17 September 2008

Sleep ApneaDiagnosis and Treatment of Sleep Apnea
Sleep apnea is difficult to diagnose and treat. Involving specialists in various areas of medicine and dentistry in an integrated approach to the diagnosis of sleep apnea.
  • At first visit, doctor will take a medical history and perform a head and neck examination looking for problems that might contribute to sleep-related breathing problems. An interview with bed partner or other household members about the sleeping and waking behavior may be in order.
  • If the doctor suspects a sleep disorder, you will be referred to a sleep clinic, which will monitor your nighttime sleep patterns through a special test called polysomnography. It will require person to sleep at the clinic overnight while a video camera monitors the sleep pattern and gathers data about the number and length of each breathing cessation or other problems that disturb sleep. a C-PAP (continuous positive airway pressure) device is used. During polysomnography, every effort is made to limit disturbances to the sleep.
  • Dentist may also be able to correct obstructive sleep apnea by fitting with a dental appliance that is worn only during the night. If your sleep apnea is caused by the tongue resting on the airway, a tongue-retaining device can correct the problem.
  • Sleep apnea caused by the incorrect positioning of the jaw may be treated with a device inserted into the mouth or strapped around the head to adjust the jaw's positioning. They are removable and worn only at night.
  • If sleep apnea is caused by excess tissue growth on the tongue or in the back of the throat, the overgrowth may be surgically removed to resolve the blockage. Oral and maxillofacial surgeons and ear, nose and throat doctor (ENT) may recommend surgery to clear blockages caused by a genetic abnormality in the nose or throat. The uvulopalatopharyngoplasty (UPPP) procedure eliminates tissue from the back portion of the mouth near the top of the throat. The adenoids and tonsils may be removed as well. Should your airflow blockage be life-threatening, the ENT may find it necessary to build an opening in the windpipe through a procedure called tracheotomy. Also, an operation on your nose might be necessary to improve a deviated septum or to remove polyps that are blocking your airflow.
  • Pulmonologist may recommend a sleep evaluation based on an analysis of your breathing muscle capacity and the use of oxygen should blood-oxygen levels fall to dangerous levels during sleep.
  • Neurologist will evaluate brain functionality and may recommend a medication such as acetazolamide to improve the brain's ability to trigger the breathing muscles.
  • Cardiologist may recommend a sleep test as well.
  • A sleep specialist may perform a sleep test that measures blood level during sleep. Sleep specialists may recommend the use of a continuous positive airway pressure (CPAP) machine. The machine delivers a continuous flow of oxygen through a mask that you wear over your nose during sleep. An alternative is a bi-level positive airway pressure (bi-level PAP) machine, which increases the oxygen level upon inhalation and decreases it upon exhalation. An adaptive servo-ventilation (ASV) machine is a third choice.
The cost for Treat Sleep Apnea Dollars
Factors that may affect sleep apnea treatment costs include :
  • The number of procedures or appliances used to avoid airflow blockage.
  • The technology used in the procedure.
  • The training of the specialist, dentist or oral surgeon.
  • The number of doctors or dentists involved.
  • The locale of the doctor(s).
  • The type of medical or dental insurance you have.
While the high cost of procedures may discourage some people from seeking treatment, the cost of not treating sleep apnea is significant. Average yearly cost for their physician visits dropped from approximately $500 one year prior to diagnosis to about $390 two years after diagnosis and treatment.

Because insurance plan administrators do not have consistent standards for reimbursement, it is difficult to predict out-of-pocket costs for sleep apnea diagnosis and treatment. For example, many insurance companies do not pay for the dental laser approach for reducing tissue surrounding the tongue, but they may pay for the surgical approach. It is wise to contact your insurance plan administrator about sleep apnea diagnosis and treatment costs.

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