May 2019 DSM Insider 32 - Page 8

ERIN ELLIOTT, DDS ALPHABET SOUP UNDERSTANDING ACRONYMS & THE TERMINOLOGY OF SLEEP A s if learning dental acronyms wasn’t enough, every DSM dentist is also tasked with learning a whole new language in the sleep world. BTDubs, “DSM” stands for “Dental Sleep Medicine.” See what I mean? I started becoming more curious about the nomenclature we use in sleep as I noticed new terminology popping up. The first was removing ‘titration” from my vocabulary and replacing it with “calibration.” Then I started noticing “REI” (not the outdoor sports store!) popping up on my home sleep study reports that were being referred to as “HSAT.” I was like OMG! If you’ve ever been confused by the Acronym Soup, this article will be like Google Translator for you. “Calibration” vs. “titration.” For years we would ask our patients to titrate their appliance or take a titration study in order to objectively measure effectiveness of an appliance. And that is really a misnomer. DICTIONARY PARAPHRASE ALERT: Titration is the method of determining the smallest amount of reagent of known concentration required to bring about a given effect. Therefore, when we talk about “titration” we should be referring to something like a PAP (positive airway pressure) machine or a titration PSG (polysomnography or in lab overnight sleep study) in which the machine or tech is slowly cranking up the pressure until the patient’s airway is treated. DICTIONARY PARAPHRASE ALERT PT. 2: Calibration is defined as determining, checking, or rectifying the graduation of (any instrument giving quantitative measurements). Calibrating, therefore, means we are slowly graduating the appliance and then objectively checking the calibration of the appliance. Don’t worry, if you slip and use the term titration we all know what you are talking about. Now the next couple acronyms have confused me lately only because my various sleep physicians use them interchangeably. I refer to home sleep tests as “HSTs” but they can be referred to as “PMs” (portable monitoring), ambulatory PSGs, out of center sleep tests, unattended home sleep test, and finally HSAT (home sleep apnea testing). The biggest distinction between HST and HSAT is that HSAT is making it a point that sleep time and sleep staging is NOT being measured. Therefore, if you are speaking with sleep physicians, I would stick to HSAT. Lastly, REI (Respiratory Event Index) has been showing up on my home sleep test reports alongside AHI. And that is because AHI is technically apneas + hypopneas/ time slept in hours and since we are not measuring sleep time they created REI to distinguish between the two. REI= apneas + hypopneas/total time monitored in hours. Hopefully this has helped clarify the ABC’s of DSM to the DDS or DMD. SMH thinking about how much we get to learn. IMHO it seems like too much sometimes. TTYL!