Sleep Technology

Positive airway pressure (PAP) therapy is widely known as the gold standard of care for patients with sleep apnea,1 and PAP compliance and adherence are common terms in the realm of sleep medicine. PAP compliance reports can help to determine if a set pressure is working, whether or not the range for an auto-PAP is appropriate and a treasure trove of other data that can help paint the picture for how a patient is tolerating, or better yet, succeeding with their PAP therapy.

Oral appliances and apparatus have been in existence in one way or another since 1923 when a dental surgeon and physician named Pierre Robin found that babies with micrognathia and posteriorly placed tongue (glossoptosis) not only had difficulty with feeding, but also had issues with breathing in general.1 It was from these observations, and the previous work of Lannelongue and Menard in 1891,1 that Robin subsequently published the first case of an infant with the complete Pierre Robin Syndrome (PRS) (sequence) in 1926.2 The idea of posteriorly positioned tongues and lower jaws narrowing the pharyngeal airway in general, outside of PRS, was to be further postulated for the next 30 years and a generation of dental academics.

AAST recently celebrated Sleep Technologists Appreciation Week (STAW) Oct. 23-29, 2022. The week, which recognizes the numerous accomplishments made by sleep professionals in sleep disorders centers, laboratories, educational facilities and within AAST this past year, is a time for celebration around the world.

Many studies have been done to assess the North American population for the presence of obstructive sleep apnea (OSA). These studies have shown that up to 80% of all patients with moderate to severe sleep apnea have not yet been diagnosed.1 With the population aging and obesity on the rise, we are not making a dent into this statistic, despite the growing awareness and the advancements in home sleep testing.

Continuous positive airway pressure (CPAP) is the gold standard treatment for obstructive sleep apnea (OSA). In OSA, the upper airway muscle tone reduces excessively during sleep, allowing structures supported by these muscles to collapse into and block airflow partially or fully. CPAP treatment involves blowing slightly pressurized air through a mask, which fits over the nose and/or mouth, to push against airway structures so they do not collapse into the airway during sleep. Unfortunately, many patients are not compliant with CPAP treatment because of discomfort from the pressure or mask and adverse effects (e.g., aerophagia [air in the stomach]).

Sleep Technologists Appreciation Week (STAW) 2022 will take place Oct. 23-29. The week allows the sleep community to applaud the numerous accomplishments made in sleep disorders centers, laboratories, educational facilities and within AAST this past year. STAW will be here before you know it — so don’t hit the snooze button on planning! Below are a few ways you can prepare to celebrate in the days and weeks leading up to STAW.

Since the early 1980s when the first patients with severe obstructive sleep apnea (OSA) were successfully treated by a prototype continuous positive airway pressure (CPAP) device made from a vacuum cleaner motor, the field of sleep medicine has been dominated by device-based therapies that aim to open the airway mechanically during sleep. Whether they work by using pressurized air as a splint, pulling the lower jaw forward, stimulating the tongue to move and stiffen with each breath or prevent sleep in the supine position, existing OSA treatment devices have one thing in common: they only work while they are used during sleep. While countless users have experienced the life-changing benefits of treating their OSA, many have wondered whether they could train their body to breathe normally without the use of a nighttime device. Now, for the first time, a device designed to do just that is commercially-available for people suffering from primary snoring and mild OSA.

The coronavirus pandemic has affected every facet of our lives, from how we work to where we spend our free time. Less often discussed is how COVID-19 has affected how we sleep, and the underlying phenomenon of “coronasomnia.”

A vital component of a full night polysomnogram is the monitoring of a patient’s heart rate and rhythm via the electrocardiogram (EKG) channel, as it gives a graphical illustration of the electrical activity of the heart and provides an important tool for maintaining patient safety. Understanding the components of the EKG is central to identifying heart rate and rhythm disturbances and assessing a patient’s cardiovascular status.

The new Virtual Patient Monitoring module series from AAST is a timely education series which supports the change in practices we are seeing in managing our sleep disordered patients and sleep wellness. I am pleased to be able to share a brief overview of the importance of a remote patient monitoring and coaching program, the topic of the first module in the series.