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Sleep Apnea in the General Practice: How to Screen, Refer & Get Started | Dr. Mark Murphy
Description
A typical practice with a couple thousand patients has about 500 with sleep apnea, and 400 of them have never been diagnosed. Dr. Mark Murphy, clinical lead at ProSomnus and Pankey Institute faculty, explains how to start screening with the Epworth Sleepiness Scale and STOP-BANG, how to build relationships with sleep physicians, why your role is filling a prescription for a medical device, and what it really takes to run sleep in a dental practice.
In this episode:
- Mark's 30-plus years in TMD and dental sleep medicine
- How the ProSomnus precision appliance was designed
- Oral appliances are Class II medical devices, not bite splints
- The ADA's 2017 resolution on screening for sleep apnea
- Why bite splints can make sleep apnea worse
- Screening with the Epworth Sleepiness Scale and STOP-BANG
- Building referral relationships with physicians
- UnitedHealthcare's 2024 rule: try an oral appliance before Inspire
- Where to get trained: AADSM and other courses
- You're the DME provider, not the treating doctor
- Letting go when treatment doesn't work
- What it takes to get paid for sleep
- Running sleep on its own day of the week
📰 Plus dental news from January 2024: a Michigan dentist's $400,000 settlement after an extraction with a sinus exposure, a Minnesota patient suing after 32 procedures in one visit, and Pearl's new US patent for its AI.
Dr. Mark Murphy is the clinical lead at ProSomnus, faculty at the Pankey Institute and the University of Detroit Mercy School of Dentistry, and has nearly 40 years in the dental and dental lab professions. More at https://prosomnus.com
Chapters:
0:00 Intro: welcome to 2024
2:11 A shout-out to ProSomnus (not a paid ad)
3:02 News: a quiet start to the year
3:44 News: Michigan $400,000 extraction settlement
6:09 News: 32 procedures in one visit lawsuit
7:24 News: Pearl receives a US patent for its AI
8:26 Meet Dr. Mark Murphy
13:52 When sleep and TMD courses were a hard sell
14:39 Mark's path into dental sleep medicine
16:33 Developing the ProSomnus device
20:08 What makes ProSomnus different
22:42 Why 90-degree posts?
24:40 Backing it up with science
27:06 Oral appliances are Class II medical devices
28:42 The real risk: not screening for sleep apnea
29:46 Where to start in dental sleep medicine
30:33 Bite splints and the airway
31:38 Screening: Epworth and STOP-BANG
32:11 400 undiagnosed patients in your practice
32:44 Building physician referral relationships
33:32 UnitedHealthcare's 2024 rule for Inspire
34:29 Where to get sleep education
36:44 Being a "quasi sleep clinician"
38:28 You're the DME provider, not the treating doctor
39:57 Letting go when therapy doesn't work
42:19 What sleep pays, and why some can't get paid
44:51 Give sleep its own day
45:23 Invest in a dedicated sleep team member
47:10 Oral appliances and the jaw joint
48:31 Closing
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