Who is Part of the Sleep Treatment Process?

When it comes to treating sleep apnea and other sleep breathing disorders, it is important to understand who each member of your team is. While we have mentioned this before, it is always a good idea to refresh your memory of just what each member does. Let’s meet he members of a sleep team, so you can better understand who is there to help in the diagnosis and treatment of your patients:

Board Certified Sleep Medicine Physician

A board certified sleep medicine physician has the necessary skills to diagnose and treat sleep disorders. If you suspect your patient might be suffering from a sleep disorder, the first person you should contact is your local sleep medicine physician. Each sleep medicine specialist has received special training that can prevent serious life-threatening diseases and improve your quality of life.

The Sleep Technologist

A sleep technologist will assist in the evaluation and follow-up care of patients with sleep disorders—they interact directly with the patients. They will assist the sleep medicine physician with diagnostic tests, including in-lab sleep studies, multiple sleep latency testing (MSLT) and the maintenance of wakefulness testing (MWT). A sleep technologist will also score sleep tests prior to the physician’s interpretation, while also assisting patients with their home sleep tests.

Advance Practice Nurse/Physician Assistant

Nurses and physicians assist the sleep medicine physician in providing care for your sleep patients. Their roles will vary by state, but both typically practice within the scope of practice as defined by a state licensing board.

Sleep Surgeon

Also known as an otolaryngologist, a sleep surgeon has a specific interest in treating snoring and obstructive sleep apnea. Sleep surgeons work closely with a board certified sleep physician to provide proper care for patients who cannot tolerate CPAP therapy. The sleep surgeon can discuss with your patient each surgery option available.

Behavioral Sleep Medicine Specialist

Mental health professionals that have training in behavioral sleep medicine can work with patients to address the behavioral, psychological and physiological factors that might be interfering with their sleep. A behavioral sleep medicine specialist will use cognitive-behavioral therapy to attempt to eliminate habits, behaviors and environmental disruptions that stand in the way of optimal rest.

As a dental sleep medicine specialist, you can often recognize a sleeping problem before it worsens. You can also provide effective treatment for your patients. Dr. Mayoor Patel is available to help teach and guide you in your role as a dental sleep medicine specialist and how you can successfully treat your patients.

Join Us for Study Club and Increased Understanding

If you have not done so already, I highly recommend joining me for study clubs and groups. It is important to always be up-to-date with various topics for dental sleep medicine and TMD areas, which is where study club comes into play. Let’s take a look at what you can expect from these groups.

What is Study Club?

Good question. Study club is a way for me to visit your office to further discuss various areas of your dental office that include you and your team. I welcome invitations to your study club and group or as a guest speaker at your office meetings to share some fun learning experiences on an array of topics. It is almost like book club, but without the books. But don’t let that limit you. If you have a book you read or are interested in, then bring it. We can touch base on it and see what it is all about and how it can help with your office.

After all, I recently wrote a book that would be great for you and your office to read together for an enhanced understanding of dental sleep medicine and your patients. The book can be purchased on lulu.com or amazon.com, whichever is your preference. “Freedom from CPAP: Sleep Apnea Hurts, the Cure Doesn’t Have To” is a joint effort by myself and Dr. David Dillard to help improve the understanding of obstructive Sleep Apnea.

Some topics we can discuss in study club might include, but are not limited to:

  • Pharmacology in Treating Orofacial Pain/TMD
  • Identifying Patients with Suspected Sleep Breathing Disorders
  • Fundamentals of Temporomandibular Disorders
  • Oral Appliance Therapy in the Management of Obstructive Sleep Apnea
  • Understanding Various Common Facial Pain in a General Dentistry Practice
  • What is TMD?
  • Link between TMD, Sleep Bruxism & Sleep Disordered Breathing
  • Understanding Bruxism

And, if you have a topic in mind and you do not see it listed above, please contact me and we can further discuss your needs! I look forward to potentially working with you and your staff on these topics!

A Day in the Life: Run Your Practice Like the Experts

At Nierman Practice Management, we have some upcoming lectures that I think you will love! For today I want to touch base on A Day in the Life: Run Your Practice Like the Experts. I highly recommend attending this lecture series to further enhance your practice and your understanding of how to properly run your practice when incorporating Dental Sleep Medicine.

What is it?

This is a two-day “over-the-shoulder” seminar that gives you the opportunity to firsthand experience how the experts run a successful dental sleep medicine or TMD practice. By having a credentialed mentor, it can help to propel you and your team to the next level in expanding your practice. Through shadowing, you will be able to discuss how to overcome specific roadblocks you may be facing. And, the pieces will come together at a much faster rate than trying to do it all on your own. After all, don’t you wish you could have questions answered immediately rather than having to wait for a response through email or a tutorial? I thought so; me too.

[Insert Video – “Dr. Mayoor Patel & Nierman CE Shadowing for Dental Sleep & TMD”] https://www.youtube.com/watch?v=3BqStiC8Xpw

This course is perfect for practices that have already taken several courses and are ready for a dedicated hands-on learning experience that will be essential to their growth as a sleep medicine dentist. Remember, though, in order to keep each session as personalized as possible, attendance is limited to three practices by application only.

I look forward to seeing you in December and hopefully working together to get your practice on track for dental sleep medicine and TMD services! You can also visit the lectures section of my website for more dates and times for different lectures.

How Does High Risk OSA and Sleep/Wake Bruxism Relate to TMD?

It seems like the symptoms are never-ending and always combining. Even when that is the case, it is important to fully understand each option so that you can provide the proper treatment for your patients. After all, we know that a misdiagnosis can make treatment unbearable and we don’t want to do that to our patients, do we? I didn’t think so.

Today I want to shed a little light on how high risk obstructive sleep apnea and sleep/wake bruxism can relate to TMD. Let’s take a look.

What is TMD and OSA?

First, here is a little background for those who may not be too familiar with this topic area. TMD stands for temporomandibular joint disorder and it is a musculoskeletal disorder characterize by persistent pain in the temporomandibular joint (TMJ), periauricular region, and/or the head and neck muscles. And, OSA is obstructive sleep apnea, which is a sleep-related breathing disorder characterized by repetitive collapsing of the airway during sleep.

The Connection

Sleep-related bruxism and wake bruxism have both been associated with TMD, headaches, and sleep and behavioral complaints. According to Dentistry IQ, one hypothetical mechanism is that OSA might be associated with an increase in parafunctional activity. This would be sleep bruxism or awake bruxism, and contributes to the initiation of TMD in susceptible individuals. Bruxism is a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth and/or bracing or thrusting the mandible. Bruxism can occur during sleep or even while awake.

To look into the connection, the Academy of Dental Sleep Medicine hypothesized that OSA symptoms, awake bruxism, and sleep bruxism at baseline were independent predictors of developing TMD in initially pain-free individuals. This data was analyzed between 2006 and 2008 with men and women between the ages of 18 and 44.Before the investigation began, each participant reported sleep bruxism and wake bruxism. And, to evaluate risk for OSA, each reported loud snoring, daytime sleepiness, witnessed apnea, and hypertension.

The Results

Up to five years after this initial phase, participants completed a TMD screening questionnaire every three months. Clinical re-examination determined TMD in the presence of 5 days per month of pain in the masticatory structures and findings of arthralgia or myalgia. This study found that symptoms of OSA, reports of wake bruxism, and reports of sleep bruxism all have a significant effect in predicting first-onset TMD. And, wake bruxism had a stronger association with OSA symptoms than sleep bruxism did.

You can read more about this study by visiting Dentistry IQ’s recent article. I found it very interesting and am looking forward to even more information on this topic because it helps us in properly treating our patients and potentially preventing further complications.