Sleep Medicine Screening Tool

Snoring More Than Usual? It Might Be More Than Just a Nuisance: The Importance of Dental Sleep Medicine Screening

Do you or your partner experience loud snoring, pauses in breathing during sleep, or daytime sleepiness? These could be signs of a sleep-related breathing disorder like obstructive sleep apnea (OSA). While often overlooked in a dental setting, dentists are increasingly playing a crucial role in identifying and managing these conditions through Dental Sleep Medicine (DSM).

Why involve your dentist in your sleep? Because dentists are experts in the oral and maxillofacial region, which directly impacts your airway. They are often the first healthcare professionals to notice potential signs of sleep-disordered breathing during routine check-ups.

Screening for Sleep-Disordered Breathing: What to Expect

Dental sleep medicine screening is a non-invasive process that can provide valuable insights. Your dentist might:

• Ask you questions: They'll inquire about your sleep habits, snoring patterns, daytime fatigue, and any diagnosed medical conditions. Be honest and thorough in your responses!

• Conduct a physical examination: This will involve assessing your airway, jaw position, tongue size, and bite. Certain oral features can be indicators of a higher risk for OSA.

• Utilize questionnaires: Standardized sleep questionnaires, like the Epworth Sleepiness Scale, can help quantify your daytime sleepiness and assess your risk level.

Tools Dentists May Use in DSM Screening:

While dentists don't typically perform full sleep studies (polysomnography), they may use or recommend tools to aid in the screening process:

• Home Sleep Apnea Tests (HSATs): Dentists can sometimes provide or recommend these convenient tests, which monitor your breathing patterns overnight in your own bed. The data is then analyzed by a sleep physician.

• Sleep Screening Devices: Some dental offices may utilize small, portable devices that record basic sleep parameters like oxygen saturation and heart rate overnight.

• Cone-Beam Computed Tomography (CBCT): In certain cases, a CBCT scan can provide a 3D image of your airway, helping to identify any structural issues that might contribute to breathing problems during sleep.

What Happens After Screening?

If your dental screening suggests a potential sleep-disordered breathing issue, your dentist will likely refer you to a sleep physician for a comprehensive diagnosis through a polysomnography. If diagnosed with mild to moderate OSA, or if CPAP therapy is not well-tolerated, your dentist, with specialized training in DSM, may be able to offer oral appliance therapy (OAT). These custom-fitted devices help keep your airway open during sleep, providing a comfortable and effective alternative for many patients.

Don't let snoring and daytime fatigue disrupt your life. Talk to your dentist about Dental Sleep Medicine screening – it could be the first step towards a better night's sleep and improved overall health!

Our Updated STOP-Bang Questionnaire

--------------------------------------------------------------------------------------Please tick the boxes if the following is present -----------------------------------------------------------------------------

❒ Snoring?
Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)?

❒ Tired?
Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during driving)?

❒ Observed?
Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?

❒ Pressure?
Do you have or are being treated for High Blood Pressure?

❒ Body Mass Index more than 35 kg/m2?

❒ Age older than 50 years old?

❒ Neck size large? (Measured around Adams apple) For male, is your shirt collar 17 inches/43 cm or larger? For female, is your shirt collar 16 inches/41 cm or larger?

❒ Gender = Male?

___________________________________________________________________________________________________________________________________________

Scoring Criteria:

For general population
Low risk of obstructive sleep apnoea (OSA): Yes to 0-2 questions Intermediate risk of OSA: Yes to 3-4 questions
High risk of OSA: Yes to 5-8 questions

or Yes to 2 or more of 4 STOP questions + male gender 2
or Yes to 2 or more of 4 STOP questions + BMI > 35 kg/m
or Yes to 2 or more of 4 STOP questions + neck circumference (17”/43cm in male, 16”/41cm in female)