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!