How to Talk to Your Patients About Sleep Disordered Breathing

Meghna Dassani, DMD


We’ve all had it happen. You take the car in for an oil change and a tire rotation. Just routine work. Then, when you go to pick it up, your mechanic explains that there’s a problem with the axle. “Is it safe to drive it?” You ask. “Well, for a little while, but it could go at any time,” comes the response. Suddenly, everything just got a lot more complicated and a lot more expensive. How do you feel?

You probably feel shocked, angry, and a little scared. Your plans have changed. You know the work needs to be done and that it will be good for the car, but you’re also busy, tired, and stretched thin. It’s one more thing. You wish you could just forget about it.

Now, imagine that instead of a person with a car in the shop, you’re a patient in the dental chair. Your dentist has just suggested that you might have a problem with sleep disordered breathing (SDB) and that you need a sleep study and some sort of intervention.

How do you think you feel? Probably pretty terrible. As practitioners who care about our patients’ health, we have to speak up about SDB and the damage it can do to their lives. But we have to speak up the right way, or we risk alienating them from the treatment they need to live long, healthy lives.

Why is SDB Suddenly Such a Big Deal?

Sleep science is a fairly new field, and every day researchers are learning more about what sleep is and what it does for the body. We now know that every function in the body depends on sleep.

We cycle through light sleep, deep sleep, and REM sleep all night long, and each stage helps us learn, heal, and grow. The work of sleep changes during the night. If we stay up too late, go to bed too early, or wake frequently, we’re shortchanging our bodies.

When a person’s airway isn’t clear enough to support sleep, they wake frequently for tiny periods, all night long. Their sleep cycles are disrupted, and the brain and body can’t do the work of sleep. This results in symptoms like:

  • Sleepiness
  • Difficulty focusing
  • Memory problems
  • Poor emotional control
  • Depression
  • Weakened immune system
  • Poor blood sugar control
  • Obesity
  • Type 2 diabetes
  • High blood pressure
  • Weight gain
  • Chronic pain
  • Alzheimer’s disease
  • Heart attack
  • Stroke
  • Car accidents
  • Death

Since SDB can cause frequent night waking, it’s a huge health crisis, and your patients may not realize that it is at the root of many of their physical and mental health problems. You’re in a unique position for getting patients screened and treated.

They like you, they trust you, they see you frequently, and they know that you understand the mouth and upper airway. There’s just one hurdle. For many of your patients, this will be the first time anyone on their care team has ever mentioned the possibility that SDB could be causing or contributing to their health problems.

Step 1: Staging and Framing Matter

News that comes out of the blue is harder to process than news that you’re expecting. “Your car needs repairs” is a shock when you went in for a tire rotation, but not when you took it in because it was making odd noises and the check engine light is blinking on and off. Health news is similar. How you frame the news and stage your office can affect patients’ ability to process information about sleep-disordered breathing.

Before your patients even see you, get them thinking about SDB with clues like questionnaires at check-in, posters and fliers, and waiting room reading materials that shine the light on SDB and how it affects their health. Your patients won’t arrive in the operatory as SDB experts, but you can at least let them see that your office takes SDB seriously.

Step 2: Learn to Use the Right Tone and Body Language

Your patients must know that you’re on their side when you try to address their sleep breathing issues. Make sure that your tone, language, and body language all convey that you’re concerned about their health and on their side.

If you find these conversations difficult, practice. Have your team or even your family roleplay with you so that you can approach patients with your suspicions about how sleep breathing is impacting their health.

Step 3: Start by Outlining the Problems

Start by listing all the SDB-related problems your patient is having, and ask if they’ve thought about root causes. Many of our patients have been led to believe that these health issues are all their fault. If they simply ate less, exercised more, and lost weight, they’d be healthy.

Unless they’ve spent a lot of time reading about sleep, they may not understand how poor sleep causes obesity and other issues. Take the time to explain that this is not their fault, that they have the symptoms of SDB, and that there are treatments that can solve the problem and even reverse the symptoms.

Step 4: Check in for Their Thoughts and Feelings

Now, it’s time to pause and to check in with your patient. What is their interpretation of what you just said? How do they feel about it? What do they think? What do they want to know more about? It’s important to ask for their interpretation and feelings.

Learning about SDB is often a huge change in the way someone perceives themselves and their health struggles. They need to work through their thoughts and feelings. If you ask if they have any questions, they’ll say no. This isn’t because they totally understand, but because you haven’t given them the space to formulate questions yet. Give them that space. SDB can kill, so it’s worth taking the time to save a life.

Step 5: Summarize the Conversation and Give Next Steps

After you’ve checked in with the patient, you can summarize the conversation so far and explain the next steps in terms of referrals, examinations, and testing. Emphasize that getting treatment for SDB is a good thing. It’s the piece of the puzzle that will help them address all their other health issues. Better health is now an achievable goal, not an impossible dream.

When we screen for and treat sleep-disordered breathing in our practices, we help our patients achieve their potential while adding years to their lives. Take the time to have these conversations the right way, and you’ll have an amazing impact on your patients and your community.

Dr. Dassani is passionate about helping patients with sleep disordered breathing get the treatment they need to live healthier, happier lives. Throughout her career, she has gained invaluable insight into what it takes to implement those services into the practice and currently shares her knowledge and experience in her role as a speaker. She is an international speaker who strives to leave audiences with the knowledge and skills necessary to deliver sleep apnea treatments. Before attending the Goldman School of Dental Medicine at Boston University, Dr. Dassani operated a successful dental practice in Mumbai. For the past 13 years, she has been practicing in Houston, Texas, where she continues to enhance her knowledge of obstructive sleep apnea. To learn more about sleep disordered breathing and how it impacts the health of your patients, grab a copy of Dr. Dassani’s new book, Airway is Life: Waking Up to Your Family’s Sleep Crisis, available now on Amazon.

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