What is Sleep Apnea?
Sleep Apnea is defined as the temporary stoppage of breathing during sleep, often resulting in daytime sleepiness. Apnea is a Greek word that means "want of breath."
The reason for this “want of breath” is a lack of oxygen coming into the lungs.
How do I know if I have Sleep Apnea?
Snoring is the most common sign of sleep apnea. Your bed partner will most likely let you know of this or you may even wake up gasping for air.
Other signs of sleep apnea occur when you’re awake. Common daytime symptoms include mouth breathing, lack of concentration, decreased performance at school or work, and daytime drowsiness.
What are the effects of Sleep Apnea on my health?
Recent study released by the AAP showed that lack of sleep ranked just under smoking as the #2 lifestyle factor impacting oral health.
Aside from the impact on your oral health, sleep apnea has tremendous effects on your overall health. Since not enough oxygen is getting into the lungs, respiratory disease and cardiovascular disease can result. These diseases can lead to a stroke or heart attack.
Other effects of sleep apnea can include impotence, menstrual irregularities, enuresis, depression and weight gain.
What are my treatment options for Sleep Apnea?
Severe sleep apnea is treated by a Continuous Positive Airway Pressure (CPAP). This consists of an air compressor and mask which delivers pressurized air through the nose when a person is sleeping. The biggest hurdle for using this method is compliance. People feel claustrophobic and others find wearing the mask to be offensive. The strap of the mask worn around the head may even cause headaches.
Moderate sleep apnea can be treated using a much more comfortable alternative. A customized night guard called the SomnoDent is created for your specific bite and actually positions your jaw in such a way that it opens up your airway. This allows more oxygen to enter your body and prevents or minimizes symptoms of sleep apnea.
With the SomnoDent you’re not restricted to sleeping in only one position and you’re much more likely to use it, which is the main aspect of successful treatment.
How can I receive Sleep Apnea treatment?
The best thing to do is call a sleep apnea dentist and schedule a consultation. The dentist will do some diagnostic tests in the office and then most likely send you home with a sleep monitor the size of a small cell phone which is worn like a wrist watch. This high-tech device will give the dentist the necessary information to determine the level of sleep apnea you suffer from and be able to recommend the ideal treatment option for you.
Frequently Asked Questions About Sleep Apnea Insurance Coverage
Does dental insurance or medical insurance cover the sleep apnea appliance?
The sleep apnea appliance is considered medical treatment and dental insurance will not cover treatment however most medical policies will consider paying for the appliance at a dental office.
Do you participate with my medical insurance?
As a dental provider we are contracted with dental policies only. Medical insurances create barriers for dental providers and usually only have medical physicians as participating providers. However, since most medical professionals are not trained in the fabrication and treatment of sleep apnea appliances, medical insurances will usually cover the appliance even though we are not in their network of providers.
How do I get my insurance to cover treatment if you do not participate?
If you medical insurance policy is not an HMO plan, we are usually able to obtain benefits from your medical carrier if you meet their guidelines for treatment. We may also be able to request a "network insufficiency" which means if your medical policy does not have any contracted providers for the service, they will provide coverage at the same rate as they would for the in-network provider. If you have an HMO policy, which does not allow members to see a physician out of their network, we may request a "gap waiver". If approved, this would allow you to be seen out of the HMO network since there are no providers in the network that perform this service.
How much does my medical insurance cover?
Medical policies vary depending an insurance companies and plans. They also set forth guidelines as to what a patient's clinical indications should be for the appliance to be considered under the medical policy. This is called "medical necessity". At the initial consult we will evaluate your signs and symptoms to make sure you are a candidate for the treatment and that you meet your insurance policy's guidelines. At the time of the consultation we will discuss how your medical insurance policy covers the sleep apnea treatment.
What do I have to do to get the waivers and reimbursement from my insurance?
Our office will contract your insurance to obtain all your benefit information and request any waivers if necessary. We will also submit all claims proving medical necessity to your insurance carrier. Our goal is to get the maximum reimbursement from your plan.