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Apnea/hypopnea is often overlooked in the pain patientmedical work up. Unless apnea or hypopnea are diagnosed by
proper screening and subsequently properly managed by an experienced practitioner, the medical outcome of the pain
patient will often be unfavorable. This is the reason that many health care professionals commonly encounter patients that are
refractory to excellent pain management protocols. Certain pain disorders such as myofascial pain and migraine, and a host
of other debilitating diseases are comorbidities of an unmanaged or undiagnosed sleep disorder. When managing a patient
presented for pain, sleep disorder has to be considered as potential contributing factor. Appropriate testing for sleep disorders
should be instituted as part of the medical evaluation for the majority, if not all patients in chronic pain.
I would like to present the topic in three parts:
1. Brief overview of apnea/hypopnea conditions, screening tests available as well as acquired expertise in the interpretation
of such results.
2. Clinical cases demonstrating a successful management of complex pain patients and how management of sleep disorders
contributed to the favorable outcome.
3. The cutting edge options that have a high percentage of patient tolerability and compliance. CPAP isn?t always effective as
it has a low rate of patient compliance anda significant percentage of patients cease using these devices due to intolerability
What I hope to make clear - what questions to ask and how to determine whether sleep is a contributing factor in painful
condition/s.
How to understand the results of the sleep study?
How to manage the patient with positive sleep study results?
I hope to demonstrate how important it is not to miss the existing sleep disorder and how managing such disorder will make
a huge difference in managing a pain patient.
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