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Welcome to CME on ReachMD. This episode is part of our MinuteCE curriculum.

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Dr. Morse:
From awareness to action: what to do with a positive obstructive sleep apnea screen? I'm Dr. Anne Marie Morse. I'm the Director of Child Neurology and Pediatric Sleep Medicine at Geisinger Janet Weis Children’s Hospital, and I'm excited to be able to unpack what are the next steps that are going to enable you to get your patients to the best success.

So, the PCP, or the primary care role in the journey moving forward is so much more than just putting in that referral. We first have identified that now we can effectively screen for obstructive sleep apnea and identify those who may be potentially at high risk. We then are putting in that sleep referral, there's that sleep testing that's going to occur, treatments may be initiated, but don't forget, there's going to be that ongoing adherence and monitoring. And so, there is this ongoing need for you to have an active role in ensuring that your patients are experiencing the optimal success of being able to successfully be diagnosed but also treated.

Why is this important to you? Because the treatment of, and optimization of sleep health, including obstructive sleep apnea, has an impact on every single thing that you're taking care of; high blood pressure, diabetes, weight management. Whether it's mood dysregulation, such as depression, anxiety, bipolar, substance use disorders. You name it, there is an impact.

So, when you're talking about the sleep referral process, do yourself a favor and establish yourself a network with who is your go-to people. This makes it easier for you, as well as for your patient to have the path of least resistance to being able to get that sleep evaluation and ensuring that everything about sleep is being looked at even beyond the obstructive sleep apnea.

In terms of the sleep testing, being able to understand that there may be differences in terms of home sleep testing or an in-lab test. This is where it can be really important for you to partner with that sleep provider to understand whether or not your patient should be getting an in-lab test, or whether a home test would be sufficient. In many primary care settings, we are seeing that they're being part of the facilitation of getting this testing done and offering home sleep testing in combination and partnership with a sleep provider. Again, try to make this as easy as possible, not only for your patient but also for your clinical practice.

Once the diagnosis has been established, there's been the identification of obstructive sleep apnea, is it mild? Is it moderate? Is it severe? Becoming familiar with the different treatment options, because the reality is, is you're the medical home. Your patient is going to come back to you and want to know, ‘Is this the best thing for me? I know I met that sleep doctor but, they're new to me.’ And so, they're going to continue to trust you, and being able to understand, is this the right selection.

You should have a check-in after their treatment is started, recognizing that many patients may have difficulty in maintaining adherence to whatever therapy it may be, whether it's a PAP device like CPAP or BiPAP, a dental device, positional therapy, or otherwise. And so, having some of those understandings, but also setting expectations beyond what the Sleep Physician may have made those expectations for of using it every night. And these are the sleep outcomes we’re looking at. You know them more in-depth. You're able to engage them and say, hey, Joe, we're really trying to improve your blood pressure, and this is a great tool for optimizing your blood pressure. Jenny, I know you've been on this weight management journey and so, by us optimizing your breathing during sleep, utilizing this on a night-by-night basis, not only are we going to have more success getting there, but you're going to have more energy and less likely to choose those foods that are going to make it harder for you to achieve your goals.

It then becomes critically important for you to continue using that framework to be able to help in monitoring that treatment adherence in the relevance to the ongoing care. You're dealing with the person as they're going through the journey, and it's really important to recognize that this is another tool in your tool belt to optimize the experience of whatever that sleep component is, but also to achieve the goals that are important to you, and of course, which is most important to all of us, our patients who are really trying to achieve that optimal wellness.
So, make sure you're considering using optimizing your nights in order to achieve the goals during the day that you've prioritized with your patient.

Thank you for joining us. And if you've missed out on any of these other roles that you can further effectively manage in this journey, please make sure you're checking out the other sequences of this series.

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