Trying To Sleep

Marketing for patients with obstructive sleep apnea (OSA): catchment segmentation with coordinated touch points

July 28, 2014
Some dentists and their respective practices are considering adding sleep apnea therapy to their treatment mix.

By Gary M. Radz, DDS, and Brad Guyton, DDS, MBA, MPH

Some dentists and their respective practices are considering adding sleep apnea therapy to their treatment mix. As the general public becomes increasingly aware of the health concerns subsequent to sleep apnea, dentists are looking for information and additional treatment solutions beyond the CPAP and surgical approaches. While historically, most patients have found solutions from the medical profession, now there are ways dentists can step up and help patients treat this life-threatening condition. The dental profession has always been at the forefront of public health education. Now, once again, we have an opportunity to expand our education into the area of sleep apnea.

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Education is an evolved form of high-level marketing. The more we enhance the awareness of a problem and communicate the options to solve it, the more likely patients are to pursue treatment. There are four fundamental steps to a marketing plan that allow you to market new verticals (treatment categories) to your community. These four steps -- when done properly and in order -- will have a real impact while remaining cost-effective:

  1. Define the demographics within your catchment area.
  2. Define the internal existing opportunity within your practice.
  3. Develop and send a clear message with coordinated touch points.
  4. Have clear parameters in place so that ROI (return on investment) can be measured.

Catchment area

Defining your catchment area can be quite simple. Ask yourself what neighborhoods or zip codes you want to reach. Some dental marketing firms specialize in helping you define this area. By working with firms such as Jameson ( that use cohort data like Nielsen psychographics, for example, you can define the appropriate neighborhoods and your target demographic.

Internal opportunity

Defining the internal demographics within your existing practice is another potential lead source. These are people who already trust you with their dental care and the care of their families. Why not extend that trust to helping them with their sleep concerns?

One way to market to existing patients is to create visual cues and educational prompts. In addition to strategic placement of patient education brochures ( in the office, we incorporate sleep apnea information into our patient education and entertainment software ( that runs on our 46-inch monitor in our reception area. When first launching our awareness campaign, we also included obstructive sleep apnea (OSA) patient education in our digital monthly newsletters ( We continue to reinforce OSA need and options on a quarterly basis. These simple strategies have proven to be very effective.

You will want to home in on five cohorts within your existing practice in terms of existing sleep apnea opportunity:

a) Patients unaware of any sleep issues. Screen all patients in your practice. The most effective tool we have found in our office to screen patients for OSA is the Epworth Sleepiness Scale. We have added this survey to our medical history updates. The Epworth Sleep Survey takes less than 60 seconds to complete and allows patients to begin thinking about the quality of their sleep. Patients at risk for OSA receive education from our hygienists to seed them for a discussion with the doctor when we begin their recall evaluation.

b) Patients who snore or partners who have to listen to someone snore. Snoring, while not diagnostic of sleep apnea, is certainly a "red flag" that there might be inflammation in the airway that should be addressed. For partners of those who snore, we use the "sleep observer survey." This is basically a variation of the Epworth survey, but written from the perspective of a third-party observer. Frequently, we will have a patient who fills out the Epworth survey that results in a low score, but as they hand it to us they will say, "If my partner were to fill this out, it would be a much higher score." This opens the door for us to ask them to fill out this questionnaire. If the results come back at high risk, then we encourage them to have their partner complete an Epworth and return the results to us.

c) Patients who have been prescribed a CPAP device and are noncompliant. Studies show that more than 60% of sleep apnea patients cannot tolerate or choose not to use their CPAP device. While a CPAP is still considered to be the gold standard for apnea patients, unless patients use it, they receive no benefit.

d) Patients who wear a CPAP, but do not travel with it. An oral appliance may be a travel alternative. Studies show compliance with an OSA appliance is typically better than with a CPAP.

e) Patients who already wear a CPAP successfully. Some severe apnea patients may benefit from simultaneously wearing an oral appliance to improve the airflow.

Clear messaging with coordinated touch points

Creating an effective marketing mix with different customer touches is key to our success. We know that it often takes five to six times for patients to see or hear a message before they act on it. Therefore, we expanded from our internal touch points mentioned above to external touches. First, we worked with our web partner ( to optimize our website for patients searching for sleep solutions and CPAP dissatisfaction, including these informational YouTube videos that we had professionally created ( Next, we launched our grassroots marketing approaches by visiting local health fairs and physicians' offices. We were invited to give lunch-and-learns in offices to educate physicians about the 40 million people who are expected to have OSA, how only 3 million have been diagnosed, and less than 1 million are effectively treated. We then explain what an OSA appliance is and how it might be appropriate for the vast majority of mild to moderate sleep apnea sufferers who are CPAP-intolerant.

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Next, we engaged in print media by working with several local magazines that we have partnered with previously to market our cosmetic services. We now alternate months between CPAP-alternative OSA ads and our cosmetic services ads. To gain economies of scale, we also use our print, radio, and website resources to market to patients searching for snoring resolution. Finally, we began radio advertising on local health awareness broadcasts. Each of these coordinated touch points were intentionally and strategically launched to reinforce one other in a timely fashion.

Return on investment

All dental practices should have a marketing budget. Typical marketing budgets for dental practices range from 1% to 10%. A healthy budget for launching an OSA vertical in your practice will be somewhere between 5% and 10% the first year and stabilize between 3% and 5% in subsequent years. Remember the mix of touch points is very important -- no single touch will do the trick for every patient. Every practice should have a marketing budget and measure the effectiveness of each marketing touch point. Only then can you determine the ROI on your investment. How else will you know where to spend tomorrow's marketing dollars most effectively?


OSA is a condition that is life-threatening for more than 40 million Americans and fewer than 2% are treated effectively. Every dentist should screen his or her patients for this condition. For the select few who wish to treat their mild to moderate sleep apnea patients with an oral appliance, they must follow basic steps to effectively market their practice. Having a marketing plan that includes definition of catchment areas, demographics, internal opportunities, coordinated touch points, reinforcement, and ROI analysis will allow dentists to grow the sleep apnea aspect of their practices.

Gary M. Radz, DDS, maintains a private practice in Denver, Colo. He maintains a faculty position at the University of Colorado School of Dental Medicine. Dr. Radz is the director of sleep studies at the Rocky Mountain Dental Institute in Denver. He is currently working on his fellowship in sleep studies with the Academy of Clinical Sleep Disorders Disciplines (
Brad Guyton, DDS, MBA, MPH, serves as the dean of dentist development at Pacific Dental Services and as an associate professor at the University of Colorado School of Dental Medicine. He practices dentistry with Dr. Radz in Denver, Colo., and can be reached at [email protected].