OBSTRUCTIVE SLEEP APNEA: SCREENING & DIAGNOSIS
Sleep is an active state; it’s as vital to your health as diet and exercise. Despite its importance, published reports indicate that as many as 9 out of 10 people who suffer from sleep disorders are not diagnosed and, therefore, do not seek information about OSA treatment that can improve their overall health and quality of life and even increase their life expectancy.
OSA is as prevalent as asthma and, in its severe form, can cause fatal cardiovascular damage. Untreated OSA can also contribute to other health problems, including: chronic headaches, acid reflux, snoring and sleep bruxism, acid reflux, diabetes, high-blood pressure, and stroke. Dental professionals like Dr. Bailey who combine advanced training in dental sleep medicine and craniofacial pain with a unique doctor-patient relationship can play a key role in screening patients and providing quality, state-of-the art care for those who are diagnosed with OSA.
Step 1: Screening
Prior to your first appointment, we will provide you with a Sleep Questionnaire to complete and bring with you to our office. In addition to providing you with an opportunity to describe your symptoms, this questionnaire will enable you to provide us with a detailed dental/medical and sleep history, which is essential to the sleep screening and assessment process.
Please plan to be with us for 30 minutes to 1 hour, which is the time required to complete a thorough examination. We believe that patients should be well-informed and will, therefore, provide you with a great deal of information. We will also ensure that there is ample time for you to ask questions and voice any concerns.
During your screening examination, Dr. Bailey will:
- Review your dental/medical and sleep history in detail.
- Ask questions about your sleep as well as jaw symptoms and headache, which commonly occur with OSA and that need to be ruled out (or ruled in) as contributing or causal factors.
- Complete a clinical examination, during which she will examine the size and shape of your tonsils, adenoids, tongue and tissue at the back of your throat plus other anatomy for specific intraoral traits that may be indicators of OSA.
Depending on the data gleaned from dental/medical history and clinical examination, Dr. Bailey may also:
- Request diagnostic images of your airway.
- Use a pharyngometer/rhinometer, which uses acoustic reflection technology to accurately map the size, structure and collapsibility of your oral and nasal airway. (Rhinometer/ pharyngometer testing can also help determine whether or not you will benefit from the oral appliance therapy we provide in our office.)
- Arrange for you to take a portable sleep recorder home with you to use for one night. Used in the privacy of your own home, this sophisticated piece of equipment will provide Dr. Bailey with valuable information about your breathing, snoring, blood oxygen saturation levels and sleep apnea events.
Once your screening examination has been completed, and we have gathered all of the necessary clinical data, Dr. Bailey will discuss her preliminary findings with you. If it is determined that you are at risk for Obstructive Sleep Apnea (OSA), Dr. Bailey will consult with a board-certified sleep physician who will be able to make a differential diagnosis.
Note: If you have previously completed a sleep study (i.e., “polysomnogram”), please let us know at the time of scheduling. We will request a copy for Dr. Bailey to review, which will assist her to determining if you are a candidate for oral appliance therapy in our office.
Step 2: Diagnosis
All sleep-disordered breathing problems, including primary snoring and Obstructive Sleep Apnea, must be diagnosed by a physician prior to treatment in our office. In addition to being a medical-legal requirement, a physician’s diagnosis is necessary for you to qualify for covered benefits under your insurance plan.
If you have not already done so, Dr. Bailey will arrange for you to complete a polysomnogram (i.e., sleep study). She will also arrange for the results to be read, scored and interpreted by a board-certified sleep physician, who will make a differential diagnosis. This is the only way to know, with certainty, if you are suffering from Obstructive Sleep Apnea or another sleep problem.
Our goal is to manage your disorder, so that you can enjoy the benefits of qualify, recuperative sleep. Upon review of the results of your screening evaluation and polysomnogram (i.e., sleep study), Dr. Bailey will be able to ascertain whether or not you are a candidate for treatment in our office.
If you are not a candidate for treatment using oral appliance therapy, we will refer you to a board-certified sleep physician or sleep specialist who can help you.
Payment & Insurance
We strive to make treatment easy and affordable. We accept:
- Credit Card: VISA, MasterCard, American Express or Discover
A significant reduction in our usual fee is available when payment is received before services are provided. We also offer CareCredit™ for the convenience of patients who prefer to finance their treatment.
Insurance reimbursement is paid directly to the patients, and most insurers do offer benefits for treatment of snoring, Obstructive Sleep Apnea (OSA) and other sleep-disordered breathing issues. To file for insurance coverage you must first be diagnosed by a physician, a process that we can coordinate for you through our office. The appropriate diagnostic code (ICD 9) is 327.23.
Insurance claims should be filed under your medical plan. Please be aware that some private insurance carriers require that you to be CPAP intolerant before providing benefits for treatment of Obstructive Sleep Apnea (OSA) using oral appliance therapy. When this is the case, we will request information from your treating physician that documents your inability to use CPAP and your need for an oral appliance. Please check with your insurance carrier for specific coverage benefits and reference billing code: E0486.
For glossary of terms that may be helpful when communicating with your health insurance provider, click here. We also invite you to contact us with insurance or other questions.