TONE DEAF
Let me describe a patient
who is in your practice
nearly every single day and
in whom you can make a
profound difference toward
quality of life and health.
Usually, a female, and she’s
tired and sleepy; grumpy;
irritable; poor sleep quality; forgetful; seems overly
stressed. Sometimes, fibromyalgia, or another auto immune disease. Often, a generalized “hurt all over” kind
of patient, but no one can
find anything wrong with
her. She’s had a battery of
medical tests, and they all
come back negative. She’s
starting to think to herself,
“Am I crazy?” Usually, TMD
is involved in some form or
fashion. Likely, you’ve already made her a night time
splint. It helped some, for
a while. You’re a student of
dental sleep medicine, and
you suspect she may have a
sleep disordered breathing
(SDB) problem, so you recommend to her and her PCP
that she get a sleep study.
You’re the first health care
provider who has recommended this.
Reluctantly, she does, maybe
9 months later. She comes
back with an AHI of 2.1 and
an RDI of 5.8; she desats to
90%. Her diagnosis: Primary
DR. RICHARD DRAKE
Co-Founder of DS3
and Dental Sleep Solutions
snoring. Another dead end,
or is it? What do you do? Do
you recommend any treatment at all? A mandibular
advancement device?
Her first two questions are,
“What does it cost, and will
my insurance cover it?”
You say, “It’s $2500 and no,
your insurance will not cover it.”
I believe this is how most
sleep apneics start out;
Snoring. Upper Airway Resistance Syndrome (UARS).
Inspiratory Flow Limitation (IFL). But her numbers
don’t meet our criteria for
a diagnosis of SDB, so every
healthcare practitioner out
there writes off her sleep
study as another dead end.
Except you.
Our bodies are amazing in
so many ways, and we adapt
to all types of situations in
order to survive. Adaptive
capacity. You can live weeks