Comments on: Mandatory Sleep Apnea Screening for Everyone? http://doctorstevenpark.com/mandatory-sleep-apnea-screening-for-everyone How You Can Breathe Better, Sleep Better, And Live Better1 Sun, 12 Feb 2012 00:10:44 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Thomas http://doctorstevenpark.com/mandatory-sleep-apnea-screening-for-everyone/comment-page-1#comment-12957 Thomas Mon, 26 Oct 2009 19:31:51 +0000 http://doctorstevenpark.com/?p=2673#comment-12957 i concur with the above coments and add that a tranport system be in place and that employment nom should be local if posible walking distants the same with schools they should be in walking distants, shops etc so that the is less reliance on transport in the future i concur with the above coments and add that a tranport system be in place and that employment nom should be local if posible walking distants the same with schools they should be in walking distants, shops etc so that the is less reliance on transport in the future

]]> By: Steven Park http://doctorstevenpark.com/mandatory-sleep-apnea-screening-for-everyone/comment-page-1#comment-12951 Steven Park Mon, 26 Oct 2009 15:58:53 +0000 http://doctorstevenpark.com/?p=2673#comment-12951 I agree. We have the resources and the knowledge to have a low-cost screening process on a large scale. Studies have shown that treating sleep apnea saves a lot more health care collars in the long run. I wonder if the politicians debating our health care policies ever considered undiagnosed obstructive sleep apnea as a major public health problem. There are a number of excellent screening tests that combine a few simple questionnaires and physical exam findings. You can either send these patients home with O2 monitors or go straight to APAPs. The hard part will be all the support and follow-up that's needed to make sure all these additional people can benefit from treatment or go to something else if they can't tolerate CPAP. This is just a personal observation, but in recent memory, every airline pilot, bus driver or train operator that I've treated seems to have adapted to using CPAP relatively easily, as opposed to people in other occupations that don't require driving or flying. I wonder if your job is on the line, you'll be more likely to make the effort to get treated and cleared quickly so you can go back to work. I agree. We have the resources and the knowledge to have a low-cost screening process on a large scale. Studies have shown that treating sleep apnea saves a lot more health care collars in the long run. I wonder if the politicians debating our health care policies ever considered undiagnosed obstructive sleep apnea as a major public health problem.

There are a number of excellent screening tests that combine a few simple questionnaires and physical exam findings. You can either send these patients home with O2 monitors or go straight to APAPs. The hard part will be all the support and follow-up that’s needed to make sure all these additional people can benefit from treatment or go to something else if they can’t tolerate CPAP.

This is just a personal observation, but in recent memory, every airline pilot, bus driver or train operator that I’ve treated seems to have adapted to using CPAP relatively easily, as opposed to people in other occupations that don’t require driving or flying. I wonder if your job is on the line, you’ll be more likely to make the effort to get treated and cleared quickly so you can go back to work.

]]> By: Victor H. http://doctorstevenpark.com/mandatory-sleep-apnea-screening-for-everyone/comment-page-1#comment-12939 Victor H. Mon, 26 Oct 2009 13:29:52 +0000 http://doctorstevenpark.com/?p=2673#comment-12939 "Now the question is, do we send all these people for overnight studies, or in-home studies? Ultimately, economic factors will probably prevail over clinical issues." IMO, the economic issues are huge due to the high prevalence of sleep apnea. What about some effective shortcuts? I suggest a questionnaire-based screening test specifically targeting the obstructive type of sleep apnea. Combine this with a physical examination of jaw structure looking for lack of depth, narrowness and poor mandibular advancement. Now identify the patient as high risk for obstructive sleep apnea and send him home with an inexpensive pulse-oximeter device. If the patient exhibits oxygen desaturations typical of obstructive sleep apnea, then prescribe an APAP set to pressure of 7 - 20 cm. Provide support and education to perform a self-titration using data from the APAP. This idea needs some development, but I am sure we can't afford the typical two nights in a sleep lab and we also can't afford to leave such a large portion of our population untreated. “Now the question is, do we send all these people for overnight studies, or in-home studies? Ultimately, economic factors will probably prevail over clinical issues.”

IMO, the economic issues are huge due to the high prevalence of sleep apnea. What about some effective shortcuts? I suggest a questionnaire-based screening test specifically targeting the obstructive type of sleep apnea. Combine this with a physical examination of jaw structure looking for lack of depth, narrowness and poor mandibular advancement. Now identify the patient as high risk for obstructive sleep apnea and send him home with an inexpensive pulse-oximeter device.

If the patient exhibits oxygen desaturations typical of obstructive sleep apnea, then prescribe an APAP set to pressure of 7 – 20 cm. Provide support and education to perform a self-titration using data from the APAP.

This idea needs some development, but I am sure we can’t afford the typical two nights in a sleep lab and we also can’t afford to leave such a large portion of our population untreated.

]]> By: Steven Park http://doctorstevenpark.com/mandatory-sleep-apnea-screening-for-everyone/comment-page-1#comment-12875 Steven Park Sun, 25 Oct 2009 00:40:21 +0000 http://doctorstevenpark.com/?p=2673#comment-12875 There are a number of simple questionnaire-based screening tests that are simple and cost nothing to administer. People at high risk can then undergo formal testing. Now the question is, do we send all these people for overnight studies, or in-home studies? Ultimately, economic factors will probably prevail over clinical issues. There are a number of simple questionnaire-based screening tests that are simple and cost nothing to administer. People at high risk can then undergo formal testing. Now the question is, do we send all these people for overnight studies, or in-home studies? Ultimately, economic factors will probably prevail over clinical issues.

]]> By: Leonard H. http://doctorstevenpark.com/mandatory-sleep-apnea-screening-for-everyone/comment-page-1#comment-12854 Leonard H. Sat, 24 Oct 2009 18:45:33 +0000 http://doctorstevenpark.com/?p=2673#comment-12854 We regularly check our weight, cholesterol levels, blood pressure, and blood sugar looking for problems. Why don't we regularly screen for sleep-disordered breathing (SDB) which is the source of the other problems? Let's diagnose and treat the root cause. Screening should become a routine part of medical and dental exams. We do need a new treatment (or better yet, a cure) for sleep apnea. CPAP is a difficult process to implement properly and there are also many problems trying to sleep with dental appliances. We regularly check our weight, cholesterol levels, blood pressure, and blood sugar looking for problems. Why don’t we regularly screen for sleep-disordered breathing (SDB) which is the source of the other problems? Let’s diagnose and treat the root cause. Screening should become a routine part of medical and dental exams.

We do need a new treatment (or better yet, a cure) for sleep apnea. CPAP is a difficult process to implement properly and there are also many problems trying to sleep with dental appliances.

]]> By: Steven Park http://doctorstevenpark.com/mandatory-sleep-apnea-screening-for-everyone/comment-page-1#comment-12759 Steven Park Fri, 23 Oct 2009 20:10:13 +0000 http://doctorstevenpark.com/?p=2673#comment-12759 Another airline incident where pilot "fatigue" is being blamed. http://www.google.com/hostednews/ap/article/ALeqM5jx2fJRl2HA8EkI9Zi8Qa1yuvjYdQD9BGD45G0 Another airline incident where pilot “fatigue” is being blamed.

http://www.google.com/hostednews/ap/article/ALeqM5jx2fJRl2HA8EkI9Zi8Qa1yuvjYdQD9BGD45G0

]]> By: Steven Park http://doctorstevenpark.com/mandatory-sleep-apnea-screening-for-everyone/comment-page-1#comment-12755 Steven Park Fri, 23 Oct 2009 19:54:43 +0000 http://doctorstevenpark.com/?p=2673#comment-12755 David, Yes, it is frightening. It'll be interesting to see that the fallout of the new regulations will be. David,

Yes, it is frightening. It’ll be interesting to see that the fallout of the new regulations will be.

]]> By: David Stillwagon http://doctorstevenpark.com/mandatory-sleep-apnea-screening-for-everyone/comment-page-1#comment-12753 David Stillwagon Fri, 23 Oct 2009 19:33:03 +0000 http://doctorstevenpark.com/?p=2673#comment-12753 Great post! It is very frightening to think that pilots and truck drivers are so tired( many of them from sleep apnea) that they put thier own lives in peril plus countless others. David Great post! It is very frightening to think that pilots and truck drivers are so tired( many of them from sleep apnea) that they put thier own lives in peril plus countless others.
David

]]>