Dr Gatti's Blog a Lawrence Dentist Reflections

Today more than ever, the idea of a good night’s sleep is a fleeting one. Scrimping on sleep causes more than midday drowsiness and saggy eyelids – it may raise your blood glucose levels and cause other medical complications that I have written about in previous blogs. We don’t really know why the body needs sleep, however we do know that sleep is a dynamic, complex activity. The hypothalamus tells the body when to sleep, wake up, change blood pressure, help the immune system and regulate hormones for digestion. Every organ of the body, including the hypothalamus depends on sleep to function properly. Lack of sleep interferes with your ability to produce insulin, increases your risk of diabetes, high blood pressure, depression, heart attack and stroke. Also, sleepless nights increase the level of stress hormones in your body, causing the body to store fat and make it more difficult to loose weight.

In the past I have talked about obstructive sleep apnea (OSA) and snoring causing sleep disruption for you and your bed partner. We have also discussed how these can be addressed with oral appliances. Now I would like to review some simple general rules to improve the overall quality of your sleep. I am talking about sleep hygiene. Bottom line is that your bed should not be an extension of your office or family room. The bed is meant for sleep and sex. I can give you some sound advice for sleep; as for sex, well…

Here are some sleep hygiene recommendations:

• Wind down for about 30 minutes prior to bedtime.
• Try to go to bed and wake up at the same time every day.
• Avoid exercising or eating within 2 hours of bedtime.
• Avoid caffeine after lunch.
• Limit alcohol intake.
• Don’t eat or watch TV in bed.
• Try relaxing breathing exercises when you get into bed.
• After an estimated 20-30 min. of not falling asleep, get out of bed. Then, do something relaxing, like listening to music or light reading until you are sleepy enough to return to bed. Do not get on the computer.
• Don’t set up camp on the couch or you will begin to associate sleep with the couch and not your bed.

These are fairly straight forward and simple; however, developing good sleep hygiene and a consistent routine is very important to sleep and that is not a laughing matter.

We have spent numerous hours of continuing education in the area of sleep apnea and sleep breathing disorders over the past five years. As we explain the health ramifications of Obstructive Sleep Apnea to our clients, one of the questions that often arises is, “Will my insurance pay for the treatment if I use an oral appliance?”

It is important to understand a couple of issues: One, this is a medical problem, not dental, so you will be utilizing your medical insurance. There is no dental coverage for the treatment of snoring or sleep apnea. Two, we are not contracting providers so you will be out of network – there are not any dentists that are in network with medical insurance companies for the use of oral appliances.

Realize that our team is well versed in, and happy to guide you through, the insurance process and coaching you on what questions to ask your insurance representative. When all of the required information has been collected we can send a pre-authorization of benefits to your medical insurance company to determine the amount they will pay.

For insurance to provide coverage three things are usually required: 1. a sleep study 2. a diagnosis of OSA and 3. a CPAP intolerant statement. Unfortunately, although snoring can be incredibly disruptive to your sleep and those people close to you, this is not considered a medical necessity and therefore no insurance coverage will be available. The general rule is the more proactive you are, the smoother and quicker the process will be of determining your insurance benefit.

When you are ready to improve your sleep and your health, or have insurance questions, please contact us.