8 barriers to sleep medicine prescribing oral appliance therapy

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Sleep Treatments | Sleep Review

As part of a virtual AADSM meeting in 2021, 150 sleep specialists were asked about their behavior and their perspectives with regard to OAT.

From Yoona Ha

How Much Do Sleep Health Professionals Know About Oral Appliance Therapy (OAT)? A recent survey of 150 sleep physicians, commissioned by ProSomnus Sleep Technologies and presented as an abstract at the American Academy of Dental Sleep Medicine 2021 virtual meeting, attempted to answer this question.

Highlighted results are as follows.

  • For the treatment of obstructive sleep apnea (OSA), sleep medics prescribed 75% CPAP and 25% a mixture of OAT, upper airway neurostimulation, and other therapies
  • 68% said their patients were satisfied with CPAP; 54% for implantable neurostimulation; 50% for OATS
  • 63% stated that their patients use CPAP successfully, 54% successfully use OAT
  • 32% of sleep health professionals expect OAT prescriptions to increase in the next 3 to 5 years, 9% expect OAT prescriptions to decrease
  1. 94% said there was no insurance or reimbursement (private and Medicare)
  2. 88% reported the unpredictable, variable performance of the OAT device
  3. 88% reported side effects of OAT
  4. 86% said there was no compliance monitoring and no data
  5. 83% indicated the availability of qualified sleep medicine specialists
  6. 82% said treatment with OAT. takes too long
  7. 81% reported unpredictable relief from everyday symptoms
  8. 78% reported patient adherence (OAT painful, difficult to use, not reliable, break frequently)

Len Liptak, CEO of ProSomnus, author of the abstract, says the results on adherence were surprising. “These results suggest that sleep health professionals are interested in practical factors such as side effects, inconsistent device performance, or device comfort and ease of use that can affect compliance in the real world,” he says.

Liptak also points to a lack of awareness of how these barriers to OAT compliance can be easily overcome. “For example, respondents cite a lack of insurance coverage as the main obstacle. Nevertheless, oral appliance therapy has been covered by private and Medicare insurance for years, ”says Liptak. “Education programs can easily close these gaps in understanding and thus facilitate the increased use of OAT.”

Of the 150 sleep doctors surveyed:

  • 39% practice pulmonology, 32% practice internal medicine or general practice, 15% practice neurology and 14% are ENT doctors.
  • 53% were not board certified, 47% were board certified
  • 75% were in private practice, 25% were in academic institutions
  • 327 represents the average number of OSA diagnoses per year
  • 50% of respondents spend less than 50% of their time on sleep medicine; 11% say they spend 100% of their time on sleep medicine
  • 33% of patients are diagnosed with severe OSA, 28% moderate, 29% mild
  • 81% have expressed an interest in learning more about new OAT technologies and protocols

Liptak says sleep medicine doctors’ willingness to learn more about OAT was a pervasive topic that was found in the study’s conclusions. “The survey suggests, both directly and indirectly, an increased future acceptance of OAT,” he says.

Yoona Ha is a freelance writer and public relations specialist in the healthcare sector.

relation

Liptak L. What do we know about sleep medicine specialists? Journal of Dental Sleep Medicine. Summaries of the AADSM Annual Virtual Meeting 2021: Executive Summary # 12.

Figure 43569226 / Barriers © Lucian Alexandru Motoc | Dreamstime.com



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