CONTINUING education
Sleep Related Breathing Disorders and the Use of High Resolution Oximetry for Screening by Craig Pickerill
Educational aims & objectives
Dental Sleep Practice subscribers can answer the CE questions on page 20 to earn 2 hours of CE from reading this article. Correctly answering the questions will exhibit the reader will: • Understand the difference between various subjective and objective screening modalities for sleep related breathing disorders • Recognize the difference between traditional pulse oximetry and high resolution pulse oximetry • Identify when and with which patients to use high resolution pulse oximetry to screen for sleep related breathing disorders • Recognize important indicators on high resolution pulse oximetry reports in order to identify which patients are appropriate to recommend potential sleep therapies
14 DSP | Spring 2019
S
leep related breathing disorders place a substantial monetary burden on the economy in the form of decreased productivity, work accidents, and health-related complications.1 Experts in dentistry, pre-surgical screening, cardiology, occupational health, and primary care find that their respective fields would benefit from screening, but polysomnography is often too expensive and impractical. However, recent technological advancements in high resolution pulse oximetry make it a straightforward, cost-effective tool, allowing more patients to be willingly evaluated.
Overnight pulse oximetry monitoring is also a cost effective and minimally invasive method for the dentist to adjust a dental device prior to a follow-up home sleep apnea test (HSAT) or facility-based polysomnography (PSG). While at least one follow-up HSAT or PSG is usually required, using oximetry reduces the likelihood that the patient will need to return for additional HSATs or PSGs.
Subjective vs. Objective Screening Tools
Overall, any health screener is used to indicate the next step – no treatment for those with no risk, more testing for people at high risk of having the disease being looked for. Screeners do not provide diagnosis – they are used