Cpap Compliance | Sleep Scholar

The Scottsdale Study Club announces its 12-month meeting schedule to include monthly club meetings as well as monthly hands-on clinical workshops with patients. The focus of this educational environment is to provide direct one-on-one experience with Dentists who have successfully integrated sleep dentistry into their practices.

About the Workshops and Meetings

General session fees are $1,499 and Workshops are $2,200. Each Dentist is welcome to bring an assistant or auxiliary to the club meeting. For information or to register to attend the meeting, please call 760-633-4162..

Topics and focus of each meeting will be determined by the mentors and may change without notice depending on the number attendees and perceived areas of academic interest. There will be no exhibits at the Study Club meetings.

Background on the Mentors

Dr. Edward Spiegel, DDS: After treating a series of patients in the 1980′s with temporomandibular joint disorder by way of oral appliances, in 1992, he discovered an interesting correlation. As he treated these patients with oral appliances their snoring stopped. Having confirmed this finding after a retrospective case review, he began to evaluate the use of oral appliances to stop patients snoring and in turn the utility of oral appliances in solving a much larger health problem: Sleep Disordered Breathing conditions such as Obstructive Sleep Apnea (OSA).

He designed a rudimentary treatment protocol within his own office based on the dental management of Sleep Disordered Breathing by way of Oral Appliance Therapy. The local success of his clinical program in Erie, PA was mirrored nationally by dental practices emulating his treatment plan. He then created a clinical protocol intended for the dental assessment and treatment of snoring and other airway-related sleep disorders. The result is a turn-key system for the dental management of Sleep Disordered Breathing.

Bradley Eli, DMD, MS: Bradley Eli has a 20 year history of work in the field of Orofacial Pain management (head and neck). Upon completion of his UCLA program there were less than 10 like providers within the United States. In 1995, he began the work in the field of Sleep Medicine and then began the STAR (Sleep Treatment and Research) Institute. This unique early look at the field has assisted him in the development of methods and solutions to assist patients with these life changing pain and sleep disorders.

Location

SleepScholar Study Club General Session

14635 N Kierland Blvd., Ste. 154

Scottsdale, AZ, 85254

Seating is limited and will be assigned on a first come first serve basis

Calendar of Events 2011

September 16- 17, 2011

Where are the patients?

Evaluation of dental patients at each dental appointment for signs and symptoms of untreated sleep disorders
Conversion from dental to medical
Dental insurance vs. Medical Insurance including Medicare
AASM as well as AADSM guidelines for treatment in the dental office
Hands-on workshop for patient evaluation and treatment

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Michael Childres, Bradenton, FL

Dr. Michael Gluhareff, Ocala, FL

Dr. Edward Spiegel, Scottsdale, AZ

Dentists and one staff member will learn proper patient evaluation, examination, jaw registration, and dental and medical records.

October 14-15, 2011

Bruxism, TMD and Sleep

Etiology of Bruxism, use of the Ordinal Scale as well as tie in to TMD and Sleep Disorders
Evaluation of the patient, documentation and medical billing for ABI
Treatment options in the pediatric patient as well as adult patient
Orthodontic evaluation and early treatment
TMD evaluation of patients as well as treatment planning
Sleep patient present with symptoms of pain and pre existing conditions
Hands-on evaluation of patient dentition and treatment planning
Proper medical referral and medical billing

Mentor Spotlight

Dr. Devin Croft, Orthodontist, Peoria, AZ

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

November 4-5, 2011

Diagnostic Testing

Diagnostic testing in the dental office for TMD and Oral Appliance
Evaluating diagnostic testing for use id the dental office
Literature support, clinical guidelines for treatment planning as well as follow-up records and documentation to insurance carriers
AAOP as well as AACP Guidelines for treatment and evaluation of patients
Hands-on evaluation for patients as well as discussion on treatment planning

Mentor Spotlight

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

December 2-3, 2011

Oral Appliance Selection

Discussion on the most used oral devices for Bruxism, TMD and OSA
Pricing as well as indications and contra indications of oral devices with a 510(k) number
Various jaw registration devices for recording the maxillary/mandibular relationship
Long-term use of Oral Appliances
Trouble-shooting problems associated with oral appliances
Materials for accurate impressions for oral devices

Mentor Spotlight
Mr. Randy Clare, Aliso Viejo, CA

Dr. Edward Spiegel, Scottsdale, AZ

Calendar of Events 2012

February 10-11, 2012

Where are the patients?

Evaluation of dental patients at each dental appointment for signs and symptoms of untreated sleep disorders
Conversion from dental to medical
Dental insurance vs. Medical Insurance including Medicare
AASM as well as AADSM guidelines for treatment in the dental office
Hands-on workshop for patient evaluation and treatment

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Michael Childres, Bradenton, FL

Dr. Michael Gluhareff, Ocala, FL

Dr. Edward Spiegel, Scottsdale, AZ

Dentists and one staff member will learn proper patient evaluation, examination, jaw registration, and dental and medical records.

March 9-10, 2012

Bruxism, TMD and Sleep

Etiology of Bruxism, use of the Ordinal Scale as well as tie in to TMD and Sleep Disorders
Evaluation of the patient, documentation and medical billing for ABI
Treatment options in the pediatric patient as well as adult patient
Orthodontic evaluation and early treatment
TMD evaluation of patients as well as treatment planning
Sleep patient present with symptoms of pain and pre existing conditions
Hands-on evaluation of patient dentition and treatment planning
Proper medical referral and medical billing

Mentor Spotlight

Dr. Devin Croft, Orthodontist, Peoria, AZ

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

April 13-14, 2012
Diagnostic Testing

Diagnostic testing in the dental office for TMD and Oral Appliance
Evaluating diagnostic testing for use id the dental office
Literature support, clinical guidelines for treatment planning as well as follow-up records and documentation to insurance carriers
AAOP as well as AACP Guidelines for treatment and evaluation of patients
Hands-on evaluation for patients as well as discussion on treatment planning

Mentor Spotlight

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

May 11-12, 2012

Oral Appliance Selection

Discussion on the most used oral devices for Bruxism, TMD and OSA
Pricing as well as indications and contra indications of oral devices with a 510(k) number
Various jaw registration devices for recording the maxillary/mandibular relationship
Long-term use of Oral Appliances
Trouble-shooting problems associated with oral appliances
Materials for accurate impressions for oral devices

Mentor Spotlight
Mr. Randy Clare, Aliso Viejo, CA

Dr. Edward Spiegel, Scottsdale, AZ

June 8-9, 2011

Where are the patients?

Evaluation of dental patients at each dental appointment for signs and symptoms of untreated sleep disorders
Conversion from dental to medical
Dental insurance vs. Medical Insurance including Medicare
AASM as well as AADSM guidelines for treatment in the dental office
Hands-on workshop for patient evaluation and treatment

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Michael Childres, Bradenton, FL

Dr. Michael Gluhareff, Ocala, FL

Dr. Edward Spiegel, Scottsdale, AZ

Dentists and one staff member will learn proper patient evaluation, examination, jaw registration, and dental and medical records.

July 13-14, 2012

Bruxism, TMD and Sleep

Etiology of Bruxism, use of the Ordinal Scale as well as tie in to TMD and Sleep Disorders
Evaluation of the patient, documentation and medical billing for ABI
Treatment options in the pediatric patient as well as adult patient
Orthodontic evaluation and early treatment
TMD evaluation of patients as well as treatment planning
Sleep patient present with symptoms of pain and pre existing conditions
Hands-on evaluation of patient dentition and treatment planning
Proper medical referral and medical billing

Mentor Spotlight

Dr. Devin Croft, Orthodontist, Peoria, AZ

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

Clinical Workshops

The intention of the workshop format is to exercise the new skills as learned at the general session in a controlled environment. There will be time provided in this forum for attendee case presentations and the exchange of information that will lead to an excellent educational outcome.

The Apnea and TMJ/Headache workshop will be conducted in small groups with patients in a dental office.

The PSG course will be conducted in a hotel room where a complete sleep diagnostic facility will be re-created for the purpose of demonstrating and teaching the process of collecting sleep study data.

Location for Apnea and TMJ/Headache Workshops

Vistancia Ortho

9772 W. Yearling Rd Suite A-1600

Peoria, AZ 85383

(All materials for the training will be provided onsite)

Location for the Overnight Polysomnography Workshops

Embassy Suites

4415 E. Paradise Village Pkwy South
Phoenix, AZ 85032

Calendar of Events 2011

September 23-25, 2011

Overnight PSG (Limited to 12 Dentists)

Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel

October 21-22, 2011

Chairside Sleep Apnea

Medical legal aspects involved in treating the Bruxing, TMD and Sleep patient
Health care attorney will review medical insurance guidelines. Medicare guidelines including anti-fraud, anti-kickback and Stark Laws.
Informational seminars for Snoring, TMD as well as Sleep Disorders.
How to organize market and follow-up.
Working with the sleep lab. How to legally refer patients with medical insurance as well as Medicare.

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

November 18-19, 2011

TMD and Headache

Headache classifications relationship between Headache/TMD/Sleep
Diagnostic Process-unique for headache and unique for sleep
Recommended Communication with Physicians
Medications in Headache Management
Oral Appliance Therapy

Headache

Jaw Disorders

Sleep Disorders

Injection uses in Headache Disorders
Injection techniques for Headache
Injection technique for TMD
Review of Tx method of action PAP vs Mandibular advancement

Mentor Spotlight

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

December 16-18, 2011

Overnight PSG (Limited to 12 Dentists)

Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel

Calendar of Events 2012

February 24-25, 2012

Chairside Sleep Apnea

Medical legal aspects involved in treating the Bruxing, TMD and Sleep patient
Health care attorney will review medical insurance guidelines. Medicare guidelines including anti-fraud, anti-kickback and Stark Laws.
Informational seminars for Snoring, TMD as well as Sleep Disorders.
How to organize market and follow-up.
Working with the sleep lab. How to legally refer patients with medical insurance as well as Medicare.

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

March 23-24, 2012

TMD and Headache

Headache classifications relationship between Headache/TMD/Sleep
Diagnostic Process-unique for headache and unique for sleep
Recommended Communication with Physicians
Medications in Headache Management
Oral Appliance Therapy

Headache

Jaw Disorders

Sleep Disorders

Injection uses in Headache Disorders
Injection techniques for Headache
Injection technique for TMD
Review of Tx method of action PAP vs Mandibular advancement

Mentor Spotlight

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

April 27-29, 2012

Overnight PSG (Limited to 12 Dentists)

Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel

May 25-26, 2012

Chairside Sleep Apnea

Medical legal aspects involved in treating the Bruxing, TMD and Sleep patient
Health care attorney will review medical insurance guidelines. Medicare guidelines including anti-fraud, anti-kickback and Stark Laws.
Informational seminars for Snoring, TMD as well as Sleep Disorders.
How to organize market and follow-up.
Working with the sleep lab. How to legally refer patients with medical insurance as well as Medicare.

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

June 22-23, 2012

TMD and Headache

Headache classifications relationship between Headache/TMD/Sleep
Diagnostic Process-unique for headache and unique for sleep
Recommended Communication with Physicians
Medications in Headache Management
Oral Appliance Therapy

Headache

Jaw Disorders

Sleep Disorders

Injection uses in Headache Disorders
Injection techniques for Headache
Injection technique for TMD
Review of Tx method of action PAP vs Mandibular advancement

Mentor Spotlight

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

July 27-29, 2012

Overnight PSG (Limited to 12 Dentists)

Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel

Could a Different Tube Actually Make the Difference in the Battle for Compliance?

The CPAP compliance equation usually hinges on a common belief: find the right mask and comfort will follow. Comfort equals compliance, and compliance equals reimbursement. The strategy makes sense, but variables can complicate matters.

For example, what if the “best” mask is still too uncomfortable? Johan Verbraecken, MD, a pulmonologist and medical coordinator at the Belgium-based Sleep Disorders Centre, has seen this scenario on many occasions. One recent patient wanted to stop CPAP treatment after many failed attempts. “I asked him to try one more thing before he stopped,” says Verbraecken. “The only thing we changed was adding a heated tube. The patient was comfortable and happy with this intervention. We focus so much on changing masks, but tubes are often overlooked.”

Using the heated tube from the beginning, along with the heated humidifier, can also benefit sleep labs economically since fewer patients are likely to stop due to condensation. “Patients get moisture on their face at night, and it is not comfortable,” says Verbraecken. “The condensation can also make noise in the tube, similar to the sound of boiling water. This noise can often lead to stopping CPAP use, but the right tube can completely prevent it.”

New Respect

A few companies have been paying close attention to tubes, and clinicians are now looking to the technology in an effort to find any edge in the race to boost compliance. The transfer of air from machine to patient is no longer overlooked. In fact, the field is literally getting hotter with heated tubes reducing the pesky problem of condensation.

A company called Plastiflex Healthcare, a division of Plastiflex Group NV, decided to use its considerable experience manufacturing industrial flexible hoses and apply it to CPAP. Plastiflex contacted Verbraecken’s Centre about 2 years ago as it reached out to the European market.

Plastiflex offered the Hybernite® Rainout Control (ROC) System, which includes the proprietary Hybernite® Heated Breathing Tube (HBT) and Hybernite® Power Supply Unit (PSU). The HBT connects to the PSU via a plug-and-play connector, with copper wires embedded in the tubing wall.

The wires generate heat that maintains air temperature inside the tube, ultimately warding off problematic condensation. Verbraecken notes that the wires are positioned for uniform heating along the tube’s entire length, a system that avoids water droplets on the wall of the tube—and the resulting accumulation of moisture. The combination of the heated tube and the humidifier works to control condensation.

Ludo van der Poel, area manager at Netherlands-based Vivisol, a home care company that supplies Hybernite systems to patients, agrees that the seemingly minor detail of the tube can make a major difference. “The old saying about the weakest link in the chain also applies here,” says van der Poel. “If you have a superior mask and a superior CPAP device, but a bad tube, you will not get the best results.”

Universality is Key

With critical CE approval in hand, Verbraecken says the Hybernite’s appeal stems from its ability to be used with each kind of humidifier. Other heated tubes on the market can only be used on one machine. “This tube is universal,” says Verbraecken. “That is a major advantage.”

Some manufacturers choose to make tubes that are only compatible with their own machines—a mistake in Verbraecken’s eyes. “I think it’s the wrong decision,” he says. “You are obliged to use their machine, and it’s protection for them. The market is so huge that it does not make sense anymore.”

Titrations with Humidification?

At the moment, titration with humidification and heated tubing is not common. However, in cases involving chronic sinusitis and nasal obstruction, Verbraecken contends that the Hybernite could be an advantage. “You could eliminate specific side effects that could be disturbing and that could make a difference,” he says. “For many people, condensation feels as if the water is running from their nose and on to their face. It is like being in a swimming pool, and for many it is unacceptable.”

Better tubes have the potential to enhance CPAP and ultimately improve patient care, although studies must be done to back up this notion. “There is room to use these tubes in a routine setting and not just as an escape tool,” says Verbraecken. “We need large trials to look at the effects of routine application, which has the potential to enhance the objective of compliance.”

Nuts and Bolts

Close proximity to Plastiflex’s European headquarters fostered a relationship with officials at Vivisol who were able to give advice during Hybernite’s development. “We discovered this product before it was launched,” reveals van der Poel. “We were involved in the early stages, giving input from the field to the developers at Plastiflex to further refine the product prior to its launch.”

Years prior to contacting Verbraecken, Plastiflex officials also underwent an exhaustive fact-finding period that took them to numerous trade shows and visits with industry professionals. Designers narrowed down CPAP tubing complaints to condensation and comfort, and refining technology to deal with these two problems has remained the top priority.

After taking into account all this information, engineers developed a Hybernite® ROC that essentially consists of two main parts; one is a heated breathing tube and the other is a power supply. With standard conical connectors, company engineers claim that the Hybernite® ROC can fit the role of a universal solution that can be fully integrated into any humidifier—including all types of masks that use standard tubes. “We like the flexibility of the tubing and the high quality plastic,” adds van der Poel. “A tube that is not flexible or long enough could prevent patients from moving in an easy way. Poor quality can also lead to breakage.”

The system itself does not take power or require power to be taken from the humidifier. It takes the energy straight out of the socket in the wall via the Power Supply Unit (PSU). The system works with all humidifiers that currently use standard tubing—which is 99% of the market.

————————————————————–

Johan Verbraecken, MD, is a pulmonologist and medical coordinator at the Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital and University of Antwerp. He also serves as vice president of the Belgian Association for Sleep Research and Sleep Medicine.

	Randy Clare Managing Editor of SleepScholar and RespiratoryScholar
	Dr. Steve Carstensen Pankey Institute for Advanced Dental Education, American Academy of Dental Sleep Medicine.
	Ruchir Patel MD Founder & Medical Director at the Insomnia and Sleep Institute of Arizona.
	Dr. John S. Viviano AADSM Diplomate and member of various sleep organizations. Has lectured internationally on the treatment of Sleep-Disordered Breathing and the use of Acoustic Reflection.
	Jeffroy Wyscarver President, DDME Online, Sleep Lab Technology and Services for the Dental Community.
	Claude Albertario RPSGT, speaker, author and mentor in the field of sleep diagnostics with 25 yrs of management experience in one of New York's premier sleep centers.
	Joseph Anderson Co-Founder and Director of Education for Priority Health Education and Priority Scoring.
	Todd Austin Managed sleep labs and has 15 experience in sleep diagnostics and therapeutic systems. .
	Marietta Bibbs Sleep specialist and manager of Sleep and Neurodiagnostics at Morton Plant Mease Healthcare.
	Bradley Eli DMD, MS Director, San Diego Headache and Facial Pain Center / Sleep Treatment and Research Institute
	Edward Grandi Executive Director of the American Sleep Apnea Association.
	Edward Michaelson MD Board Certified in Pulmonary Medicine, Internal Medicine and Sleep Medicine
	Ashley Truitt Founder & Director of Dental Sleep Medicine Worldwide, Co-Founder of TPT Dental.

Scottsdale Study Club Announces and Sets Dates for Clinical Workshops and Meetings Focused on Dental Treatments of Sleep Disordered Breathing, Bruxism and TMD/Headache

Overlooked No More – Hybernite Rainout Control System

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