Dr. Abelar has a specific and thorough procedure for the treatment of obstructive sleep apnea. He and his team begin with a consultation, clinical exam and medical history review. These important fact-finding steps determine the likelihood of obstructive sleep apnea and the patient’s chances for successful treatment. Dr. Abelar may give patients a take home sleep study. A sleep study gathers important data to further understand the patient’s condition and how they are sleeping. If a prior PSG (polysomnograph) has been administered by a certified sleep center and interpreted by a sleep physician, Dr. Abelar can make an oral sleep appliance that addresses the patients’ needs.
If the patient has not completed a PSG, Dr. Abelar will make a referral to a certified sleep center for a PSG and physician interpretation. With the information from these steps, Dr. Abelar can make the oral appliance.
Treatment sequence Oral Sleep Appliance Therapy with prior diagnosis of OSA by Sleep MD
- Gather records, history and clinical exam along with dental impressions of the jaws. Dr. Abelar will measure a calibrated bite to open the airway with instrumentation to start appliance therapy. If more than 1 year has passed since PSG, Dr. Abelar provides take home study for baseline prior to oral appliance therapy.
- Deliver oral appliance and make adjustments for comfort and fit. Provide instructions for completion of adjunctive sleep logs, and specific instructions on patient guided titration
- Make checks at one month intervals in the first 2-5 months. Review sleep logs, physical evaluation and check on appliance. Possible custom calibration of appliance for increased efficiency.
- Completion of titration phase at the 4-6 month point. Administer take home sleep study to objectively measure appliance therapy results.
- Possibly make referral back to sleep physician or other medical professional for further management. Consider possible of co-therapy to increase results.
Treatment sequence: Oral Sleep Appliance Therapy without prior diagnosis OSA by Sleep MD
- Consultation and intake screening exam with the possibility of providing a take home sleep study. The results to be sent to sleep physician for interpretation
- Referral for polysomnograph and formal diagnosis from certified sleep center and physician
- If diagnosis indicates so, take records, impressions, and calibrated bite for fabrication of sleep appliance.
- Deliver oral appliance with instructions on use: Possible course of actions after delivery of appliance: A-Referral back to sleep center for adjustment of CPAP and initiation of co-therapy of CPAP and oral appliance. B- If the patient is truly CPAP intolerant, the recommendation is sleep physician supported Oral Appliance Therapy with supervision to maximal improvement (MMI) in place of CPAP C- If other nasal airway problems exist, make referral to ENT physician for nasal patency treatment either before or during OAT treatment.