Still Misunderstood – View from a Sleep Navigator

The job title of “Sleep Navigator” is still relatively new within the world of sleep medicine. Exact duties are still evolving depending on the specific needs of hospital departments, but newly anointed navigators are involved in all aspects of sleep-related care. Even in 2020, that includes occasional dealings with physicians who just don’t “get it.”

Ken Hooks, sleep navigator at the Bonsecour St. Francis hospital system in Greenville, S.C. has seen the lack of understanding among rank-and-file physicians. “Sleep medicine is still misunderstood, and I believe that’s because it’s relatively new,” Hooks says. “Many physicians do not have that training and do not wish to go that deeply into sleep.” 

In short, there is still not much attention afforded the field of sleep health, with the notable exception of sleep physicians. “Among many dentists, orthodontists, speech language pathologists, and myofunctional therapists, sleep medicine is huge,” says the 38-year-old Hooks. “There is an evolution of sleep that is happening right now, but much of the medical profession is not fully appreciating it.”

When it comes to rank-and-file physicians, Hooks does not mince words, contending that, “Too many physicians want to get as many patients in and out as they can, and to medicate them for instant gratification.” On the other hand, dentists, orthodontists, speech language pathologists, and myofunctional therapists “are in the mouth and they can see a small airway.” 

Cultivating a strong referral base among patient-focused clinicians is one way that Hooks avoids turf wars and boosts outcomes. “I’m not a salesman,” Hooks says. “I want patients in compliance and sustaining a healthy lifestyle. CPAP is obviously the easiest, but you really must be in a place where the technicians and physicians are going to adequately give you the pressures you need and switch you over to BiPAP if you need it. At the same time, if you have some difficulty with wearing the mask, I can work with you on that.” 

Sometimes no one has ever taken the time to work with patients, and that education only boosts compliance rates. For those who are adamant about not wearing CPAP, Hooks does not shy away from oral appliances. However, he cautions: “If you do oral appliances, you must have follow-up therapy with the dentist. You can do a combination therapy and have an oral appliance made to stabilize your mouth. Keep your teeth stabilized and then apply nasal pressure to keep the airway open. It’s a more tolerable mask and perhaps a better likelihood of continuing therapy.” 

Written by Greg Thompson

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