THE AIRWAY IMPERATIVE: Diagnosis and Sleep Testing

For clarity’s sake, let’s begin by acknowledging that “screening” is not the same as a “diagnosis.” Screening is the first step in the airway health management process and is targeted at assessing the need for a sleep test – a polysomnogram.

That being said, the only way to achieve an accurate, viable airway diagnosis is to order a sleep test.

Previously only performed in a hospital setting, sleep tests were extremely comprehensive (and are still considered one of the most comprehensive physical tests available today). They were also frequently considered by participants to be counter-conducive to actual sleep. Strange bed, ever present technicians, wires and terminals from head to toe — and a hospital sleep test often gave rise to the question, “Did I actually get enough sleep to even be evaluated?” Add to the mix that hospital sleep tests were more expensive and less accessible and you have a mixed bag at best. But not that long ago, they were the only game in town.

Things have changed. Home sleep tests are now considered technologically sound enough and accurate enough to determine whether or not a patient suffers from sleep apnea. Information gained by a home sleep test, combined with the information gleaned from the previously discussed clinical screening, is enough for a sleep specialist to accurately make a decision and accurately decide the severity of a compromised airway. And the home sleep test is easy to provide, easy to perform, far less expensive and is now considered by most insurance companies to be the standard starting point in the process.  In today’s world, a home sleep test is selected as the first step.

NOTE: SML works with preferred partners who can provide you with home sleep testing solutions. All are AASM-recognized and FDA-approved, to ensure a surefire, convenient sleep test for your patients – as well as a viable success-monitoring tool for your dentists and staff.

The Dental Practice Acts in every state are different, but most states allow dentists to order sleep tests. After you have screened, if you think a sleep test is warranted you can order it.  When you get the results of said test, it is imperative (and required) that you share the results with the patient’s primary care physician.

You may also, after screening, choose to inform the patient’s primary care physician that you believe an airway problem exists and that it is your recommendation that a sleep test be ordered. Once the physician orders the sleep test and results are received, the physician would then share those results with you.

Either way, the sleep tests MUST be read and evaluated by a certified sleep specialist. Once the diagnosis is made, dentist and primary care physician share the results with the patient and proceed to discuss all available treatment options. Naturally, if an appliance is the treatment of choice, it falls upon the dentist to provide it.

NEXT UP: TREATMENT OPTIONS – DISCUSSION AND SELECTION

In just a few minutes you can gather information that, when included with your written screening questions and a review of the patient’s medical history, should give you enough information to make a determination on whether to move forward and order a sleep test. This is the next critical step to getting a true diagnosis.

Click this link for the complete text of The Role of Dentistry in the Treatment of Sleep Related Breathing Disorders. –
or visit ADA.org/sleepapnea for more information. 

SML – Your Source for All Things Airway™