Sleep medicine is a medical specialty or subspecialty devoted to the diagnosis, therapy and education of sleep related disorders and disturbances. Since the middle of the 20th century, increasing research has provided advanced knowledge of many sleep related disorders present in patients today. The first sleep labs in the United States were established in the 1970s by interested physicians and respiratory therapists; the study, diagnosis and treatment of obstructive sleep apnea (OSA) were the earliest discoveries in the early days of sleep medicine.
As knowledge and technology continue to growth and developed through the 1980’s and 1990’s, the diagnosis and testing of sleep disordered breathing became much more of a specialized field and require a more specific set of knowledge skills and attributes.
Positive airway pressure (PAP) machines and oral appliances are most often utilized to manage sleep-related breathing disorders such as apnea. In some cases, upper airway surgery is indicated. In mild cases in obese people, weight reduction may be sufficient in addition to PAP devices. The PAP treatments minimize airway collapse, which interrupts breathing during sleep. It has been reported that an average of 36% of patients experienced fewer apnea episodes after successfully completing the treatments. Adherence to PAP devices and oral appliances are the key to successful management and treatment.
Clinician’s Guide to PAP Adherence
The AARC and its members have long recognized that patient adherence for management of sleep-disordered breathing is at an unacceptable level—about 50% discontinue positive airway pressure therapy within the first year. The AARC has developed the following guide to train clinicians how to communicate with sleep patients, identify reasons why adherence is poor, and intercede with interventions that may improve compliance.