View
306
Download
0
Embed Size (px)
Citation preview
The Dental Sleep Medicine Paradigm Diagnostic Sleep Interpretation
“Changing Lives, One Breath at a Time”
Pat Mc Bride, BA,RDA,CPSGT, CCSH, Sleep ClinicianBoard of Directors American Academy of
Physiological Medicine and DentistrySleep Scoring and Reporting 2016
Disclosures AAPMD, ATS Consultant for:
CA Centers for Sleep Disorders
Respiratory Medical Group John Muir Physicians and Surgeons
Contra Costa Sleep Centers Faculty Member for Metz Sleep Continuum Hang Orthotropic Post Doctorate Residency
Staff Writer for “Talk About Sleep” Dental Sleep Practice Journal
Private Clinical Practice Practice Management & Consulting for Sleep
How Do we Score Sleep?
⦿ Scoring a sleep study is divided into 4 parts: ⦿ 1) Scoring sleep stages ⦿ 2) Scoring respiratory events ⦿ 3) Scoring arousals ⦿ 4) Scoring periodic limb movements
Scoring and Staging Basics
⦿ Read between the lines ⦿ EEG takes precedence over EOG & EMG ⦿ Pattern Recognition ⦿ Sleep architecture ⦿ Score sleep stages in 30 second sequential epochs (from
Lights Out to Lights On) ⦿ Assign a stage to each epoch ⦿ •If 2 or more stages exist in a single epoch, assign the
stage comprising the greatest portion of the epoch (majority rules).
Testing and Reporting Issues⦿ Slow turn around time for results⦿ Interpreters failing to review raw data⦿ PSG analysis by automated scoring algorithms⦿ Tweaking analysis to under score data⦿ Tweaking analysis to meet reimbursement
criteria⦿ Failure to report/count RERAS⦿ Poor/incomplete reporting to Physicians and
Dentists
System Fails the Patient⦿ Under testing children⦿ Inappropriate set up for children’s testing⦿ Lack of sufficient knowledge to refer⦿ Access to PES⦿ Access to care– is HST the answer?⦿ Thin Fit Females⦿ The insomnia Patient⦿ The daily Headache Patient