Grosvenor Nuffield Hospital

Diagnosis and Treatment of Sleep Disorders

Investigation

The initial consultation will cover the sleep history, other medical history, review of your current medication (you must bring this with you: various medications can have profound effects on sleep), and a physical examination, which includes breathing tests and a baseline measurement of the oxygen saturation using a finger clip.

 

The diagnosis of OSA depends on the symptoms described, and a sleep study overnight at the Grosvenor Nuffield Hospital to demonstrate frequent episodes of upper airway obstruction. The Grey Flash diagnostic system is used. It allows an audio recording of the subject, with measurement of their body position and movement, pulse plethysmography,  pulse rate and oxygen saturation (using a finger clip), and air flow (using nasal prongs incorporating a microphone). The limited “attachments” to the subject make going to sleep naturally relatively easy, and allows accurate diagnoses to be made without multiple scalp electrodes (see printout below).

 

Following analysis of the sleep study, a review appointment will be made to discuss the findings, and decide on appropriate treatment.

 

Treatment of OSA

 

The usual treatment is continuous positive airway pressure (CPAP) delivered via a special mask connecting by hosing to a CPAP machine. The mask fitting is critical to acceptance of the device, and a trial of CPAP at home is arranged. If successful, the CPAP machine may be bought directly from the company. The machines are robust and last for several years, whilst the masks need to be changed at least annually.

 

In those subjects where CPAP is unsuccessful or not tolerated, then special devices to place in the mouth during sleep to prevent the jaw slipping back can be made (the Sleepwell Appliance). This is a specialist dental procedure, and an appropriate referral will be made from the Grosvenor Nuffield to the Redcliffe Dental Practice in Neston. Other options that may be appropriate, depending on the clinical findings, are surgical interventions, where referral to ENT surgical colleagues at the Grosvenor Nuffield would be made.

 

Where a diagnosis of loud snoring only is made, then CPAP is not an appropriate treatment, but ENT surgery or the Sleepwell Appliance will often help.

Grey Flash Diagnostic System