What is the prevalence of general dentists who screen for OSA?

Now this is an interesting study that I know many of you will want to learn more about. While I was searching the internet for new studies and information on sleep apnea I found this study in the Journal of Dental Sleep Medicine. The researchers were looking to determine the prevalence of general dentists screening for obstructive sleep apnea (OSA).

One thousand general dentists across the U.S. received a brief 12-item questionnaire consisting of a demographic section and questions about OSA screening methods, parameters and preferences. Here is what researchers found.

General dentists screen for OSA

Out of 1,000 general dentists who received the questionnaire from researchers, only 71 responded. However, based on demographic results, those who did respond represent a broad range of general dentists practicing in the U.S.

Dentists were asked to select which screening modalities they use and to supply specific information to provide validity to their responses. Researchers found that 76 percent of general dentists who responded, reported that they screen for sleep apnea.

Dentists use more than one modality

Most of these dentists also use more than one modality when screening for sleep apnea in their patients.  The questionnaire found that 60 percent do not routinely screen more than 70 percent of their patients. And a total of 37 percent ranked themselves a three or less on a scale of one to five regarding their confidence in screening for sleep apnea (one being uncomfortable and five being confident).

To screen for OSA, 72 percent of dentists reported using a patient interview, 52 percent identified anatomical parameters and 39 percent used patient questionnaires. Of the dentists who screen for OSA, 41 percent stated that they have their patients perform an at-home sleep test. There were also 87 percent of dentists suspecting OSA who referred their patients to physicians for further evaluation.

Additionally, dentists with fewer than 30 years of experience were significantly more likely to screen for OSA (87 percent) than those with more than 30 years of experience (63 percent).

A majority of general dentists do screen for OSA in their patients. However, most lack the confidence in performing accurate routine screenings. They do so in fewer than 70 percent of their patients. If you are a general dentist, reach out for help. By completing education courses and attending upcoming lectures, you can better prepare for screening for sleep apnea.

GERD and Barrett’s esophagus patients have sleep apnea

It has been shown that gastroesophageal reflux disorder (GERD) and Barrett’s esophagus (BE) patients have higher rates of obstructive sleep apnea (OSA) and poor sleep quality. Studies found that about 20 percent of Americans suffer from GERD, which is chronic heartburn or acid regurgitation. These studies have looked at the relationship between GERD and poor quality of sleep. From this they found that on average, these patients have worse sleep and overall low quality of sleep.

What is the connection?

GERD may contribute to sleep apnea by causing upper inflammation. However, sleep apnea might lead to GERD because it causes an increase in intra-thoracic pressure. Researchers found that OSA cases were higher among GERD patients than BE patients. Even when smoking, BMI and hypertension were considered, the rates of poor sleep still remained higher in those with GERD.

While BE is considered a more severe condition than GERD, researchers still found that poor quality of sleep and OSA were more closely associated with GERD. However, another study states that OSA is actually a leading risk factor for BE. What is also interesting is that sleep apnea and BE have common risk factors, including being overweight and having GERD.

With a closer look into our patients’ overall health, we can get a better look at what might be adding to their symptoms or even what might be causing further complications.

Truckers for a Cause Help Raise Awareness

We’ve previously discussed sleep apnea and its prevalence in truck drivers, so you’re already aware of the high risk of accidents there. While we continue to educate and raise awareness for sleep apnea, we’ve got a little extra help – Truckers for a Cause. I think it’s great! The more awareness for sleep apnea, the better!

What is Tuckers for a Cause?

Bob Stanton is a cofounder of Truckers for a Cause, and is a truck driver. Truckers for a Cause is dedicated to educating truckers about the dangers of sleep apnea. In their words, “people helping people with sleep apnea”. This is a great cause and one that should never be taken lightly. If you are aware of a truck driver in your life, or a patient that might be a truck driver, direct them to this group for further help and guidance.

While at a conference on fatigue research, Stanton outlined several challenges truckers face in treating sleep apnea with the use of a CPAP machine in-cab. This is where dentists can step in. We understand that the use of a CPAP machine while on the road can be difficult and bulky, which is why an oral appliance might be a great alternative–truck drivers can get the rest they need, while treating their sleep apnea. It’s a win-win situation.

Sleep Apnea Regulations

According to Title 49 of the Code of Federal Regulations, section 391.41(b)(5), it states:

“A person is physically qualified to drive a commercial motor vehicle if that person: Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with ability to control and drive a commercial motor vehicle safely.

Since a driver must be alert at all times, any change in his or her mental state is in direct conflict with highway safety. Even the slightest impairment in respiratory function under emergency conditions (when greater oxygen supply is necessary for performance) may be detrimental to safe driving. There are many conditions that interfere with oxygen exchange and may result in incapacitation, including emphysema, chronic asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea.”

It’s interesting to look into this topic further because truck drivers who suffer from sleep apnea can directly affect other drivers on the road. This is why so many regulators have taken a strict stance on testing for sleep apnea in truck drivers.

Let’s take charge of this new insight and new partner in sleep apnea care. What steps do you think we should take to further educate truck drivers on the importance of sleep apnea treatment and how oral appliance therapy can help?