What Should a Dental Sleep Exam Include?
At a minimum, your dental sleep exam should include:
- Look for a dentist who is trained in dental sleep medicine!
- Medical History
- Dental History
- Personal & Family History
- Physical Evaluation plus a Pharygometer/Rhinometer Test (computerized testing to measure airway patency and nasal passages) to evaluate your airway.
In addition to studying your medical and dental histories, we will examine the soft tissues in your mouth, throat, neck and nose. The purpose of this clinical evaluation is to:
- Determine the degree of laxity in those tissues; and,
- Find out how they may be obstructing your breathing while you sleep
Since sleep-disordered breathing can also occur as a result of improper alignment of the jaw and structures within the mouth, we also examine the temporomandibular joint (TMJ) as an important part of every sleep patient evaluation.
Depending on the complexity and severity of your sleep concern, we may also recommend that you seek a referral to an overnight sleep lab for a diagnostic polysomnogram (i.e., a sleep study) in order to confirm your diagnosis. If that should be necessary, we will assist you in the process by providing you with names of sleep physicians and sleep laboratories.
Who Will Benefit?
Anyone who suffers from non-restful sleep will benefit from a thorough exam and, if indicated, treatment by a dentist with advanced training in dental sleep medicine. Today, 70 million Americans suffer from sleep disorders according to Carl E. Hunt, director of the National Center on Sleep Disorders Research. Sleep disorders are most common in middle-aged men and, in particular, those who are over weight. However, women and children can suffer from sleep-disordered breathing, too. Early Diagnosis is the Key. If sleep disorders go undiagnosed and untreated, their effects on health can be far more serious than simply feeling tired and irritable.
SLEEP DIAGNOSTIC CENTER
Most hospitals have sleep diagnostic centers which are being run by sleep technicians working with physicians. Sleep centers have sophisticated equipment in an adjoining room where an intercom and video camera allow communication between the technician and the patient. The patient comes in at night and is hooked up to a number of machines, which are used to monitor the activities of the brain, the eyes and the muscles. The recordings are done in a private room and there is no discomfort to the patient. Recordings are done during the night in a seven-hour sleep period and the patient is discharged in the morning. This type of testing is called a POLYSOMNOGRAM.
The purpose of a polysomnogram is to evaluate the individual sleep architecture including the stages and cycles of sleep as well as to record the electrical activity of the brain, the eyes, muscles and heart by utilizing
- Electroencephalogram (EEG) - Records the activity of the brain. This verifies and records the different stages of sleep.
- Electro-occulogram (EOG) -Records the movement of the eyes and measures the periods of rapid eye movement (REM).
- Electromyogram (EMG) -Records muscle activity throughout the body.
- Electrocardiogram (EKG) -Measures cardiovascular abnormalities during sleep.
It also uses a finger or ear oximeter to measure the amount of oxyhemoglobin (oxygen saturation) in the blood. Patients suffering from OSA have a decreased amount of oxygen in the system.
IN OFFICE TESTING
The Watch PAT_100 can screen for OSA by measuring Peripheral Arterial Tone through a finger-mounted optoneumatic probe. It also incorporates pulse oximetry and an actigraph which give information such as blood oxygen desaturation, pulse rate to detect respiratory disturbances and sleep/wake state detection. The W100 is worn on the wrist and the patient is able to undergo the test comfortably, in a familiar setting, at home. I would like to stress again that this does NOT replace PSG testing, but is an invaluable testing tool when testing with PSG is restricted.
Watch-PAT 100 is FDA approved