In the past few years there have been some wonderful technological advances in sleep research and sleep observation and even more amazing advances are on the horizon. Any dental team member can get excited about something that will enhance the job at hand making it fun and rewarding. Technology can play a big role and has its place in a dental sleep practice.
Let’s reflect on the history of technology in the dental field. Prior to 1896, we had no way of viewing the inside of a tooth or the integrity of its structure. However, in 1924 the bitewing radiograph gave us this ability. Now we have cone beam technology making it possible to see a 3D image of our patients’ teeth and airway structures. We have seen dental offices transition from paper charts to digital charts allowing electronic charting for every encounter. We have seen intra-oral cameras evolve to magnify small structures so patients can visually experience what is being evaluated. In some offices we’ve seen the transition from articulating paper to the use of digital bite recording with T-scan to measure timing versus force and electro-diagnostic equipment to measure muscle activity, jaw tracking and joint vibration analysis (JVA). The dental profession has evolved to scanning impressions instead of the use of impression material. These advances play a significant role in educating patients to move forward with treatment, help dentists get a full picture of their patient’s dental and musculoskeletal health and enhance the ability of dentists and dental team members.
In the sleep industry the technological advances have also evolved to help practitioners glean what is occurring during a night of sleep. The first electroencephalogram (EEG) of man was recorded in 1929 to help understand brain function during sleep. In 1953 the same technology was used to identify sleep stages REM and NREM and in 1970 the first sleep lab was established. Today the sleep industry has several different types of Home Sleep Apnea Testing (HSAT) units to work with and several new wearable technology pieces are available to the average consumer. Let’s evaluate sleep technology currently on the market and what is on the horizon and how it can play a role in a dental sleep practice.
An educated patient will make educated decisions. Patient education is a fundamental staple in any dental practice offering dental sleep medicine. Educational videos and presentations are great especially if the information is illustrating the patient’s specific condition. The use of cone beam technology and 3D images are a fascinating way to educate patients because patients are able to see their own airway and how it can be affected with mandible position. The procedure Drug-Induced Sleep Endoscopy (DISE) is also a great advancement in technology, unfortunately is used only by otolaryngologists, not dentists. DISE is the closest thing to evaluating a collapsing airway in real sleep. Identification of the site of obstruction and pattern of upper airway changes during sleep is a key point to guide therapeutic approaches of OSA. What is really exciting is the work of Zephyr Sleep Technologies. Zephyr is the only company evaluating the ideal position of the mandible for maximum airway patency during sleep. The MATRx system is patient specific and is available for dentists to use at many sleep labs. Keep your eye on this company as technology is constantly advancing (www.zephyrsleep.com).
Since seeing is believing, any time a patient can experience what is happening with their own airway during sleep, it’s a winner! Wearable technology is becoming the norm and the average consumer can get a pretty good idea of the quality of sleep he or she is experiencing. This technology is very new and only has room to improve. Some of these products include: Fitbit to track movement and hours slept, the Oura ring is specially designed for sleep to measure data and provide textual message flow showing trends, details and changes over time (Ouraring.com). Even one of the largest gaming companies in the world wanted to watch us sleep – Nintendo had plans to release a bedside sensor that tracks sleep and sends data up to the cloud for analysis that would provide suggestions for better sleep. Sadly, the project came to a halt in February 2016 but may be revived anytime. Products like inclining beds and cooling pillows are all the rage in the sleep market. These tools are great to amp the awareness of sleep quality!
The app technology is providing some great tools for a dental sleep practice. Recently, Dr. Gail Demko, Dental Director of Sleep Apnea Dentists of New England pointed out a couple great apps for patients regarding positional therapy. She was excited that the SomnoPose app used for iPhones and the Apnea Sleep Position app used for Android phones can monitor a patient’s position during sleep. These apps sound alarms to alert the patient to get off their back. Check out the many sleep apps available today like SnoreLab, Sleep-Cycle, SleepBot and Sleep Time. They use your phone’s accelerometer to record sleep habits and sleep cycle theory to wake you up at the right time to ensure optimal rest. Of course there are a slew of apps providing soothing soundtracks and white noise to help the onset of sleep like Pzizz, White Noise and Sleep Genius. Mediation for sleep apps like Relax & Sleep Well Hypnosis and dream journal apps like Awoken may be helpful for some patients.
These types of technology will only help the dental sleep medicine industry as along as we (dental professionals especially TEAM) take advantage of them! Ask your patients if they have ever purchased any such technology, keep a sleep diary or use any type of sleep app. Your patients may not want to bring up consumer products with your doctor, but they’ll be happy when you are willing to explore with them. Talk with your doctor and possibly suggest apps or ancillary products to your oral appliance therapy that will help your patients get the best night’s sleep possible.
This Sleep Team Column will be dedicated to the team and provide practical tips and resourceful information. Let us know your specific issues by email to: SteveC@MedmarkAZ.com, while we can’t respond to every individual. Your feedback will help us create the most useful Sleep Team Column we can!