The Sleep Medicine Team: Physicians, Technologists, Educators, Dentists

A patient who suspects they have a sleep disorder learns pretty quickly that they cannot just hire a sleep doctor to fix their problem. Rather, what they enter into is much better: a relationship with a team of specialists who work in tandem across the continuum of that patient's care to ensure they are diagnosed and treated properly and that they are compliant to their therapies over the long term. This team model illustrates a positive step toward improving patient outcomes, which bodes well for everyone involved.

 

The sleep medicine team

Aside from the typical staff that any healthcare setting offers, the sleep medicine team includes several professionals with specific training to help patients challenged by sleep disorders to receive the best long-term care possible. Teams include sleep medicine physicians, sleep medicine technologists, sleep medicine educators, and sleep medicine dentists.

Sleep medicine physicians

The sleep medicine physician is typically a practicing, board-certified physician who has undergone additional training through the American Board of Sleep Medicine (ABSM) and/or the American Academy of Sleep Medicine (AASM) to earn their credentials. They sit for exams and must maintain additional earned credits to keep their certification. 

The clinical background of a sleep medicine physician often also identifies their specialization. A board-certified sleep physician who is a pulmonologist will specialize in breathing disorders of sleep, for instance, while a board-certified sleep physician who is a psychiatrist is probably most interested in insomnia patients. However, all sleep medicine physicians are trained to have expertise in the broad expanse of potential sleep disorders they might encounter. Other fields of medicine whose specialists bring expertise to the fore include neurologists, internal medicine physicians, family practitioners, otorhinolaryngologists, pediatricians, even surgeons and anesthesiologists.

Sleep medicine physicians work inside hospital systems as well as freestanding hospital-affiliated clinics and private practices. They accept referrals from other physicians and dentists; write orders for the various kinds of assessments available to their patients; interpret sleep test results; provide diagnoses; and write prescriptions for therapies which can include pharmaceuticals, cognitive behavioral therapy sessions, and durable medical equipment. They are considered the anchor of any sleep medicine team.

Sleep medicine technologists

The sleep medicine technologist may bring several credentials to the sleep lab. Generally, these credentials can include one or more of the following: registered polysomnographic technologist (RPSGT); registered sleep technologist (RST): neurodiagnostic technologist (NDT); and/or respiratory therapist (RT). They sit for exams and must also maintain their certification through regular training. They may have studied for one year in an accredited technical program focused on polysomnography, but others have higher levels of education which allow them to bring other valid experiences to the job.

The sleep clinic, center, lab, or DME supplier is where you will most likely find a sleep technologist. Their primary task is to run diagnostic assessments of patients and to perform titrations to find the perfect settings for their patients' therapeutic devices. They also spend a great deal of time in patient education as they are often the sleep health professional that patients spend the most face time with, due to the nature of the test setting. Technologists also score studies; write reports analyzing study data; manage laboratories; set up home sleep apnea tests; coordinate, deliver, and follow through on equipment prescriptions for patients; and provide additional educational services beyond the laboratory experience (i.e. patient support meetings, CPAP education visits for individual patients and their families, and public speaking). 

Sleep technologists are often described as the "eyes and ears" of sleep medicine physicians, as their patient encounters (especially during overnight studies) are more interactive and intimate over a longer stretch of time; this provides them with excellent opportunities to learn about patient habits and history that may not have been revealed during daytime office visits. 

Sleep medicine educators

A new credential is now awarded to sleep professionals from different arenas in the healthcare field who sit for rigorous competency exams that test their knowledge of clinical sleep health: the CCSH (certificate in clinical sleep health).

These patient educators can be RNs; sleep technologists; health educators; nurse practitioners; physicians; dentists; physician assistants; or PhDs in health, counseling, or science. They must show more than 1000 hours of cumulative direct experience in the field of sleep health (including experience in patient education, counseling, management, and/or coordination of patient care and outcomes). Sleep medicine educators are typically more formally educated than sleep medicine technologists.

Sleep medicine educators work inside hospital systems or independent clinics. They may also be independent educators engaged in public speaking, digital education efforts, telemedicine, or publishing. They are often thought of as "physician extenders" who can take care of specific tasks for established patients in order to provide the busy sleep medicine physician some relief in an otherwise demanding schedule.

They are critical to a strong sleep medicine team, pivotal in improving general patient health literacy and in serving as a focused task force to follow through with patients in the long term to improve therapy compliance rates and overall outcomes.  In the age of patient-centered care and reduced Medicare reimbursement trends, their role is critical to the livelihood of sleep centers.

Sleep medicine dentists

Dentists who undergo specific training in dental sleep medicine can earn credentials through the American Board of Dental Sleep Medicine or the American Academy of Sleep Medicine. While dental sleep medicine is not a brand-new field, it has become a bigger part of the sleep health landscape as clinicians continue to seek therapy alternatives for their patients.

Sleep medicine dentists specialize in helping to identify breathing disorders of sleep; manufacturing and fitting oral appliances for patients who qualify to use them as therapies for their snoring, upper airway resistance issues or obstructive sleep apnea (OSA); and maintaining compliance rates and patient outcomes for those using therapeutic dentistry.

Some sleep medicine dentists work in full-service practices that include all aspects of dentistry; others who specialize only in dental sleep medicine constitute a new trend worth watching. 

The beauty of working with a sleep medicine dentist is that they often see their patients more regularly than other physicians. They can take advantage of these opportunities to ensure that their patients with sleep breathing disorders are well taken care of. They are also trained to identify certain markers of OSA, such as bruxism, clenching, problems with the TMJ, even observed daytime sleepiness at chairside.

The sleep medicine dentist can refer patients to a sleep medicine physician, and a sleep medicine physician can refer patients who qualify for oral appliance therapy (OAT) to a sleep medicine dentist. The relationship is a symbiotic one that, although fairly new, promises options for treating sleep breathing disorders when patients find they cannot tolerate or won't comply with continuous positive airway pressure (CPAP) therapy. 


Here at Sound Sleep Health, the concept of the sleep medicine team is a reality. We have 3 locations in the greater Seattle/Kirkland areas. We hope you'll reach out to us with your sleep health concerns. Improve Your Sleep Today! 

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