Author: Michael Kelley
Transportation Industry Regulators Are Looking for Solutions: A Conversation with Marty Russo
As a member of Congress, Marty Russo (D-Ill) served the land of Lincoln from 1975 to 1993. These days, the CEO of Russo Capitol Strategies is a sought after speaker on a variety of issues, including the regulatory issues surrounding sleep medicine. The American Sleep & Breathing Academy sat down with Russo to get his opinions on a variety of sleep medicine topics, particularly the level of sleep apnea awareness among transportation professionals. ASBA: How aware of sleep apnea are transportation industry officials these days? Marty Russo: I think they’ve come a long way. They are more aware today than they were two years or five years ago. The National Transportation Safety Board in their 2016 report said one of the top priorities is to reduce accidents related to operator fatigue. Operator fatigue can happen from many different factors, but one of the biggest is untreated sleep apnea. They are much more aware today than they ever were. ASBA: Among transportation industry officials what is the biggest misconception about sleep apnea and treatment? Russo: I think they are aware that untreated sleep apnea is very dangerous, but transportation officials and patients are not always aware of the latest technology in treatment. Some patients respond better to CPAP, and others do better with oral appliance therapy. They both should be available. Both treatments are well documented as being affective when used. They key is when used. Oral appliance therapy has newer technology, and sometimes the latest advancements are not well known. Compliance is the critical question. Whatever you can do to make it compliant is what we should do. ASBA: What is your opinion of the current proposal to issue a regulation (Federal Motor Carrier Safety Administration – 2014-0419)? Russo: Before the final draft, regulators are getting input. When I speak to audiences, one thing I say is, you need to be part of the solution, not part of the problem. You need to share expertise on the latest treatment methods. ASBA: How important is the comment period which has now been extended to July 8? Russo: What you’re seeing now, as a result of this comment period, is that a lot of the dental sleep experts are now responding and participating—which is important because they have a lot to offer, and not everybody knows as much as they do on this issue. When the government begins to legislate or regulate an industry, they don’t have all the answers, and that’s why they put these comment periods out there so they can hear from experts. It’s critical that we have these experts commenting on those proposals. ASBA: What do you say to people who say, ‘Oh they don’t read those comments’? Russo: That’s a cop out. People do read them. It’s a public record. They need to respond to that. If they try to do this without public comment, and the public gets up in arms, then the public goes to the legislator and explains we’ve been shut out. They’re making decisions without our input. Now they’re getting input, and if they don’t pay attention, you can go back to your congressman and say, ‘Look, they’ve got all this information, and they still aren’t doing anything right.’ In this county, you have the right to petition your government to redress grievances. It’s the first amendment. ASBA: How much sleep-related regulation do you believe is needed, particularly in the transportation realm? Russo: You’ve got people dying on the streets because of sleep fatigue. The biggest problem is untreated sleep apnea, so it’s really important we do something to make sure it doesn’t happen in the future. I’m not somebody who believes in overregulation, but I don’t believe in no regulation. You have to balance the needs of both the operators and the trucking industry. But the key is safety comes first. We can’t have individuals operating trains, buses, trucks, and working in air traffic control who have untreated sleep apnea. ASBA: What specifically do you want to see? Russo: We need to have clear standards for screening, identifying, and treating sleep apnea. We need to be consistent to be able to track compliance. This idea that you can use CPAP for four hours, and then you’re ok, well what happens the other four hours? If someone is going to sleep, and they have sleep apnea, whether it’s with an oral appliance or CPAP, they must use it the whole time they’re asleep—not just for four hours. That is a stupid regulation. The regulation can’t be so onerous that it causes a huge burden on trucking firms and truckers, so you have to balance everyone’s needs. ASBA: What’s your main motivation in taking on this issue? Russo: The number one key in everything we do is safety—protecting the public. That’s the job of the government. One of the best ways to make sure this gets done is that everybody needs to be at the table; that means regulators, medical and dental professionals, industry reps, and actual people who operate trucks, railways, and buses. Some comments show that truckers are saying that they know their fellow truckers are not doing what they are supposed to do. ASBA: What are your hopes for the proposed regulation? Russo: I just hope the regulators listen to the public and the experts. The problems we’re facing as a result of untreated sleep apnea are well documented. It needs to be a level playing field. Which modality will the patient actually use? What is in the best interest of the patient? I think the difference this time is that all the oral appliance people have spoken up. They have not kept quiet. ASBA: How are industry organizations doing in the fight to highlight dental sleep medicine? Russo: Big credit goes to the American Sleep & Breathing Academy. They’re the impetus behind all these comments on the dental side of sleep. This is the first time they have actually participated, and they have done a good job. Their voices are going to be heard.
Attention Dentists-David Gergen In First National Live Webinar Speaks on Working With NFL
Imagine being the talk of every dentist in your area…when they look at your practice, they will all wish they were you. That’s exactly what happens when you have a unique competitive advantage-something that can’t be duplicated, replicated, or ripped off. How many times have you acquired a new piece of equipment just to discover your nearest competitor did too? Or how frustrating is it to invest time, money, and effort perfecting a new marketing technique, just do find out the dentist down the street ripped you off word for word? The problem is: tools, techniques, and marketing can all be “borrowed.” However, you can easily create a unique competitive advantage and become the envy of every other dentist. It all comes down to the type of patients you have in your chair. The most successful dentists understand they have to attract the right type of patient, because even one of the right type of patient, will lead a flood of others to your door. Register now to discover how you can create an exclusive competitive advantage that’s specifically engineered to drive patients to your door. The webinar will be today, Tuesday July 5 at 8 PM eastern. Click HERE to register So how do you create a unique competitive advantage and become the envy of every other dentist in your area? Simple: by working with professional athletes. Every single one of these athletes has one thing in common: they need a dentist who will not only help them with their oral hygiene needs, but who understands how to treat sleep apnea. You see, contrary to popular belief, athletes are more prone to suffer from sleep apnea –and yet, like the general public, sleep apnea is diagnosed and treated less than 2% of the time. In fact, untreated sleep apnea caused the premature death of NFL legend Reggie White and NBA superstar Moses Malone. All this has led to David Gergen and Pro Player Health Alliance to create a new division called Dentists and Athletes Unite for Sleep (DAUS). David Gergen is considered a pro in his own industry…working with/helping NFL and NBA legends Marcus Allen, Eric Dickerson, Roy Green, Derek Kennard, Tony Dorsett, Charles Barkley and hundreds more with sleep apnea needs. As a result of a combined effort by the Pro Player Health Alliance team, Dr. Mark Castle and Arrowhead Pro Sleep, 3,000 people attended the Pro Player Health Alliance Sleep Apnea Awareness EventJanuary 26, 2016. As a member of the DAUS, an event of this caliber is available to you. DAUS is creating additional awareness with professional athletes to ensure they get the treatment they need; this means there is massive opportunity for you and your practice, but you must act quickly… Of the “ideal” markets across the US (where there is a high concentration of active and retired professional athletes) there are fewer than 35 markets still available. One of these athletes can be the source of dozens of new patients (because, as we all know, “We want to be like Mike.”) But we’re not talking about just one athlete, we are talking about dozens coming to your practice and, in turn, helping you help others. That is how you become the top of the town and how you become the envy of every dentist out there. That is what we will talking about in this upcoming webinar. Today, Tuesday July 5 at 8 PM eastern. Click HERE to register Register now to be part of this exclusive opportunity. Will you be the one dentist that everybody wants to be, or will you be stuck trying to compete against that dentist? The marketing and publicity you will receive from just one athlete in your practice is PRICELESS. Imagine your practice when dozens of these athletes make their way to your office for treatment. Sign up now to participate in this week’s webinar and discover the secret of using a celebrity in your practice; something only the American Sleep and Breathing Academy can offer you. Today, Tuesday July 5 at 8 PM eastern. Click HERE to register
Regulators and Congress to Review Oral Appliance Therapy as Benchmark for Mild to Moderate OSA and Tackle Transportation Industry!
Whether it’s the slow degradation of bodily organs over many years, or a train conductor falling asleep at the switch, sleep apnea causes more than its fair share of human misery. Regulators charged with overseeing the transportation industry are paying attention to the problem as evidenced by a current proposal to issue a regulation (Federal Motor Carrier Safety Administration – 2014-0419). The proposal could result in a regulation that would significantly influence screening, diagnosing, treating, and tracking compliance for OSA in highway and rail professionals. Regulators want solutions, and oral appliances are increasingly part of the conversation. The comment period for FMCSA-2014-0419 has been extended to July 8, and dental professionals are encouraged to make the case for oral appliances by clicking here and adding their comments (546 comments have been added to date). For those who make their living in sleep medicine, the time is ripe for opportunity. Consider that earlier this year, Gov. Andrew M. Cuomo of New York declared that conductors and engineers with two commuter railroads must be tested for sleep apnea. The move came two and a half years after a deadly derailment in the Bronx that killed four and injured dozens. The conductor was found to have “severe sleep apnea.” According to an article in the New York Times, “Mr. Cuomo, a Democrat, said the testing would be required for employees of the Long Island Rail Road and the Metro-North Railroad. What starts in New York rarely stays there, and former Congressman Marty Russo, along with the American Sleep & Breathing Academy (ASBA), is advising dental sleep professionals to continue the momentum and make their voices heard in the comment phase of the FMCSA regulatory proposal. “The National Transportation Safety Board, in their 2016 report, said one of the top priorities is to reduce accidents related to operator fatigue,” says Russo, a U.S. Representative (D-Ill) from 1975-1993, now CEO of Russo Capitol Strategies. “Operator fatigue can happen from many different factors, but one of the biggest is untreated sleep apnea. They are much more aware today than they ever were.” CPAP is generally more well known among members of the general public, and Russo suspects much the same can be said about transportation officials who are not always aware of the latest technology in treatment. “Some patients respond better to CPAP, and others do better with oral appliance therapy,” he says. “They should both be available. Oral appliance therapy has newer technology, and sometimes the latest advancements are not well known. Compliance is the critical question. Whatever you can do to make patients compliant is what we should do.” Congressional Hearing on Sept 27 Dr. Elliott Alpher, on staff at George Washington University Hospital, is heading up a team to represent the dental sleep medicine community during a special presentation to Congress scheduled for Sept 27, 2016. “David Gergen, CEO of the ASBA selected this team,” says Alpher, who recently headed a delegation to the FMCSA and Medical Advisory Board (MAB) to introduce micro recorder compliance in oral appliances. “Dr. Neal Seltzer from Long Island, NY, will be part of the team and presenting on the evolution of oral devices, specifically talking about the Herbst appliance, and why the government chose it as the go-to mechanism for treating OSA.” After Gergen, Seltzer, and additional clinicians give testimony about the power of treating sleep apnea with oral appliances, the panel will get a dose of star power when NFL greats take the podium. “Eric Dickerson, Marcus Allen, Roy Green, and others will give personal experiences of being treated for sleep apnea,” enthuses Alpher. “Roy Green suffered three heart attacks and two strokes, and had never been diagnosed with sleep apnea. David Gergen met Green many years ago, got him treated by Dr. Mark Castle, and he has had no issues after being treated more than six years ago with only oral appliances.” “Our objective is to make oral appliances the true benchmark for mild to moderate sleep apnea,” says Gergen. “We know big CPAP manufacturers have their lobbyists to ensure that does not happen, even though in 2006 the government said oral appliances should be a treatment option. We’re fighting every step of the way.” “David Gergen has done more for dental sleep medicine in four years than the entire industry has done in 30,” adds Seltzer. “He is turning this industry on its ear. Joining the ASBA is one way to encourage that kind of leadership, and ensure that the dental sleep community continues to progress in the right direction.”
Increase Accuaracy and Improve Your “Sleep Bite” With The Ricketts Phonetic Bite Given To You By The Man Who Worked Alongside Of Him For Years-David Gergen
Oral appliance therapy is considered an effective treatment for snoring and obstructive sleep apnea (OSA). The appliance functions by supporting the jaw in a forward position to help maintain an open upper airway. When utilized properly, it is worn at night and fits like a mouth guard used in sports. The success of the appliance, however, depends largely on the quality of the bite registration taken. While many view the process as an uncomplicated procedure, if it is not done using the correct technique with precision it could negatively impact the treatment. The late Dr. Robert Ricketts DDS, NMD who was a well-known and arguably the greatest orthodontist of all time, leader in orthodontic instruction as a professor and a noted researcher in many areas of dentistry including craniofacial growth and development, TMJ, orthodontics and esthetics invented what is known as the the Ricketts Phonetic Bite. The Ricketts Phonetic bite may be used for patients suffering from snoring or obstructive sleep apnea and it determines the position of the mandible that creates the so-called sweet spot for patients using oral appliance therapy. Instructions are as follows: The dentist should instruct the patient to sit upright in the chair. The dentist should instruct the patient to count out loud numbers 55-75. Notice numbers 5, 8, 9 for vertical opening and 66 for maximum anterior posterior positioning. If you do not get the desired AP with the “ss” sound, you can use the second “s” sound, “sh” to acquire the max AP. The “n” sound in 69 will drop their mandible vertically as well and give you their full natural opening. The “n” sound is a straight vertical drop wherever you’re at in speech; using the word “shun” is another method for obtaining the best AP position. The dentist should use a round surfaced instrument as opposed to a flat one (for anterior stabilization during the registration) between teeth #8 and #9 to hold that position of the jaw. Use a fast set bite registration material to capture the bite. You will always want to start with having the patient occlude their teeth a few times in order to make a mental image of their natural occlusion. Having the patient counting those numbers should give you a feel for the most balanced yet natural vertical opening. All three types of basic classes of anterior occlusion must open to disclude the posterior teeth in order to allow a person to speak, and when “ss” sounds must be made, at least 1 to 1.5 mm of clearance must be developed between the upper and lower central incisors. Note that saying “s” will not be sufficient; you will actually have to force the sound to occur using it in a word, as seen during the count in numbers that contain the “ss” sound or like with the word “Mississippi”. The amount of disclusion depends on the degree of forward movement of the teeth from centric relation to their “ss” position. These movements define the incisal guide angle and represent vertical and horizontal overlaps of the teeth. Thus, the greater the forward movement, the greater the amount of posterior disclusion and the resultant “s” space – or posterior speaking space as found in the number “66” and word “Mississippi”. Once again, repeat these steps a few times to make sure you get the same results. It is important to capture the optimum vertical as it is much harder to adjust after the appliance is fabricated. After using this technique, utilize the Airway Metric System by placing the correct jigs correlating with the sleep bite for reference. Lean the patient back in the chair and see if they can snore. If they cannot, ball game over. I specifically instruct doctors to only use the Ricketts Phonetic Bite with NFL players because of the accuracy and rate of success. For example, Super Bowl Champion Derek Kennard’s AHI went from a 72 to 2 on the first try using this technique. This is demonstrated and practiced at the American Sleep and Breathing Academy annual meeting and study clubs in a workshop setting. Visit americansleepandbreathingacademy.com to learn more.
Gain The Upperhand-More Political Influence For ASBA Members
There is no doubt that the Presidential election has been at the forefront of political news this year. The latest on the subject mentioned by multiple media outlets surrounds the possibility of Former Arizona Governor Jan Brewer joining Donald Trump’s national ticket as the vice-presidential pick. So where is the connection to members of the American Sleep and Breathing Academy (ASBA)? David Gergen, Executive Director of the ASBA, has remained close friends with Jan Brewer and the family for decades including the duration of her six year service to Arizona. This adds to the already vast reach the ASBA has in the political world and provides an additional valuable connection for ASBA members and their PAC. In January this year, Gergen hosted the largest public sleep apnea awareness event in the Country which attracted not only over 3,000 attendees, but future NFL Hall of Fame Larry Fitzgerald, Phoenix Police Department Chief of Police and Gergen’s school friend Arizona Attorney General Mark Brnovich. Subsequently, Mr. Brnovich was treated for obstructive sleep apnea (OSA) by ASBA Diplomate Dr. Castle at Koala Sleep Center of Arrowhead. The ASBA has long held strong footing associated with congress and the US Department of Transportation. This has clearly been shown by current involvement in the process of establishing protocol for the transportation industry to be treated exclusively by ASBA members; David Gergen commissioned Dr. Elliott Alpher, ASBA Diplomate, earlier this year to launch an initiative in collaboration with Congresswoman Anna G. Eshoo to make oral appliance therapy the benchmark treatment for OSA. As a result, a special committee of ASBA Diplomates and other powerful figures such as NFL greats Roy Green, Eric Dickerson, Marcus Allen, Congressman Marty Russo, Congressman Jim McGovern, Congresswoman Anna Eshoo, and Ex-Senator Chris Dodd will be sent back to Washington to speak to the Senate on September 27, 2016. Dr. Elliott Alpher says, “The ASBA is the only academy fighting for the dentists’ rights in the sleep apnea arena and the efforts will become stronger as the American Sleep and Breathing Academy grows. The more members we have the more firepower we’ll have. I am so pleased that I have joined this academy because this is the only academy making a huge difference in my humble opinion. We are so blessed to have so many congressmen and congresswomen as well as NFL legends backing us.” When considering the political/NFL ties the American Sleep and Breathing Academy holds, value in being a member and advantages over non-members certainly become apparent. Learn more about becoming a member/diplomate of the ASBA at Americansleepandbreathingacademy.com or call 602-478-9713
The ASBA Feeds 40 New Patients To Its Members in Under a Month!
At the recent Dental Sleep meeting in Denver, there extra buzz among attendees. Apart from discussions about the conference program, the other topic of conversation was the American Sleep and Breathing Academy “ASBA” and how quite a considerable number of Doctors were also joining this organization. This is very positive, as there is room for another strong group that expands the field of dental sleep medicine and practice management for its members. So why the interest in the ASBA? The answer is quite simple. The ASBA is the only Academy that works tirelessly for its members, both individually and collectively. With a full week still left in June, this month alone, the ASBA has placed 40 new patients with Academy Doctors. In addition to feeding patients directly to our members, the backing of former and current NFL and NBA stars such as Marcus Allen Eric Dickerson, Chuck Foreman and Roy Green, is a marketing gold mine that is exclusive to the American Sleep and Breathing Academy membership. In addition, the ASBA promotes non vendor education as another way to advance the profession and push for oral appliance therapy as the benchmark treatment for Obstructive Sleep Apnea (OSA). ASBA membership affords you the ability, through online and in person course options, to receive the newest information in treatment, billing and case studies from the most successful dentists treating OSA in the nation. In addition, the moment you become a member you will receive constant updates regarding state/federal guidelines and reimbursement information. This is just one more way that the ASBA is giving our doctors a leg up on non-members. If you thought that wasn’t enough, congressmen/congresswomen and special committees formed by the ASBA are fighting politically for dentists as a whole. In an industry where CPAP is vastly over prescribed and reimbursement for it is plummeting, one of the most important goals of the Academy is to catapult oral appliance therapy into the go to treatment for OSA. On September 27th, key members of the American Sleep and Breathing Academy, along with NFL icons Roy Green, Eric Dickerson, Marcus Allen, Congressmen Marty Russo, Congressmen Jim McGovern, Congresswoman Anna Eshoo, and Senator Chris Dodd will be in front of a special congressional committee to discuss just that. Aside from aggressively fighting for your rights as a dentist in the sleep medicine space, from a marketing standpoint, the ASBA is unrivaled. The Academy magazine, Sleep and Wellness, features articles on ASBA members every issue and distribution in over 100,000 medical and non-medical offices gives our members a reach that they could not obtain on their own. Now is your time. Do not be left behind while the American Sleep and Breathing Academy and its members continue to revolutionize dental sleep medicine. Join us and let us fight for you! https://asba.net/membership-3/
Join Us In Dallas For The Most Turn-key Intro. To Sleep 101 Course In The Country Through The American Sleep And Breathing Academy
Many dentists start out on an arduous road with road blocks everywhere in dental sleep medicine. It doesn’t have to be like that. When you sign up for vendor sponsored courses they try to sell you products which are often old, obsolete and not beneficial at all to the success of the practice. How many of you have purchased vendor equipment that is sitting in your office which you have never even taken out of the box? We’ve all been there. This is why the ASBA does not allow vendor sponsored training at the intro to sleep courses. ASBA mentors are the top dentists in the country in treating sleep and have experienced all of the pot holes and road blocks so you don’t have to. The next Intro to Sleep 101 course will be a two day event held in Dallas, TX on August 19-20. While all doctors and their staff members will benefit from the information provided, the agenda is going to focus on getting to the basics. It will be an in depth course on introduction to dental sleep medicine for anyone interested in treating OSA in their practice and also for the doctor who has a number of cases under their belt, but has trouble getting paid or successful results. David Gergen, Executive Director of the ASBA and dental icon, designed the course to be taught by dentists who have formed their own business models for success. Gergen spearheaded the largest sleep apnea awareness event in the world which attracted 3,000 attendees in January 2016. After the event, Dr. Neal Seltzer of Long Island, NY stated, “David Gergen has done more for dental sleep medicine in the last four years than the entire industry has done in the last 30 combined.” Through the last four years, Gergen has brought NFL legends to the ASBA team that have become advocates to not only dental sleep medicine, but to the members of the academy as well. ASBA members have partnered with Pro Player Health Alliance and NFL stars such as Eric Dickerson, Tony Dorsett, Michael Irvin, Roy Green, Ed Too Tall Jones and Derek Kennard. It is almost certain that Gergen will be bringing iconic Cowboys to this event for autographs, pictures and possible marketing opportunities. The keynote speaker will be Dr. Rod Willey, Diplomate of the ASBA and the largest standalone dental sleep practice in the country with over 60 cases/month and holds the record for 106 successfully treated cases in a single month. As a master of navigating the medical world, he will be teaching you techniques that will put you in network with insurance companies so you can spend your time and energy giving your patients a better quality of life instead of losing it on back end work. Dr. Stacey Layman- also a Diplomate of the ASBA- a proven winner in dental sleep medicine practicing in the beautiful Arrowhead Lakes Community of Arizona and Owner of Go Go Billing, will enlighten guests on the secrets to billing in office for oral appliance therapy. Additional speakers will spotlight staff training, things they wish they knew before treating sleep apnea and how to be more involved in the community. This course will give you an easy-to-follow cook book for success in dental sleep medicine. Don’t let the amateurs teach you bad techniques. Learn from the experts who have years and thousands of cases behind them. Not only will you receive a wealth of information, attendees will be granted 16 CES and a membership with the ASBA. Sign up for Intro to Sleep 101 to receive instant access to the ASBA’s vast library of sleep articles, journals and papers. In addition, You will also receive Breathless, the official weekly newsletter of the ASBA. To learn more about the American Sleep and Breathing Academy go to: Americansleepandbreathingacademy.com Event Details Date: August 19-20, 2016 Location: Cooper Hotel and Conference Center 12230 Preston Road Dallas, TX 75230 Any questions please call 602-478-9713 or direct them via email to info@myasba.com Americansleepandbreathingacademy.com
What Does Your Academy Do For You? ASBA Working With Congress, NFL/NBA Players, Transportation For Higher Reimbursements And Policy Changes To Make OAT Benchmark Therapy For OSA
There was a time when snoring was considered annoying for bed partners or “funny” to listen to. Unfortunately, the “normal” sound of snoring has been found to be a general indicator of a possible abnormal condition known as obstructive sleep apnea (OSA). To-date, the only process used to diagnose OSA is to undergo an overnight study in a sleep lab or via a home sleep test (HST). Sadly, sleep labs have proven to be costly for the patient and the health care system. With the sleep medicine industry growing exponentially, an alternative must be adopted. According to a publication by the Office of the Inspector General, Medicare payments for sleep testing increased from $62 million in 2001 to $235 million in 2009. In addition, patients find that they need to take time off of work, sleep labs are booked full for up to a month and the environment makes for an uncomfortable night’s sleep. According to the Mayo Clinic, “These tests usually involve measuring your heart rate, blood oxygen level, airflow and breathing patterns. If you have sleep apnea, the test results will show drops in your oxygen level during apneas and subsequent rises with awakenings.” In most cases the test can also show the body’s positioning patterns during the night as well as a snoring index and time spent in different levels of sleep in the form of a visual timeline. The American Academy of Sleep Medicine (AASM) gives approval of HSTs when the patient has a high risk of having moderate-severe sleep apnea, no other diagnosed sleep disorders, is 18-65 years of age and has no other major medical issues. The American Sleep and Breathing Academy (ASBA) fully supports the utilization of home sleep tests as well when medically indicated and within the guidelines set by the state and AASM. It is important to know that as a dentist treating sleep disorders, it is imperative that you understand your state’s Dental Practice Act. Dr. Paul Van Walleghem DDS, FAGD, says, “If your state says a dentist is allowed to screen or titrate with an HST and your referring physician is in agreement, then you should be within the standard of care. If it is written in your Dental Practice Act that it is not allowed, then it is not allowed.” Home sleep studies are also becoming increasingly popular in the industry due to insurance companies’ efforts, reports showing rising effectiveness, cost and patient satisfaction. The average HST cost is $400 as opposed to an in-lab study that can see upwards of $1200. The majority of people affected by sleep apnea would also prefer to sleep at home in their own bed because of advantages such as accessibility, affordability and convenience. After attending the most recent AADSM annual meeting, many attendees felt that use of HST by dentists for screening or titration was discouraged because they “do not want to be involved politically”. Instead, the American Sleep and Breathing Academy feels that we need to be involved politically if we want to make changes and ultimately be able to offer more treatment opportunities for the millions of people suffering from sleep apnea in this country. That is why the ASBA is has received the support of current and former congressmen/congresswomen, NFL players, NBA players and transportation employees.