Should Sleep Apnea Really be the Best Defense in a Trial?

We’ve heard it several times already, “sleep apnea made me do it” or “sleep apnea is the reason I fell asleep.” Is this argument always valid? Should we pay closer attention to those who claim they suffer from sleep apnea? These are all important questions, and while we don’t want to lessen the severity that sleep apnea has on an individual, we also don’t want to overuse it. In a New York Post article, sleep apnea appears to be a lawyer’s new favorite criminal defense.

The Charge

On a flight, a 21-year-old woman had her earbuds in and hood up while she was eating her in-flight lunch when a large middle-aged man sleeping next to her appeared to jump awake. At first, the man grabbed the woman’s shoulder. Soon after he went around and grabbed the woman’s right breast. The groping from the large man lasted about 30 seconds before fellow passengers could pull them apart. The woman’s attacker was brought up on federal sex-abuse charges.

The Defense

In response to the federal sex-abuse charges, the man’s lawyer presented a bizarre defense that has been used far too often. And, that’s a shame for those who actually suffer from this condition. He said, “Sleep apnea made me do it.” The man was eventually acquitted.

Can you believe that? A deadly condition like sleep apnea is not one to be used lightly, and when someone uses this condition as an excuse, it can give sleep apnea a bad name. We don’t want that to happen.

What We Can Do

We’ve seen this happen far too many times now, but what can we do about it? While we can’t change the opinions, we can continue to educate our patients. Through proper education and treatment, we can not only help our patients live healthier lives, but also understand the true definition of this condition.

From train crashes to cases of sexual abuse, where do we draw the line? I wish I knew the answer to this, but I believe that the more we educate ourselves, employees, and patients, the more we can avoid these situations. Whether it is preventing a crash through proper treatment, or allowing for people like the man in this story to not get away with sleep apnea as an excuse for touching a woman by providing proper education, we need to stay strong.

Sleep apnea is a serious condition, and we need to continue to provide the services we offer in order to educate the masses.

Stop Putting Off Education–Start Now!

I’ve heard it before, “I’ll find time next year for continuing education courses. I’m too busy now.” But the thing is, next year will turn into another year and another. Next thing you know, it will be five years down the road and you still haven’t completed that continuing education you’ve been meaning to.

I’m holding you to your 2016 goal of attending more courses “next year”. Now that we’re four months into 2017, I think you should sign up for an upcoming lecture. I’ve even made it easy for you by including my lectures through September (with links), so you can gain access to all the information right here instead of jumping from page to page. Let’s take a look:

 

  • April 28-29, 2017 in Jupiter, FL
  • Screening your existing dental patients for obstructive sleep apnea is a crucial piece of the dental sleep medicine puzzle. Are you ready?

 

  • May 12-13, 2017 in Atlanta, GA
    • Topic: Pinpoint the Pain: TMD, Craniofacial Pain
    • Did you know 45 million Americans suffer from TMD & headaches, but a majority go untreated? Get involved in helping these patients by understanding common pain complaints in the head and neck, how to diagnose pain and TMD, when and how to treat, and when to refer.

 

  • May 19-20, 2017 in New York, NY

 

    • This interactive sleep, TMJ, & pain symposium will give you the knowledge you need to integrate yourself into the sleep and pain medical community, increasing your knowledge and referral network, while providing your patients the best quality care.

 

  • July 7-8, 2017 in Chicago, IL

 

    • Did you know there is a link between sleep apnea, bruxism, and craniofacial pain? Learn how to assess your patients, prioritize, and fabricate a treatment plan that provides the best results for these three conditions.

 

  • July 14-15, 2017 in Atlanta, GA

 

    • Get involved in helping patients suffering from TMD or Craniofacial Pain by understanding common pain complaints in the head and neck, how to diagnose pain and TMD, when and how to treat, and when to refer.

 

  • July 21-22, 2017 in Atlanta, GA

 

    • The SCOPE Institute Dental Sleep Medicine Mini Residency is a 4-session, 64 CE Credit program designed to give dental practices the knowledge and guidance to fully incorporate obstructive sleep apnea treatment into their practice, and the experience to overcome obstacles in order to grow and flourish in dental sleep medicine.

 

  • September 15-16, 2017 in Phoenix, AZ

 

    • Continue to learn more about common pain complaints in the head and neck, how to diagnose pain and TMD, when and how to treat, and when to refer.

Which lecture series are you interested in the most? Share your answers with me–I’d love to hear from you. I look forward to seeing everyone at an upcoming lecture in 2017!

Could Sleep Apnea be Affecting Your Patient’s Dental Implants?

 

When our patients are missing teeth, many might turn to dental implants for a more permanent solution. And that’s great, but what if something is changing the permanence of those dental implants? In a study from the Journal of Oral Implantology, the impact of obstructive sleep apnea (OSA) on dental implants was investigated, and they found a connection. If we can treat our patients’ sleep apnea to prevent harming their dental implants, we can continue to help them smile for longer.  

The Study

Researchers looked at how OSA affects implant-borne prostheses, and the frequency with which a complication occurred was studied in 67 different patients. The researchers found a high instance of complications related to OSA, which means we need to pay closer attention to our patients’ oral health when they have dental implants and/or suffer from sleep apnea.

Of the 67 patients studied, about 16 experienced complications with their dental implants. In fact, 13 of those had OSA. Among the 16 patients with complications, there were 22 prostheses with a total of 30 issues, including:

  • Porcelain Fracture
  • Facture of the Screw/Implant
  • Loosening of the Screw
  • Decementation

The average time for a complication to occur in patients with sleep apnea is about 73 months post-implantation–that’s a long time. In fact, about 81% of patients with OSA experienced complications with their dental implants–that number is far too high.

What Options are Available?

As you know, the availability of oral appliance therapy is essential in helping our patients find relief from sleep apnea. And now, it seems it can help to prevent further harm to their dental implants. It is also important to keep an eye on sleep bruxism, or bruxism in general, because this will be a leading cause of damage to dental implants, too.

We’ve got a lot on our plates when it comes to treating obstructive sleep apnea and sleep bruxism in our patients, but now we need to be on the lookout for complications with dental implants. Are you ready to take charge of your patients’ health even more? Good. So am I.

Let’s keep an eye on sleep apnea, sleep bruxism and dental implants. If we can pay extra attention to these patients, we can continue to not only improve their sleep, but their oral health as well. If you have any questions, please do not hesitate to contact me further. In the meantime, continue to seek advanced education by attending one of my upcoming lectures!

There’s a New Guideline for Sleep Apnea Testing…

At the beginning of March we were introduced to a new set of guidelines for sleep apnea testing. The American Academy of Sleep Medicine (AASM) developed new guidelines with an expert task force of board-certified sleep medicine physicians. These guidelines were then published in the Journal of Clinical Sleep Medicine.

The Guidelines

Recommendations were based on a systematic literature review, meta-analyses, and assessment of the evidence using the Grading Recommendations Assessment, Development, and Evaluation (GRADE) method. These new guidelines also include circumstances in which an attended polysomnography in an accredited sleep center or home sleep testing should be done for suspected obstructive sleep apnea (OSA). It’s a lot to take in, but these guidelines were created to further help us dentists, and other physicians, better treat our patients.

In addition to new guidelines, there were also updated recommendations from previous practice parameters published in 2005 and 2007. For the foundation of high quality care when diagnosing OSA, two “good practice statements” were adopted:

  1. Diagnostic testing for OSA should be conducted along with a comprehensive sleep evaluation and adequate follow-up.
  2. Polysomnography is the standard diagnostic test for adults in which OSA is suspected based on a comprehensive sleep evaluation.

To further help clinicians in diagnosing OSA in adults, the following recommendations were also made:

  • Clinical tools, questionnaires and prediction algorithms should not be used to diagnose OSA in adults, in the absence of polysomnography or home sleep apnea testing.
  • Polysomnography, or home sleep apnea testing with an adequate device, should be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA.
  • If a single home sleep apnea test is negative, inconclusive, or technically inadequate, polysomnography should be performed for the diagnosis of OSA.

And the list goes on, but it is important to understand these guidelines so we can better care for our patients.

Where do Dentists Come Into the Picture?

As you know, dentists don’t diagnose sleep apnea, but we can recommend our patients seek outside help. If your patient is displaying signs and symptoms of sleep apnea, it is important to be prepared. While you can’t diagnose them, you can recommend a doctor to visit for a proper diagnosis. You can also share your knowledge of the process so your patient doesn’t go into it blindly.

To review the guidelines and learn more about these new additions, you can read the article here.