When patients come in for a consultation, one of the issues we look for is sleep-disordered breathing. Sleep apnea, the most severe type of sleep-disordered breathing, is defined by pauses in breathing during sleep. The severity of sleep apnea is measured based on what’s called the apnea-hypopnea index (AHI), which measures the number of breathing disruptions lasting at least 10 seconds per hour. People with severe apnea stop breathing for at least 10 seconds or more for 30 times or more an hour—240 times during an eight-hour night of sleep. Over time, those breaks in breathing can lower the body’s overall oxygen levels. And a body deprived of oxygen can suffer a range of chronic and even deadly diseases. Today, dentists can provide treatment for sleep apnea sufferers, although the condition can only be diagnosed by a board-certified sleep physician. At the Julian Center, when we suspect sleep apnea during an evaluation, we have the patient undergo a home sleep study. Although there are sleep centers that offer sleep studies, we prefer the home version of the sleep study.

The home sleep study is a unit that the patient takes home. It is the only home sleep study that measures for Bruxism. When the patient lays down to sleep for the night, they strap a sensor around their chest, insert a cannula in their nose, attach a sensor to their finger, and attach sensors to their jaw muscles. These apparatuses record the following for the study:

Apnea-hypopnea index (AHI), or the number of breathing disruptions per hour: 0 to 4 disruptions are considered to be within normal limits, 5 to 14 indicate mild apnea, 15 to 29 is moderate, 30 or more is severe apnea, and 45 or more is extremely severe.

Oxygen desaturation index (ODI) is the number of times your oxygen levels fall below 97 percent divided by the total number of hours you have slept during the recording. Oxygen saturation, or the available oxygen in your blood, should be at 98 to 100 percent.

Snore index (SI) is the total duration of time spent snoring during the recording.

Bruxism episode index (BEI) is the number of clenching/grinding events that occur during the test: 0 to 2.5 events is within normal limits; 2.5 to 5.0 indicates significantly destructive bruxism, which usually requires treatment with an oral appliance; and 5.0 or more indicates highly destructive bruxism, which usually requires multiple treatment methods.

In addition to being a more comfortable option for a sleep study, allowing the patient to be tested in the comfort of their own home, the home sleep study costs far less than a study conducted at a sleep center. Insurance does not always pay for the study, and out-of-pocket deductibles apply, so the $250 cost of the home version is far easier to deal with than the $2,500 or more that a sleep center study can cost. Plus, at the Julian Center, $225 of the study cost is applied toward any treatment, and subsequent studies to determine the effectiveness of treatment only cost $25.

The home sleep study used by our office has the added benefit of evaluating a patient for bruxism, or clenching/grinding of the teeth, in addition to identifying airway obstruction. That’s important for us to know since bruxism is often an indicator of breath stoppage during sleep—bruxism occurs because the body is automatically trying to open the airway by stimulating the dilator muscles in the throat and jutting the lower jaw forward.

If you or someone you know has one or more of the following symptoms—snoring, waking and gasping for breath during sleep, headaches upon waking, brain fog, insomnia, daytime sleepiness, broken teeth, and more—make an appointment today to get checked for sleep-disordered breathing or sleep apnea.