This Week in Sleep Medicine: September 1, 2016
While You Were Sleeping: What Sleep Technologists Need to Know This Week
Your media watchdog for headlines and trends relevant to sleep technology and patient education.
“A third of hospitals don't have mandatory translators”
August 12, 2016
From the article: “A new Health Affairs study finds that 1 in 3 hospitals in the U.S. lack the translators required by federal law, a deficiency that can have serious adverse effects on patient safety. ... In areas where demographics create high or moderate need for language services, hospitals are better-equipped, but not by much―only a quarter of hospitals in such areas have interpreters.”
Takeaway: Most sleep technologists have encountered language barriers at some point in their careers. Does your lab have a specific protocol established to serve patients who do not speak English? If not, it absolutely should. Without these protocols in place, the test itself could be difficult to perform and the patient could feel alienated and anxious without knowing what is happening.
“Why Actigraphy Should Be Considered Before An MSLT to Diagnose Narcolepsy”
August 25, 2016
From the article: Robert Auger, MD: “We have 20- and 30-year-olds diagnosed with narcolepsy; we put an actigraph on them and find out they are actually suffering from insufficient sleep. That can be a difficult conversation because it’s often not what they want to hear. Many are hard-driving executives who don’t want to be told they feel tired because they just need to sleep longer. Or they may have been consigned to a lifetime of stimulants and don’t want to give that up. Whatever the case, we have the actigraphy data to back up our conclusions and recommendations.”
Takeaway: Diagnostic assessment comes in all kinds of forms. Insurance companies don’t always want to pay for actigraphy, but this recent study suggests it may be a good protocol to always begin with this form of diagnostic data collection if the goal is to achieve an accurate diagnosis, reimbursement or not.
“Opening the Dental Sleep Patient Pipeline”
August 22, 2016
From the article: Brandon Quijada, MBA, for Smile for Life Dentistry in Phoenix, AZ: “Maybe you’ve read about dental sleep medicine (DSM) and see its potential to help many people lead healthier, longer lives, but you wonder how to get your staff working as a team to implement the nuts and bolts into your dental practice. DSM is different from general dentistry, so most dental teams are not used to the mechanics of administering it effectively.”
Takeaway: Check out the thoughtful strategy that this dentistry clinic has put into place for establishing new patients who could benefit from dental sleep medicine. These are protocols that other sleep medicine dentists might model their own efforts on; as sleep techs, we can also learn a few things about dentistry from this that might better illuminate what we already know about sleep apnea, as well.
“Brain Scans in Non-REM Sleep Show Dreams”
August 10, 2016
From the article: “A team from Finland and the United States has measured electrical activity in the brains of subjects in the throes of dreams during shallower, non-REM sleep, they report in the latest issue of the journal Scientific Reports.”
Takeaway: Remember… sleep medicine is still a “young” field. This might be a detail that changes certain test questions on board exams. Stay tuned.
“Drowsy Driving vs. Drunk Driving vs. High Driving”
SLEEP BETTER, LIVE BETTER BLOG
August 25, 2016
From the article: “It’s well known that there’s a correlation between sleeping patterns and marijuana usage. Research shows that there are some strains that work better at inducing sleepiness or lowering pain and stress symptoms. This alone makes marijuana an appealing alternative or last resort when nothing else works. …
“Those who are turning towards marijuana to cure insomnia, though, should be aware of the problems associated with consuming it as it can certainly be tempting to use it for purposes other than as a sleeping aid. One common problem, for instance, is that people are now smoking marijuana and getting behind the wheel. Some may think that one puff won’t affect them enough to fall asleep while driving, but the problem goes beyond that. There’s a bigger picture to consider. …
“The facts about driving drowsy versus driving drunk are well known, but what about driving drunk versus driving high?”
Takeaway: For those of us who live in states where marijuana is legal to use recreationally or medicinally, this is going to continue to be a safety concern and a necessary conversation to have between sleep specialists and those patients who are already using this drug. Note the useful infographics included in this blog post.
HEALTH LITERACY WATCH
“Consider using herbal treatments for patients with sleep apnea”
August 26, 2016
From the article: “Because the root cause of this cascade of events is caused by a diminution of the signal from the brain to the diaphragm, you can turn to lobelia. Used in small doses, lobelia acts as a respiratory stimulant and has been used for thousands of years to treat respiratory conditions. … This herb, when taken before bed, can actually increase the quiescent level of respiration sufficiently to avert the dangerous drop in blood oxygen levels that occurs upon muscular inhibition. Lobelia can maintain deep steady breathing throughout the stage 2 sleep transition period. This keeps the brain from calling for a rapid inhalation that would suck in the soft- palate and arouse the sleeper.”
Takeaway: When patients go online to research alternatives to CPAP, they find recommendations like these. Note the lack of scientific reference to this author’s claims about using herbs. A patient could read this, buy one of the herbs, visit a chiropractor, and think they have solved the dilemma of sleep apnea. This is not a judgment against chiropractors (I see one monthly), but it is a caution to sleep technologists everywhere to make sure you are prepared to hear from patients that taking a few herbs and getting an adjustment will “fix” them. Until science proves this to be true, we must be held to evidence-backed therapy in the interest of patient safety.
“Medical board’s rec’s to FMCSA on sleep apnea could preview rule”
COMMERCIAL CARRIER JOURNAL
August 23, 2016
From the article: “The Medical Review Board of the Federal Motor Carrier Safety Administration outlined this week its official recommendations to the agency on screening and disqualification criteria for truck drivers who are suspected of having moderate to severe obstructive sleep apnea.”
Takeaway: Lots of people are watching to see how this all spins out. Though there are, at present, no federal rules regarding screening of commercial drivers for sleep apnea, these latest recommendations could become the basis for writing that rule into legislation, if findings from the last few months of inquiry into the public health and safety risks associated with drowsy driving trend toward increases in losses and costs.
About the author
Tamara Kaye Sellman RPSGT, CCSH curates the sleep health information clearinghouse, SleepyHeadCENTRAL, where she follows sleep health news headlines daily. She the Chief Content Officer (CCO) for inboundMed and SomnoSure and contributes as a freelance writer to AAST’s magazine, A2Zzz, and MultipleSclerosis.net, among other places.