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The Water Cooler
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First sleep study this week. What should I expect?
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<blockquote data-quote="ratski" data-source="post: 3779899" data-attributes="member: 936"><p>Well, figured I'd chime in here.</p><p></p><p>Some good information already, some not so good.</p><p></p><p>First: you don't necessarily HAVE to go to a sleep center for diagnosis of sleep apnea. There are a LOT of other options in the Home Sleep Apnea Test (HSAT) area. I use something called a WatchPat in my office. Wear it like an Apple watch with a sensor that fits over your finger and one that you tape to your chest. You sleep in your bed on your schedule. You push the button when you get ready to go to bed and take it off when you wake up. Last literature I read had it at 95-97% as effective as a PolySomnoGram (PSG) lab test.</p><p></p><p>Next: If you do go to a lab, there are some issues that have already been mentioned. Wires, videos, masks, etc. The sleep lab that I observed in would place a mask after several hours of sleep and then they were computer controlled to find the best level for you. </p><p></p><p>Next: There are four recognized levels of Obstructive Sleep Apnea (OSA). None, Mild, Moderate and Severe. I add a fifth that is "Oh my God, how did you live thru the night." The only level that a CPAP really should be first line of treatment is Severe. Mild and Moderate can be treated effectively with an alternative therapy as has been mentioned.</p><p></p><p>Next: There is a world wide shortage of CPAP machines. Most labs and Sleep docs are reserving the few that they can get for people in the Severe levels of Sleep Apnea.</p><p></p><p>Next: I would venture to say that 99% of Sleep Docs out there are completely unaware of the role that dentists can/do play in the Treatment of Sleep Apnea. Oral Appliance therapy (OAT) is AS EFFECTIVE AS CPAP in the treatment of Mild and Moderate levels. This is also in the position statements of the Academy of Sleep Medicine. Not some out of left field comment by a dentist that has been treating this stuff for years.</p><p></p><p>Next: Oral appliances are VERY effective and relatively easy to wear. </p><p>They ARE NOT covered by Dental Insurance.</p><p>This is Medical Insurance and/or Medicare stuff. </p><p></p><p>Next: NOT EVERY dentist is trained in this field. NOT EVERY dentist is qualified to treat Sleep Apnea. Some think that they are after taking a weekend course, but that really isn't the case. If you decide to go the route of dental therapy, make sure that the dentist you select is qualified. The two biggest societies for this are the American Academy of Dental Sleep Medicine (AADSM) and the American Sleep and Breathing Academy (ASBA). Both have websites with a LOT of information on sleep apnea the treatment of it. They also have locator functions to help find dentists that are trained.</p><p></p><p>Sleep Apnea is NOT something to ignore. Sure, you may think that you sleep "just fine". There have been a lot of people who have made that mistake. Sleep Apnea affects just about every organ and hormone system in the body. Directly linked to blood pressure, cholesterol, obesity, ED, heart disease and a host of other things. Even mild sleep apnea affects these things.</p><p></p><p>There are a myriad of Oral Appliances out there. Somnomed has been mentioned. Good company with a good product line. There are other manufacturers out there as well. Prosomnus is one of my go-to appliances as well. And, this is where having a qualified dentist treating you is important. There are a LOT of piss poor appliances and appliance designs out there.</p><p></p><p>Active Duty Military, Retired and Dependents is it relatively easy to get treatment and get the Oral Appliance option. But they may have to "push" their PCP and educate them a little.</p><p></p><p>VA: Some VA centers will authorize Oral Appliance therapy, others still haven't caught on. I have friends that work with the VA on both coasts, Texas and Florida, but for some reason the OK/ARK/LA centers still haven't caught on.</p><p></p><p>CDL drivers, train drivers and pilots pretty much have to have CPAP as it is trackable to insure that they are using their CPAP.</p><p></p><p>One other thing to remember, no one dies "quietly in their sleep." A lot of these deaths are Sleep Apnea related in one way or another. Either directly (look up Reggie White) or indirectly (James Gandolfini)</p><p></p><p>So, don't take this stuff lightly.</p><p></p><p>Best of luck.</p></blockquote><p></p>
[QUOTE="ratski, post: 3779899, member: 936"] Well, figured I'd chime in here. Some good information already, some not so good. First: you don't necessarily HAVE to go to a sleep center for diagnosis of sleep apnea. There are a LOT of other options in the Home Sleep Apnea Test (HSAT) area. I use something called a WatchPat in my office. Wear it like an Apple watch with a sensor that fits over your finger and one that you tape to your chest. You sleep in your bed on your schedule. You push the button when you get ready to go to bed and take it off when you wake up. Last literature I read had it at 95-97% as effective as a PolySomnoGram (PSG) lab test. Next: If you do go to a lab, there are some issues that have already been mentioned. Wires, videos, masks, etc. The sleep lab that I observed in would place a mask after several hours of sleep and then they were computer controlled to find the best level for you. Next: There are four recognized levels of Obstructive Sleep Apnea (OSA). None, Mild, Moderate and Severe. I add a fifth that is "Oh my God, how did you live thru the night." The only level that a CPAP really should be first line of treatment is Severe. Mild and Moderate can be treated effectively with an alternative therapy as has been mentioned. Next: There is a world wide shortage of CPAP machines. Most labs and Sleep docs are reserving the few that they can get for people in the Severe levels of Sleep Apnea. Next: I would venture to say that 99% of Sleep Docs out there are completely unaware of the role that dentists can/do play in the Treatment of Sleep Apnea. Oral Appliance therapy (OAT) is AS EFFECTIVE AS CPAP in the treatment of Mild and Moderate levels. This is also in the position statements of the Academy of Sleep Medicine. Not some out of left field comment by a dentist that has been treating this stuff for years. Next: Oral appliances are VERY effective and relatively easy to wear. They ARE NOT covered by Dental Insurance. This is Medical Insurance and/or Medicare stuff. Next: NOT EVERY dentist is trained in this field. NOT EVERY dentist is qualified to treat Sleep Apnea. Some think that they are after taking a weekend course, but that really isn't the case. If you decide to go the route of dental therapy, make sure that the dentist you select is qualified. The two biggest societies for this are the American Academy of Dental Sleep Medicine (AADSM) and the American Sleep and Breathing Academy (ASBA). Both have websites with a LOT of information on sleep apnea the treatment of it. They also have locator functions to help find dentists that are trained. Sleep Apnea is NOT something to ignore. Sure, you may think that you sleep "just fine". There have been a lot of people who have made that mistake. Sleep Apnea affects just about every organ and hormone system in the body. Directly linked to blood pressure, cholesterol, obesity, ED, heart disease and a host of other things. Even mild sleep apnea affects these things. There are a myriad of Oral Appliances out there. Somnomed has been mentioned. Good company with a good product line. There are other manufacturers out there as well. Prosomnus is one of my go-to appliances as well. And, this is where having a qualified dentist treating you is important. There are a LOT of piss poor appliances and appliance designs out there. Active Duty Military, Retired and Dependents is it relatively easy to get treatment and get the Oral Appliance option. But they may have to "push" their PCP and educate them a little. VA: Some VA centers will authorize Oral Appliance therapy, others still haven't caught on. I have friends that work with the VA on both coasts, Texas and Florida, but for some reason the OK/ARK/LA centers still haven't caught on. CDL drivers, train drivers and pilots pretty much have to have CPAP as it is trackable to insure that they are using their CPAP. One other thing to remember, no one dies "quietly in their sleep." A lot of these deaths are Sleep Apnea related in one way or another. Either directly (look up Reggie White) or indirectly (James Gandolfini) So, don't take this stuff lightly. Best of luck. [/QUOTE]
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