Sleep and Snore Therapy

About Sleep
Why a Sleep Study
Do I need a sleep study?
Valid reasons and indications for a sleep study may include any of the following:
• Snoring which disturbs your bed-partner (or neighbours!)
• Always tired
• Falling asleep whilst driving
• Disturbed sleep
• Going to the bathroom during the night
• Waking up tired
• Waking up with a headache
• Waking up with a dry or sore throat
• High blood pressure (or on medication)
• Depressed (or on medication such as Zoloft)
• Sexual dysfunction (or on medication such as Viagra)
People with a thick, short neck (> 42 cms in men, > 38 cm women) and BMI > 30 kg/cm are also more likely to have sleep apnoea, but about 10% of people with sleep apnoea are “skinny” – they just have narrow airways.
If you have any of the above symptoms or indications, you may have a sleep disorder which can be treated by your doctor or some Sleep Dentists.
What will a sleep study tell me?
The most important result is a measure of your sleep disturbance. The cause of most sleep disturbances is identified by measuring breathing, leg and jaw movements.
Sleep disturbance is reported as the Arousal Index, which is the number of times you wake up per hour of sleep. Most of these awakenings are too short to remember (only 3 to 10 seconds in duration – you usually only remember being awake if it lasts more than 5 minutes) and it is normal to wake up to 5 times per hour. Waking 5 to 15 times is considered mild disruption, while waking more than 15 times per hour definitely indicates a sleeping problem that requires urgent intervening treatment. The sleep study also reports how many times you stop breathing or have reduced breathing per hour (AHI – Apnea Hypopnoea Index or RDI -Respiratory Disturbance Index) and how many times your legs twitch per hour (PLMI – Periodic Limb Movement Index).
What treatments are available?
Depends on the diagnosis. Many people with sleeping problems have a combination of up to 88 different sleep disorders as defined by the International Classification of Sleep Disorders (ICSD). That is why a full sleep study is so important.
For example, if the sleep study indicates you stop breathing more than 15 times per hour, you have moderately severe sleep apnoea and probably should start using CPAP immediately. Minimum cost is usually about $200 to rent CPAP for 2 weeks. If you then decide to buy a CPAP machine, the total cost for machine and mask is usually around $1500.
If the sleep study indicates mild to moderate sleep disordered breathing (less than 30 per hour) an oral appliance fitted by a sleep dentist is recognised by the Australian Dental Association (ADA), the Australian Sleep Association (ASA) and the Thoracic Society of Australia and New Zealand (TSANZ) as valid first-line treatment for sleep apnoea and snoring. This is a specialised service offered by a few sleep dentists. Our sleep dentists use the latest technology to measure the minimum cross-sectional area in the nose and back of the throat with an acoustic rhinometer and pharyngometer. This enables your dentist to fit the most appropriate dental device and adjust it to the optimal position. Without these measurements, a dentist may fit an inappropriate device and it may take many months and several visits to find the optimal horizontal and vertical position of the jaw. Cost of a dental device is usually around $1500 to $1800 including fitting.
If you are diagnosed with Periodic Limb Movements Syndrome (PLM Index > 5) or Restless Leg Syndrome, your doctor may prescribe central nervous system depressants and stress the importance of avoiding stimulants like caffeine and nicotine. Simple treatments include relaxation in the hours prior to sleep and high doses of magnesium supplementation. For example, Cramp-eze is available at most pharmacies around Australia for less than $20 for a months’ supply.
Home Sleep Study Benefits
Compared to in-patient hospital sleep studies:
Benefits to patients
• Independent diagnosis
• Independent assessment of treatment
• Sleep study in the comfort of your own home
• No hospital bed fees
• Freedom of movement
Move around and resume most daily activities while wired up
Go to the bathroom at any time during the night without assistance
Roll over in bed easily
• Consult with one doctor at one clinic
• Time from initial consultation to treatment is usually days or weeks
• No private health cover required
• Sleep study reported by experienced Sleep Scientists and Sleep Physicians
• Referred to a Sleep Physician for consultation only if indicated by the sleep study report and after simple (including dental) treatments have been tried first