The goal of our sleep practice is to help our patients sleep better, experience open and unobstructed airflow so they can breathe properly...which aids in overall health.

Every patient is unique. The team at RVA Dental Care will help each patient identify if they are at risk for a sleep-breathing disorder.

Our AADSM qualified dentists work as a team with medical professionals to find our patients the proper diagnosis and treatment. We work closely with Certified Sleep Physicians, Pulmonologists, Primary Care Physicians and other health care providers to assure the best possible sleep solutions for you and your family.

If you, your loved ones or friends have concerns regarding sleeping, breathing or snoring, please contact our office to set a FREE consultation with our doctors and team.

Please schedule your appointment with our Sleep Coordinator:

Ashley Lyon | 804.282.3838
stop snoring richmond dentist bed

Common Sleeping & Breathing Disorders

What is sleep apnea?

A potentially serious sleep disorder in which breathing repeatedly stops and starts

Symptoms may include
• Loud breathing
• Dry throat
• Excessive daytime sleepiness

Upper Airway Resistance Syndrome

Upper airway resistance syndrome is a sleep disorder characterized by increased airway resistance resulting in breathing difficulty

Sleep Disturbances

Changes in sleeping patterns or habits that can negatively affect health

Chronic Obstructive Pulmonary Disease

A group of lung diseases that block airflow and make it difficult to breathe

Symptoms may include
• Frequent respiratory infections
• Chest tightness
• Cough with phlegm

richmond sleep disorders


  • Our youngest sleep patient is 6 years old
  • Children should never snore
  • Sleep quality affects aging and function
  • 42 million Americans suffer from sleep apnea
  • 30-83% of patients with high blood pressure have sleep apnea
  • 1 in 5 adults have at least mild sleep apnea
  • 1 in 15 adults have moderate to severe sleep apnea
  • 75% of severe sleep apnea cases remain undiagnosed

Why Sleep Dentistry?

Dr. Friend, Dr. Lawrence, and Dr. Collie all have personal experience with their own sleep and breathing disorders. After turning 50, Dr. Friend began to experience severe daytime sleepiness and difficulty falling asleep and remaining asleep through the night. After several unsuccessful changes to diet, routines and even sleeping medication, exhausted and frustrated, Dr. Friend sought the advice of a local sleep physician. A home sleep test was conducted, diagnosing Dr. Friend with mild obstructive sleep apnea with severe symptoms.

At the instruction of the sleep physician, Dr. Friend made himself an oral appliance called a “mandibular advancement device.” Immediately the appliance eliminated the snoring and after some time and appliance adjustment, his symptoms began to fade away. It was at this point that Dr. Friend began educating himself on sleep apnea and his role as a dentist in helping people with the same disease.

Due to an athletic injury, Dr. Lawrence spent most of his high school years with a deviated septum. After surgical correction, the difference in breathing was immediately evident. Patients with similar conditions can greatly benefit as nasal breathing is more beneficial than mouth breathing during sleep and daytime hours.

Dr. Collie's interest in sleep apnea treatment began with his own mother's diagnosis with sleep apnea. After struggling with CPAP therapy, Dr. Collie recommended an oral appliance for her. She quickly saw improvement in her sleep quality, energy level and overall quality of life. Witnessing the tremendous benefits she received from treatment, Dr. Collie has joined Drs. Friend and Lawrence in their dental sleep medicine education, and looks forward to providing his patients with excellent care

Why Us?

Dr. Friend, Dr. Lawrence, and Dr. Collie are all Qualified Sleep Dentists with the American Academy of Dental Sleep Medicine and are actively pursuing Diplomate status with the AADSM, a prestigious award held by only a handful of dentists in Virginia. They have seen the transformative power of a good night’s sleep in themselves and their patients. Drs. Friend, Lawrence, and Collie use acoustic pharyngometry, a safe and painless method to measure the airway, to screen patients for potential sleep-breathing disorders. The same technology is used to properly titrate every custom oral appliance to each patient. This technology ensures that oral appliance therapy is effective in relieving both snoring and sleep apnea episodes.

Bed Partner/Witness Screening Questionnaire:

Please answer the following questions as they pertain to your bed partner in the past month.

1. While sleeping, does your partner:

  • Snore more than half the time?
  • Always snore?
  • Snore loudly?
  • Have “heavy” or loud breathing?

2. Have you ever seen your partner stop breathing during the night?

3. Does your partner:

  • Tend to breathe through the mouth during the day?
  • Have a dry mouth when waking up in the morning?
  • Occasionally wet the bed?

4. Does your partner:

  • Wake up feeling unrefreshed in the morning?
  • Have a problem with sleepiness during the day?

5. Has a friend, coworker or supervisor commented that your partner appears sleepy during the day?

6. Is it hard to wake your partner up in the morning?

7. Does your partner wake up with headaches in the morning?

8. Is your partner overweight?

STOP – BANG Sleep Apnea Questionnaire

Please answer YES or NO to the following:

1. Have you been told that you snore?

2. Do you often feel tired, fatigued, or sleepy during the daytime?

3. Has anyone observed you stop breathing during your sleep?

3. Do you have or are you being treated for high blood pressure?

5. Are you 15-20 lbs. overweight?

6. Do you have morning headaches?

7. Do you have a family history of sleep apnea or snoring?

8. Do you have a family history of heart attack, stroke or diabetes?


I wanted to write this note to anyone wondering if a snore guard could help you feel better and stop the snoring for you. Yes, it will!

On August 22nd I came to RVA Dental for a consultation with Dr. Jeffrey Friend and it was a great experience right from the start! Prior to the appointment I received documents by email which could be completed in advance which saved time and they could have my history before my visit.

Upon arrival I was greeted with warm smiles and receive those each time since.

As a little background, a sleep study had been performed a few years ago which was suggested by my neurologist. It was determined I have moderate sleep apnea and snore much of the night. So I was prescribed a CPAP machine. Unfortunately, I was just unable to sleep wearing it. Just too bulky, cumbersome and uncomfortable.

I learned that it is a common complaint and problem for many and I was advised of other options. I am thankful as I had gotten used to feeling tired and sleepy and not well rested.

I was thoroughly tested and fitted for the best appliance for me. The very first night I wore my appliance and using an app to record my snore levels, I realized I had already, in the first night, gotten a better night's sleep.

I record my levels often and on a whim decided to go without the snore guard one night to see what the levels would be not wearing the appliance so I had numbers to compare to, and it was a terrible result! No wonder I have been so tired for so long.

I have been using my Moses snore guard for about 3 weeks and it is helping me already! I am snoring about a quarter of the night (lightly) instead of three quarters of the night at loud levels. And, I am sleeping better, getting up only once during the night instead of 2 or 3 times. Another great thing about the appliance is that it's fully portable. It comes in a little case small enough to fit in your purse.

Thanks to the referral to Ashley and Dr. Friend I am sleeping better and feeling more rested already. It is quite amazing to see the difference and I have to think it will only get better.

- RM

I love my sleep appliance! I experienced improved sleep starting the first week and every week since. The device is easy, unobtrusive, and low-impact. I feel better rested, improved air capacity and an increase in energy and stamina. Overall improved quality of work, rest and play.

- KC

Dr. Collie provided expert emergency assistance and restored my smile with professionalism and good cheer. RVA Dental Care was available on a Friday when my regular dentist wasn't. Very pleased with the service, the location, and the quick response. Another plus: phone calls are answered by a real person without having to push a series of buttons first!

- Anonymous

My entire life, I have struggled with feeling spacey and lethargic. One day Dr. Friend suggested that this could be caused by sleep apnea, and although I'm not an overweight individual, the anatomy in the back of my throat showed some warning signs. He referred me to Bon Secours Sleep Center and the sleep test came back as positive for mild obstructive sleep apnea. Dr. Friend made me a SomnoMed mouth guard, and the results have been incredible. After the second day of sleeping with it, I was able to stop taking the ADHD medication that I had been on for the past four years, and my mental clarity was better than it was while I was taking medication. The only regret I have about getting involved with the sleep therapy program at RVA Dental is that I didn't start it sooner!

- BW

My experience with Dr. Friend and Ashley in the RVA Dental Sleep Center - along with the rest of the office staff -  has been nothing short of fantastic. My sleep improved dramatically after receiving an oral device, but the process of getting fitted was most impressive. the office invested in the latest technology and training in this emerging field and they provided what felt like concierge level care in getting to know me and managing my case. It's no wonder they get results. Wow........

- GH

I LOVE MY Sonnamed SLEEP APPLIANCE! I have had several appliance prior to this one, and I can honestly say this is the most comfortable one I've ever had. Yes, it is a bit pricy, but worth EVERY penny. Not to mention, that Dr. Friend at RVA Dental Care, is so passionate about his patients getting a quality nights sleep, that he worked with me on a payment plan. American's do not put enough importance on a good nights sleep. I grew up in the era where sleep was a waste of productive time. This is how I lived my adult life until my health failed. Studies have shown how vital quality sleep is to our overall emotional, mental and physical health. Not only do I look forward to a quality nights rest now while using my sleep appliance but I also look forward to the comical entertainment when remembering bits and pieces of dreams while in R.E.M. Sleep cycle the night before. A cycle of sleep that I don't reach without my sleep appliance. Don't wait until your health fails you to understand the importance of a quality nights rest and the importance of the R.E.M. sleep cycle.

- RP

My visits with Dr. Collie have been beyond exceptional! He is very kind, personable, and customer service oriented. During the procedure he would periodically stop and ask how I was doing. I really appreciated the fact that he was invested in making sure I had a comfortable and pain free experience. His friendly nature and easy going personality only added to the superior service I received. I think the entire staff at RVA Dental Care does a great job of making you feel like a valued patient. I would recommend this practice to anyone!!!

- FG


Independent Predictors of Heart Attack

Risk Factor Odds Ratio
Standard 1.0
Overweight 7.1
Hypertension 7.8
Smoking 11.1
Obstructive Sleep Apnea 23.3

Dental Symptoms of OSA

  • Bruxism/ clenching and grinding of teeth
  • Tongue thrusting
  • Scalloped tongue
  • Dry mouth
  • Mouth breathing

Most Common Symptoms of Obstructive Sleep Apnea

  • Snoring
  • Excessive Daytime Sleepiness
  • Hypertension (High Blood Pressure)

Other Symptoms

  • Acid Reflux (Gerd- Gastro Esophageal Reflux Disease)
  • Morning Headaches
  • Diabetes
  • Sexual Dysfunction
  • Social Problems
  • Memory Problems – Alzheimer’s / Dementia
  • Dental Symptoms (Abfractions from Nocturnal Bruxism)
  • Nocturia - frequent need to urinate at night

Contributing Factors

  • Obesity & Large Neck Circumference
  • Menopause
  • Mouth Breathing
  • Family History

Heart Attack and stroke
OSA increases the risk of heart attack and stroke more than any other single factor – including smoking, obesity etc. (5 X increase ) Nearly 80 % of nocturnal strokes can be directly attributed to OSA.

Why are headaches a symptom of OSA?
Three types of headaches have been directly linked to the presence of OSA.

• Migraine
• Cluster Headaches
• Dull Morning Headaches

All are caused by different things, morning headaches and cluster headaches have been linked to oxygen desaturation events caused by OSA.

Migraine headaches are correlated with REM & Delta sleep patterns which are severely disrupted in patients with OSA.

Why is sexual dysfunction a sign of OSA?
Lack of nitric oxide in the body narrows arteries and decreases blood flow to all areas of the body. The major erectile dysfunction medications all function by causing a spike in nitric oxide production, which causes vasodilation and increased blood flow.

Why are social problems a sign of OSA?
Simple equation! OSA = Poor sleep= Unhappy, grumpy, irritable person=work/relationship/school problems

Why is Diabetes a symptom of OSA?
Obese patients are more likely to have OSA, they are also more likely to have diabetes. Perpetual lack of sleep in young adults results in changes in glucose metabolism and endocrine function.

New Studies Related to Cancer
Severe Apnea results in 5X the number of cancer deaths for those with cancer. New studies show that periodic lower oxygen results in 2X the speed of growth of cancer tumors

Cancer Statistics
Mild OSA= 10% increase in cancer deaths
Moderate OSA= 200% increase in cancer deaths
Severe OSA= 480% increase in cancer deaths

Problems with sleeping, breathing or snoring?

Contact our dental office to set a FREE consultation with our doctors and team.

Please schedule your appointment with our Sleep Coordinator:

Ashley Lyon | 804.282.3838