  |
|
|
|
How to Find Diagnosis and Treatment for Apnea?© Kerrin Leon White
This question comes so often in my e-mail that I decided to write an article for people who need to find a sleep specialist or sleep center near where they live. I will also go a bit further, and try to give helpful suggestions about how to find a "good" sleep doctor.
The first step is simple: Go to the web site of the American Board of Sleep Medicine at http://www.absm.org. Scroll down the left frame to click on the button labeled "ABSM Diplomates." This will take you to a page where you should choose to have the doctors listed by state. Then, select the alphabetical range of states which includes your own. You will see a list, usually a long one, of doctors in your state who are board certified in sleep medicine. You will also find the city or town where each practices. Also you will see the specialty in which the doctor trained prior to certification in sleep medicine. Note: All physicians who seek training for board certification in sleep medicine must have previously completed specialty training in some other area of medicine. Most often this is pulmonology (internal medicine specializing in the respiratory system or lungs). These are probably the best type for people with sleep apnea. Other sleep specialists may have had their prior training in neurology, psychiatry, or otolaryngology (ENT surgery). If you go first to a physician with prior specialty training in surgery, be aware that you may find yourself encouraged towards surgery as a treatment of first choice--or at least, discouraged about your chances of adjusting well to CPAP, which is the generally accepted treatment of first choice. Personally, I would reserve consulting a surgical sleep specialist until after a non-surgical sleep specialist has recommended surgery as a reasonable next step. Even then, be aware that many ENT surgeons will know only one or a few common procedures--such as the UPPP--which are not the most effective. The most effective surgical procedure so far developed for sleep apnea appear to be the bilateral maxillomandibular osteotomy and advancement procedure developed at Stanford and available at a few other advanced centers only. However, this is a major undertaking, financially as well as surgically, and should be put off until a thoroughgoing trial of CPAP has really proven truly intolerable or, more rarely, ineffective Many people who write me want to know more than just the name and telephone number of a sleep specialist within driving distance. They want to know how to find the best sleep specialist or clinic within that area. This is very difficult for me to answer. |
|
|
|
