Like it or not, change has come to the way obstructive sleep apnea is diagnosed and treated. Out-of-center testing and the use of autoPAP are likely to impact significantly the number and type of allied health professionals needed in a changing industry.
Couple this challenging situation with a "new" interest in the value of sleep and how it contributes to a healthy life, plus the movement towards the patient-centered medical home model of primary care, and there is new opportunity for sleep techs and other allied health professionals.
Enter the Clinical Sleep Educator (CSE), a new allied health professional credential currently in development.
Many sleep medicine practices, particularly those based in hospitals, have someone providing sleep education services. However, a properly trained allied health professional could be deployed differently and have a significant impact on patients in other healthcare settings.
For instance, a possible role for the CSE might be to serve as a sleep resource for primary care physicians and their patients. In many primary care practices, the physician does not have the time to delve deeply into all issues confronting their patients and, frequently, sleep issues require time to discuss.
The CSE could administer screening tests like the Epworth Sleepiness Scale or the STOP-BANG questionnaire and assist patients and the physician to understand test results and discuss options for addressing sleep problems. After a diagnosis of sleep apnea, the CSE also could provide educational material to help patients modify behavior in order to improve sleep hygiene.
Recognizing that diagnosis and treatment of those at higher risk of sleep apnea does not always require in-lab polysomnography (perhaps as many as 80 percent of cases), the CSE can coordinate testing and, in cases where PSG is necessary, recommend it to the physician.
Once a patient is identified as having a sleep disorder like sleep apnea, perhaps the most important role the CSE can play is to provide support and continuing education to help ensure adherence with therapy. In a practice where there are a number of patients with sleep disorders, the CSE could even coordinate a support group.
Recognition that healthy sleep is the third leg of the stool of a healthy life, along with healthy diet and sufficient exercise, makes the Clinical Sleep Educator a logical member of the primary health care team. This allied health professional could extend the physician's services into an area that previously has been underserved.
Beyond the physician's office, the CSE can be a resource to the community by working with schools and community organizations to provide sleep education and promote good sleep hygiene.
Sleep technologists and respiratory therapists who work with positive airway pressure therapy are naturals for the Clinical Sleep Educator position. Nurses and physician assistants with the proper supplemental training can be successful in this role as well.
Whether by evolution or revolution, changes in sleep medicine and general healthcare are providing new opportunities for allied health professionals interested in sleep health to take a lead role in helping Americans get a better night's sleep-either through improved sleep hygiene or diagnosing/treating the sleep disorders.
Ed Grandi is executive director of the American Sleep Apnea Association, www.sleepapnea.org.
CSE Certificate Program
The Board of Registered Polysomnographic Technologists (BRPT) will offer a Clinical Sleep Educator Certificate Program at the BRPT Symposium in Reno, Nev. on September 20. For more information: www.brpt.org.
The Clinical Sleep Educator:
• Has knowledge of diagnosis and management of sleep disorders, with a focus on obstructive sleep apnea syndrome;
• Understands communication techniques for teaching and the principles of learning to enhance education for patients, families, and the community;
• Understands what to look for and how to analyze the results of the various tests and tools used to diagnosis, evaluate, and monitor sleep disorders;
• Knows how to assess patient compliance and comfort with treatment to improve clinical outcomes;
• Knows when and how to communicate effectively with physicians and other health care professionals to report new or continued symptoms, persistent treatment issues, or barriers to optimal care and management;
• Serves as a resource to the community and other health care providers by promoting education on sleep disorders, treatment, follow up and outcomes, as well as good sleep hygiene.