for any help with TMJ issues. The staff are all very helpful, kind, and willing to help and answer any questions you might have. Dr. Shirazi is also a fantastic doctor, he goes everything in detail with you about the treatment plan, what to expect, and is open to any and all questions, and strives to make sure that the patient is comfortable through the whole process. Really happy to have been referred to this place by my dentist Read more Carol Ellis 2023-05-23 Trustindex verifies that the original source of the review is Google. I came to TMJ & Sleep Therapy with severe pain from lock jaw. This included headaches and not being able to open my mouth comfortably to even brush my teeth. I was given a complete and thorough exam to address my issues, including clenching and grinding my teeth, which I have done for years. My treatment plan, including acupuncture, and being fitted for a new nighttime appliance has given me complete peace of mind in avoiding any surgery. I am thankful to Dr. Shirazi and his team for seeing me through the journey to end pain free. Read more Heather Shields 2023-05-10 Trustindex verifies that the original source of the review is Google. Life Long Teeth Grinding - Finally a SolutionI started going to the TMJ & Sleep Therapy Centre in December 2022 after experiencing some jaw pain that my dentist said was not tooth related. That was a relief as dental work is insanely expensive. However, I knew something was going on since I had been chewing up the inside of mouth at night and needed to figure it out. I have been grinding my teeth my whole life and never realized the pain it was causing me. After my initial visit, which was very comprehensive and lasted about 2 hours I was really excited to get my program started. Dr. Shirazi took molds of my teeth for day and nighttime appliances to correct my grinding, which he suspected was the cause of my very frequent migraines, not just the recent jaw pain I was having. It only took a couple of weeks to get those and then almost immediate relief. I have to say that after 6 months of seeing Dr. Shirazi my situation is so so so much improved. I rarely get migraines anymore and my teeth grinding is no longer an issue with the custom appliances that were made for me.The office is really nice, very modern and always clean. Dr. Shirazi and his staff are top notch and they have appointments that can accommodate my work schedule. Dr. Shirazi is always asking me how things are going and what other things might be bothering me and is willing to help with those if he can. He is very knowledgeable about his profession and genuinely seems to enjoy his work.I have to say this was not the most inexpensive endeavor, but I’d say it’s likely less than dental work in general. I was aware of this before I had my consult as I had read other patient’s reviews, but it actually turned out to be less expensive than I had thought. In any case I look at it as an investment in my health. I got so much more out of this than just managing my teeth grinding. The biggest benefit is one I wasn’t even expecting. NO more almost daily migraines. I ABSOLUTELY recommend giving The TMJ & Sleep Centre a try if you are having any cranial or facial issues, not just TMJ. Read more

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