Sleep Disorder Analysis

Home Sleep Studies Australia (HSSA) provides the first and only full polysomnography (PSG) home sleep study service in Australia.

This service is available in Melbourne, Brisbane, Adelaide and Perth.

Patients can be conveniently set-up at the clinic or at home with a referral from a GP, dentist or consultant physician. The data is analysed by a Sleep Scientist and reported by a Respiratory and Sleep Physician, both with over 14 years experience diagnosing and treating sleep disorders. Most sleep study costs are covered by Medicare and up to 50% of treatment costs are usually covered by Private Health Insurance (please check with your insurance company).

Frequently asked questions

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)
• sick and tired of feeling sick and tired

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 . 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?

Home Sleep Studies Australia (HSSA) will submit an online claim with Medicare. This covers the cost of the Sleep Scientist and the report and diagnosis by the Sleep and Respiratory Physician.

The Doctor or dentist delivering your set-up and report will normally charge approx $250.

What are the payment options?

Full payment for the set-up is required prior to or at the time of the sleep study. The sleep study will only be provided after payment is received.

How do I book in?

1. Go to AlbanyDental and Sleep Health Centre for an assessment of your sleep-related symptoms.
2. Complete a Home Sleep Study Request Form, which is available from info@homesleep.com.au or from reception
3. The setup may take up to 1 hour for the initial appointment and 30 mins for follow-up appointments.
4. Payment of $250 will be required to secure your booking.    This pays for the set-up and for the consultation to explain the report and diagnosis.

What do I do on the day?

1. Exercise and shower in the morning – you will not be able to shower after being fitted with the sleep study kit. However, you will be able to continue most activities such as driving, working, walking and house-work.
2. Wear the t-shirt you will be  sleeping in.
3. Guys: please shave, especially over the jaw muscles. Beards are OK.
4. Ladies: please no makeup, dark finger nail polish or dark acrylic nails.
5. Set-up Appointment: Takes about 45 mins with instructions given to set up the video camera.
6. Follow your normal pre-bedtime routine, which may include medications and alcohol.

What happens the morning after?

1. Remove all  items (sticky electrodes, nasal airflow cannula, tape) and place in  bag.
2. Pack the everything back into  the black briefcase.
3. Return the case and tripod to the clinic before 10 am.
4. 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.
5. Book in to see Dr David Stephenson after 14 days. Your doctor  will be sent a copy of the report. Dr Stephenson will review the results of the Home Sleep Study with you and discuss treatment options under the instruction of the Respiratory Physician and Sleep Scientist. You will also be given a copy of the report

 Can my GP or dentist request the sleep study directly?

YES.
Please contact info@homesleep.com.au for a request form for the GP or dentist to sign.

In contrast, to have a sleep study in a hospital requires a referral by a GP or other specialist for a consultation with a sleep physician who then requests the sleep study. Besides the inconvenience and time (often in the waiting room), this initial consultation with the sleep physician usually costs around $200 and leaves the patient out-of-pocket by $100 from the Medicare. this is just to recieve a referral for a sleep study.

Waiting lists for most public hospitals are usually 6 months to 1 year. Many private laboratories are also booked out for many months.

Many private sleep laboratories charge from $0 to $500 depending on your private health cover. Typically, the out-of-pocket cost is around $250 plus the cost of seeing the sleep physician before and after the sleep study, which can add another $200 to the cost of having a sleep study. In summary, you may be out-of-pocket by up to $700 just to get a sleep study test at a private hospital and for the privilege of sleeping in a foreign environment tied to the wall by 20 wires. And, yes, going to the bathroom is a challenge and requires the assistance of the sleep technician on duty.

Home Sleep Studies Australia respects that most people would prefer to sleep in the privacy and comfort of their own home, be mobile and to spend this money on treatments.

Can it be done in my home?

YES.
Home Sleep Studies Australia uses the latest portable sleep technology and a special night vision camera 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 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.

Is it an independent diagnostic service?

YES.
Some companies are inherently biased towards diagnosing moderate to severe sleep apnoea because they also sell CPAP machines. Home Sleep Studies Australia is a sleep testing company and does not sell any treatments. All of the 100 private hospital sleep laboratories in Australia are owned and run by the sleep physician who also requests the sleep study. Unfortunately, many of these doctors are under pressure by the private hospitals to keep the beds full. That means almost all patients seen by a sleep physician are sent for a sleep study even if it is not indicated by presenting symptoms.

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.

Anyone who is sinussy or mucousy from sensitivity to dietary proteins in gluten, eggs, dairy and nuts should think seriously about having a sleep study to assess their breathing and oxygenation while asleep.

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 to e-mail info@homesleep.com.au 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 a month. 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 info@homesleep.com.aufor 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 info@homesleep.com.au 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:

• 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

To book your at home sleep study, please ring Albany Dental and Sleep Health Centre 07 32645698