Dental Sleep Medicine Insider March 2015 | Page 16

The Changing Face
of Dental Sleep Medicine

granted this status by on-the-job training
after medical school and their residency in
whatever specialty tract they pursue. The
typical time a medical student is exposed to
sleep medicine in medical school is one l
ecture on sleep and its disorders.

Sleep Medicine

is a unique field that faces many
challenges. These challenges have
resulted in the typical sleep apnea patient
suffering from sleep apnea for 10+ years
prior to being diagnosed and initiating
treatment. A majority of sleep apnea
patients remain undiagnosed and/or
untreated. Snap Diagnostics was founded
on the vision that we can provide a better
solution for patients and healthcare
offices that are seeking a cost effective,
one-path solution for sleep apnea testing.
Yet, if sleep apnea is "so bad" why is
apnea so low on most healthcare radars?

Sleep is a New
Discipline.

Sleep Medicine is relatively new with
respect to other medical disciplines. In the
mid-70's a medical society was first
formed to govern the practice of sleep
medicine. Thirty-five years ago there were
less than 100 sleep centers in the entire
US. Apnea was poorly understood.
Limited Education on Sleep. Even today,
you remain unable to undergo a "sleep
specialist" tract in medical school. One
hundred percent of sleep specialists are

Limited Treatment
Options Historically.

As recent as 1985 (prior to the PAP) the
most common treatment strategy was to
scare a patient to lose weight or get a hole
cut in their throat. Tracheotomy was the
only known truly effective treatment. The
patient would open the trach at night and
close it during the day. It is hard to grow a
discipline on the back of a trach as the
primary treatment.

Apnea has a
Profound Impact
on Society.

dramatic change in the entry process for
sleep medicine. The IOM report called the
state of sleep disorders "public health crisis"
and urged healthcare providers to "increase
their diagnostic procedures for apnea 4 to 5
times their current rates." Two years after
this IOM report was issued, Medicare issued
a policy change and began accepting an
at-home sleep test for the diagnosis of sleep
apnea. The home test quickly gained
traction in part due to its appeal to the
consumer as well as the dramatic I
mprovement in the cost and efficiency of
the diagnostic process. This year over 25% of
patients will use a home test. Left
unchecked, the growth of spending for
in-lab sleep testing for Medicare shown
above would have reached approximately
$400 million by the year 2011. A modest use
of home testing resulted in savings on the
order of $100 million in 2011 alone.
Widespread adoption will save dramatically
more.
Sleep Apnea Causes Normally Effective
Medical Interventions to No Longer Work
Most providers fail to fully appreciate why
Apnea has a profound negative impact on
virtually every human system. Sleep plays a
critical role in the maintenance of our overall
physical and mental health. Apnea is best
understood when you fully appreciate that
its disruption on sleep results in a disruption
on every physiological and mental function
in our body. Repetitive disruption of sleep
each night by apnea episodes causes
normally effective recuperative and
restorative mechanisms of sleep to fail.
When sleep breaks down, the majority

Many clinical studies now show that
untreated sleep apnea imposes a dramatic
cost on our society both in direct costs, e.g.,
higher utilization of expensive healthcare
resources like ER visits and extended
hospital length of stay, as well as indirect
costs, e.g., reduced work productivity and
increased mortality. [Commissioned Report:
Institutes of Medicine. 2006. Colten &
Altevogt, Sleep Disorders and Sleep
Deprivation: An Unmet Public Health
of your health systems break down. That is
Problem, pp 1-500.]
why apnea is so prevalent.
The 2006 IOM report cited above sparked a The best single way to recognize a