About Sleep

Frequently Asked Questions - FAQ's

Do I need a sleep study?

To determine if you need a sleep study, your doctor (medical or dental)* needs to perform a thorough assessment of your presenting sleep-related symptoms and record some simple measurements (eg height, weight, blood pressure). If indicated by this assessment, your doctor may request a sleep study to assist in diagnosing up to 88 possible sleep disorders ( http://www.absm.org/PDF/ICSD.pd ). The most common sleep disorders are Sleep Disordered Breathing, such as Obstructive Sleep Apnoea (OSA), and Movement Disorders, such as Periodic Limb Movement Syndrome (PLMS).

How much will it cost?

There is a small out-of-pocket booking fee - please contact the clinic nearest to you for exact costs.

What do I do on the day?

• Exercise and shower in the morning - you will not be able to shower after seeing the Sleep Consultant. However, you will be able to continue most activities such as driving, working, walking and house-work.
• Bring a t-shirt to sleep in.
• Guys: please shave, especially over the jaw muscles. Beards are OK.
• Ladies: please no makeup, dark finger nail polish or dark acrylic nails.
• Set-up Appointment: Takes about 30 minutes
• Follow your normal pre-bedtime routine, which may include medications and alcohol.

What happens the morning after?

• Place all the disposable items (sticky electrodes, nasal airflow cannula, tape) in a rubbish bag.
• Pack the sleep monitor and wires into the black bag.
• Return the equipemnt to the clinic before 10 am. If you are unable to do so, please arrange with the Sleep Consultant for alternative arrangements or a courier to collect the items at your expense.
• The sleep data will be sent overnight to Home Sleep Studies Australia for reporting by a Sleep Scientist and Sleep Physician. If the data is not of sufficient quality, you will be notified within 48 hours and a repeat study will be offered at no extra cost.
• Book in to see the doctor (medical or dental) after 14 days. Your doctor (medical or dental) will review the results of the Home Sleep Study with you and discuss treatment options if required.

Can my GP or dentist request the sleep study directly?

YES.
Please click here to write us for a request form for the GP or dentist to sign.

What is the waiting list to have a sleep study?
Less than 4 weeks.

What is the cost?

Please contact us to confirm costs.

Can it be done in my home?

YES.
Home Sleep Studies Australia uses the latest portable sleep technology (and a special night vision camera as an option) which has only been available in Australia since mid-2006. Home Sleep Studies Australia is the only company to utilise this technology for sleep studies.

Does it include audio-video?

YES (optional only).
Home Sleep Studies Australia provides the only home sleep study service with audio-video recording. This is very important to verify body position, as many people only snore or have sleep apnoea when they lie on their back. The body position recorded automatically by most sleep monitors requires editing in most cases. Body position should not be reported in any sleep study report unless it has been verified by video. Every patient receives a DVD with "sleep highlights", which may include loud snoring, breath-holding, teeth grinding, sleep-talking, body movements and Rapid Eye Movements.

Does it include leg movements?

YES.
Leg movements are important for the diagnosis of Restless Legs Syndrome and Periodic Limb Movement Syndrome. The disorders are a common cause of insomnia and are just as common as sleep apnoea.

Does it include jaw movement?

YES.
Did you know 95% of people grind or clench their teeth at some point in their lives? Without a mouth-guard fitted by a dentist, people who grind or clench risk losing their teeth due to excessive wear or cracking of the enamel. A sleep study which includes jaw muscle activity can identify teeth grinding or clenching.
Jaw muscle activity is also important to differentiate between awake and sleep. Sleep studies should not be reporting sleep stages or arousals without recording jaw or sub-mental muscle activity. Arousals can only be scored during REM sleep with jaw or sub-mental muscle activity.

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 with 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. The first step is e-mail us for a request form, which needs to be completed in consultation with your doctor or dentist*.

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 (Apnea Hypopnoea Index AHI or Respiratory Disturbance Index RDI) and how many times your legs twitch per hour (periodic Limb Movement Index PLMI).

What treatments are available?

Depends on the diagnosis. Most people have a combination of up to 88 different sleep disorders as defined by the International Classification of Sleep Disorders (ICSD) Manual. 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 for 2 weeks. If you then decide to buy a CPAP machine, the total cost for machine and mask is usually around $1500 less any rental money already paid. Contact us for your nearest CPAP supplier.

Longer term options are a dental device and weight-loss. From February 2006, an oral appliance fitted by a 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 at present. These sleep dentists use the latest technology to measure the mimimum cross-sectional area in the nose and back of the throat with an acoustic rhinometer and pharyngometer. This enables the dentists 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 including fitting. Contact us for your nearest sleep dentist.

If you are diagnosed with Periodic Limb Movements Syndrome (PLM Index > 5) or Restless Leg Syndrome, the 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
• Cost of initial diagnostic study is 66% rebated by Medicare
• Cost of follow-up treatment review study is 90% rebated by Medicare
• 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 (incl dental) treatments have been tried first

Benefits to GPs, dentists, ENT surgeons and other doctors

• Direct request for a sleep study
• Fast turnaround time - sleep study reported by a Sleep Scientist and Sleep Physician usually within 5 working days
• No capital outlay required for equipment - the sleep monitoring system is on permanent loan (as long as it is used frequently)
• Staff training provided and assistance in finding staff if required

Benefits to Sleep Physicians

• See patients who are more educated and have already tried simple treatments
• Propose a treatment plan at the first consultation with the benefit of facts from a full diagnostic PSG sleep study report
• Consult with patients who need their help
• Provide a more efficient, lower cost sleep diagnostic and treatment service to patients

Benefits to Private Health Funds, Hospitals and Governments

• Frees up bed spaces
• Less than half total cost of diagnosing and treating sleep disorders
• Early detection and treatment minimizes chances of patient's developing more costly health complications such as high blood pressure, strokes and heart disease

*"doctor" usually refers to a GP, but also may include Medical Specialists, Consultant Physicians and dentists who specialise in treating snoring and other sleep disorders. Please contact HSSA for a list of Sleep Physicians and Sleep Dentists throughout Australia and New Zealand.