THE WEBSITE OF ALLEN J. MOSES, DDS
SEARS TOWER - CHICAGO
DIAGNOSIS OF OBSTRUCTIVE SLEEP APNEA
There are many sleep disorders. Among them are:
There are many reasons for disturbed sleep. Making the appropriate sleep diagnosis is difficult and preferably made by an experienced, board certified, sleep specialty physician. The differential diagnosis between sleep disorder and seizure, pulmonary disorder or neurologic disorder is very complex, and often it is best made by a multidisciplinary group at a clinical case conference.
The gold standard diagnostic tool for sleep disorders is POLYSOMNOGRAPHY (PSG). Polysomnographic testing, usually done at a sleep lab, monitors and records anywhere from 14 - 18 bodily functions while an individual is asleep. The electrical activity of the brain, body motion, eye movement, sleep stage, ventilatory effort, desaturations, apneic events, hypopneas, upper airway resistance, snoring, arousals, muscle activity, heart-rate, air flow, blood oxygen, pulse rate, body position and limb movement are all simultaneously recorded and measured. This information is utilized by the sleep physician to make the proper diagnosis and determine its severity.
There are also many ambulatory PSG devices on the market for home sleep testing. Ambulatory PSGs do not record electroencephalograms or electro-oculograms. Many do not record electrocardiograms or electromyograms. They are used in dental offices to establish baseline recordings, and then after insertion and adjustment of oral appliances to objectively their success. Ambulatory home sleep testers are not as effective at diagnosing sleep disorders, other than OSA, as an attended study is, but they do serve a critical need as screening tool and to evaluate treatment outcomes for oral appliances as
Decisions on treatment are customized for the patient based certainly on the PSG but also on the medical history, sleep specialist's physical examination, the individual's unique needs, preferences, other health problems and life style. Success of the selected treatment can and should be verified by a repeat PSG study.
DENTISTS CAN OFTEN PLAY AN IMPORTANT ROLE IN REFERRAL AND TREATMENT OF OBSTRUCTIVE SLEEP APNEA - BUT NOT THE DIAGNOSIS.