Can and should Dentists carry out home sleep testing?



It’s actually super easy and I have been doing it for 18 months!



What happens after you screen them—do you know what to do next? This episode will teach you!



Dr. Jaz Gulati shares his personal journey into incorporating sleep testing in practice—after 1.5 years of doing it, the impact has been nothing short of game-changing.




https://youtu.be/H4rTkIuOHWI
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Joined by clinical sleep scientist Max Thomas in this jam-packed episode, they deep dive into what it really means to go beyond awareness of sleep-disordered breathing. He breaks down the practical steps for dentists who want to do more than just refer—and start making a difference in their patients’ lives.



You’ll learn how to bridge the gap between theory and action, how to screen effectively, and why you play a pivotal role in the patient’s journey to better sleep, more energy, and a healthier life.



Protrusive Dental Pearl: If a patient has been seen gasping, choking, or stopping breathing during sleep — that’s pathognomonic for sleep-disordered breathing.



🛑 Don’t ignore it — they likely need a sleep study. Ask this in every history!



Need to Read it? Check out the Full Episode Transcript below!



Key Takeaways:




Understanding obstructive sleep apnea is crucial for dentists.



Dentists are in a unique position to screen for sleep disorders.



The Malampati score is an easy tool for assessing airway obstruction.



Sleep disorder breathing can significantly affect quality of life.



Patient history is vital in diagnosing sleep apnea.



Quality of sleep is more important than quantity.



Dentists should ask specific questions to identify sleep issues. Sleep position can significantly affect sleep quality.



Screening tools like Stop Bang and Epworth are essential for identifying sleep disorders.



NHS sleep testing can vary greatly in wait times depending on location.



Snoring is often a precursor to more serious sleep disorders.



Dentists can play a crucial role in sleep disorder management.



CPAP is the gold standard for treating sleep apnea.



Understanding the legalities of sleep screening is vital for dental professionals. Remote monitoring became essential during COVID-19, shifting paradigms in sleep medicine..



Remote monitoring helps ensure patients are truthful about their usage of devices.



Mandibular advancement devices may be more effective for certain patient profiles.



Patient compliance is crucial, with many struggling to adapt to CPAP.




Highlights of this episode:




00:00 Teaser



01:15 Intro



04:51  Protrusive Dental Pearl



05:52 Introducing the Expert: Max Thomas



09:39 Importance of Screening and Diagnosis



13:41 “Crowding” at the Back of the Mouth



14:46 Mallampati Score



18:54 Understanding Sleep-Disordered Breathing



25:35 Screening Tools and Techniques



32:09 Screening Questionnaires



37:24 Midroll



40:44 Screening Questionnaires



40:53 Athlete Sleep Screening and Marginal Gains



44: 20 Identifying Patients for Sleep Testing



46:15 Snoring: Risk Factor for OSA



51:44 Mandibular Advancement Devices and Legalities



55:33 Diagnostic and Treatment Options



56:57 CPAP: The Gold Standard for Sleep Apnea



01:08:33 Retesting Before MAD



01:14:41 Dentists Warning about DVLA Implications



01:17:18 Final Thoughts and Recommendations



01:19:19 Outro




Resources for Screening Sleep Apnea




S4S Pre-Screening Questionnaire



Mallampati Score



Epworth Sleepiness Scale



STOP BANG Questionnaire




Screening Tools




The Acupebble Device 



WatchPAT as an alternative



Send your sleep test for reporting to Max Thomas - excellent service and affordable



Max Thomas’ LinkedIn




If you loved this episode, don’t miss Sleep Disordered Breathing and Dentistry – PDP139



#PDPMainEpisodes



This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. 



This episode meets GDC Outcomes A, C, and D.



AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Sleep Medicine)



Aim: This episode is aimed at empowering general dentists with the knowledge and practical steps to actively participate in the screening and co-management of sleep-disordered breathing through the integration of home sleep testing in their clinical practice.



Dentists will be able to -




Understand the role of general dentists in identifying signs and symptoms of sleep-disordered breathing, particularly obstructive sleep apnea (OSA).



Identify when and how to refer appropriately to sleep physicians or medical specialists after screening.



Explore collaborative workflows between dentists, sleep scientists, and GPs to ensure effective patient management.








Click below for full episode transcript:



Teaser: When you think about the number they have per hour, less than five is normal, right? Less than five of these breath holds is normal. Between five and 15 is your mild category. 15 to 30 is moderate, and above 30 is severe. You see patients that have what we call an AHI Apnea-Hypopnea Index of 60, and sometimes these breath holds can be 30 seconds.



Teaser:You end up looking at these studies and there's actually more time spent not breathing than there is breathing. In some areas, you are six weeks away from a test because they're not only on top of their list, but their numbers are lower. In other areas, you've got high population density and low service output.



So you know, I have seen sleep departments that have got 60 week wait list just for the initial diagnostic tests. You already got the suspicion that they have obstructive sleep apnea. They're already telling you that they're struggling, and then they're told to-



Sleep apnea is one of those things that a patient may need to report and they may need to report it in the case where they have moderate or severe obstructive sleep apnea with sleepiness.



And it's really important that with sleepiness part is the main focus of the DVLA guidance. 'cause the sleepiness is the symptom that affects safety on the road. If the patient has sleep apnea, but they don't wake up frequently from their breath holds, they don't have the interruption to sleep, they don't have the reduced cognitive function in the day. That sleepiness is what? This is all contingent on. 



Jaz's Introduction:Protruserati, I think this is one of the most profound episodes we've done to date. You see, the problem is that everyone's telling us that sleep apnea is this huge thing and that as dentists we ought to know about it. And there's plenty of podcasts now out there. Plenty of content out there, plenty of courses out there that are kind of filling that gap of knowledge.



The issue is we're still hungry. I'll tell you what we're hungry for. We're hungry for the following. Okay, so now you know what sleep apnea is. Now you've asked your patient, you've done some screening questions to your patient, but then what?



What happens then? Because if you're not already actively in this space and you kind of refer and you lose that patient forever, what if you as a dentist want to do the sleep test? That's what I do. I've incorporated sleep testing into my clinic for about 15 months now and it's amazing the results we come back.



Now, I just wanna start by saying that we as dentists, we cannot diagnose sleep disorder breathing. Okay, let me repeat. We as dentists cannot diagnose sleep disorder breathing, but we can screen and we play a pivotal role in its management. So what this episode will do is we'll bridge that gap between actually knowing about sleep apnea and actually doing something about it as a dentist.



And that is only achieved by those who are testing in their clinic. And let me tell you, it's not mega expensive. It can be very convenient for your patients. And hey, even if you don't start testing yourself, you ought to find someone near you or a center near you that can get your patient tested for sleep disorder breathing, such as obstructive sleep apnea.



And correctly reported so that you can genuinely help your patients, help them live a healthier life with more energy, less dozing off during the day 'cause of sleepiness, better quality of sleep for them and their partners, and adding quality life to their years.



Hello Protruserati. I'm Jaz Gulati and welcome back to your favorite dental podcast. If you're new to the podcast, welcome, you picked a great one, and of course, if you're a returner, thank you so much. Really means a lot. Your time is important to me, so I'm gonna make sure we absolutely smash it in this episode.



This episode is a bit longer than usual, but let me tell you, it is full of gold, full of protrusive pearls when it comes to sleep apnea and actually doing something about it as a GDP being proactive, rather than just screening and then leaving it there and doing a big tick. Like, oh yeah, I've screened, I've done my job, actually helping your patients get the correct treatment.



And the person who's helping me today is a clinical sleep scientist. His name's Max Thomas, and he's such a knowledgeable guy and he explains things really well. The funny thing about this episode is we're talking about sleep here, right? And I was recording this like 10:00 PM after my evening shift at clinic, and Max said this just come from Japan, suffering the most major jet lag ever.



Yet, I still think we've created a piece of art, which I hope you will love and you may wish to listen to again as a reference. But most importantly, I think this is the one where the penny drops and things actually make sense in terms of how you can play a role to help and serve your patients. Let me tell you, the done for you notes of this episode are absolutely brilliant.



You're gonna absolutely love them because our premium notes,