The BBC reported that the number of tests carried out by the NHS to diagnose people with sleep disorders across England has doubled in the past decade.

NHS data shows that 147,610 sleep diagnostic tests were carried out last year - compared to 69,919 in 2007-08. Sleep tests are more commonly undertaken to diagnose Obstructive Sleep Apnoea (OSA) - the most common sleep disorder, according to the NHS. OSA occurs when the muscles and soft tissue in the throat relax, causing a blockage of the airways. The lack of oxygen to the brain causes those with the condition to wake up or have regular interruptions to their sleep. Common symptoms include loud snoring or gasping and grunting whilst asleep.

Matt Everatt – Technical Director at S4S (UK) Limited, a Sheffield based company who provide dental appliances to treat snoring and Sleep Apnoea, said: “In 2005, we set up the company to help patients in the UK get help for Snoring and Sleep Apnoea. Having worked in the NHS for around 10 years treating these patients, it was obvious that there were millions unable to get help, either because there were no sleep services in their local hospitals, or they simply didn’t know how.”

He went on to say, “It comes as no surprise to me that the figures for sleep testing have doubled in the last 10 years. In fact, I suspect that our work at S4S and the network of 2000 dentists that we have trained to screen for OSA has contributed to the number of referrals to the NHS. Sleep Medicine in the UK is often referred to as a ‘3rd World service’ when compared to the US, Australia and, indeed, Europe. We have worked hard over the past 12 years to get more patients screened for signs and symptoms of OSA. We even set up links with Philips Respironics several years ago to try and offer a cost-effective ‘Private Sleep Study’ in hope to get more patients tested - patients unable to get tested in the NHS due to access or waiting lists. It’s staggering that only 22% of OSA patients get treatment here in the UK. Access to treatment needn’t be an obstacle anymore. Up until recently, Sleep Physicians would usually only offer cPAP to OSA sufferers. Dental appliances, known as Mandibular Advancement Splints (MAS) are now used more regularly in NHS units, not only to treat simple snorers, but patients with severe OSA too. The devices, like the Sleepwell MAS, are not only clinically effective, patient compliance has now been proven to be higher than with cPAP in several studies.”

A local Sheffield MP, Meg Munn has spent many years of her career lobbying for Westminster to take a serious look at treating more OSA sufferers. In September 2016, she met Lucinda Roberts and Tamara Sandoul from the British Lung Foundation who presented a new report on the health economics of Obstructive Sleep Apnoea (OSA). The report showed that treating OSA can generate direct health benefits to patients, and reduce costs incurred by the NHS, in comparison with not treating the condition.

Currently, only 22% of OSA patients are treated in the UK - but increasing diagnosis and treatment rates to just 45% could yield an annual saving of £28 million. This includes savings from reductions in road traffic accidents, heart attacks & strokes, as well as the positive impact on patients’ quality of life and improved survival rates. It is estimated that, if everyone with moderate to severe OSA was treated, approximately 40,000 road traffic accidents could be prevented - accidents that not only affect sufferers, but cause injury and death to others.

At Westminster Hall, Munn debated with the Health Minister on OSA and stated that as many as 40,000 lorry drivers may suffer from sleep apnoea, with one third of road accidents being caused by a working driver. In 2012, the number of people killed in road accidents was 1,754, with approximately 600 deaths involving people who drive for work.

Josie Beatson, from Sheffield, reported to the BBC that before receiving treatment for her sleep apnoea, the condition had a terrible impact on her life. She said: "It's embarrassing to be at work and have your colleagues wake you up because they can hear you snoring. The condition turned me into a recluse. I was so exhausted all the time that I didn't want to socialise, and, because of my loud snoring, I was too embarrassed to go and sleep at anyone else's house."

 

THE FACTS ABOUT OSA & SLEEP TESTING

  • Sleep tests are designed to identify sleep apnoea, a condition that causes people to stop breathing during sleep.
  • Only 22% of OSA sufferers are treated in the UK.
  • Sleep apnoea is a serious condition which can lead to other problems, such as: high blood pressure, strokes and heart attacks.
  • An estimated 40,000 lorry drivers may suffer with OSA.
  • Approximately 600 people who drive professionally die in road traffic accidents.
  • Dental appliances such as a Mandibular Advancement Splints (MAS) are appropriate for people who snore or have mild OSA with normal daytime alertness. They can also be used as an alternative for people unable to tolerate CPAP [SIGN, 2003Lim et al, 2006].
  • Sleep quality and nocturnal respiratory function are both improved following the use of a MAS in people with OSA. They are effective, non–invasive, and easy to manufacture [Lee et al, 2009].

Further Study

The role of the dentist is crucial in the diagnosis and treatment of those suffering with snoring or OSA. S4S pride themselves on offering a comprehensive service that allows GDPs to get the training required to treat their patients. 

Presented by Professor Ama Johal, one of the leading clinicians in sleep related breathing disorders, Snoring: A Role for the GDP stresses the part the dentist has to play and covers: sleep related breathing disorders, clinical reviews of MAS devices, skills required to prescribe MAS devices, and more. Find more information at here.