If you suffer from snoring or sleep apnoea, chances are that you’ve heard about plenty of treatments out there which claim to treat or cure your condition. The differences between these treatments can be mystifying, and understanding which treatment might be right for you can be confusing. While any treatment for snoring or sleep apnoea should be prescribed by either a doctor or somebody with training in treating sleep disorders, it is good to have a general understanding of the treatments out there.

Dr Levi uses a combination therapy approach, meaning he will often use several of the treatments on this list in combination with each other, to produce maximum results. In general, the therapy approaches can be broken into Major and Minor.

Major

CPAP

Price: $2 000 – $4 000

The CPAP (Continuous Positive Airway Pressure) machine, has always been considered the gold standard for treating sleep apnoea. This treatment involves the patient wearing a gas mask over their mouth and nose and having a pump push air through the mouth into the lungs. While this is an extremely effective way of treating sleep apnoea, it is not very comfortable, meaning patients are unlikely to use the CPAP all night every night. In fact, a recent study from Sydney University found that in the first year of being given a CPAP, patient compliance was extremely low, with most patients using the machine for just a few hours a few nights a week. So while effectiveness when wearing the mask is extremely high, the overall effectiveness of the CPAP machine is often reduced due to low patient compliance.

Pros:

  • Highly Effective

Cons:

  • Often uncomfortable or noisy
  • Low patient compliance

 

MAS

Price: $2 200 – $3 300

The MAS (Mandibular Advancement Splint) and other dental devices are tailor made to fit the patient’s mouth and are worn like a mouth guard during sleep. It works to bring the jaw and tongue forward and lift the soft palate, keeping the airway open during sleep. While the efficacy of these devices is somewhat lower than that of the CPAP, compliance is much higher due to the comfort and ease of wearing the device. This means that overall, a MAS can be a better treatment option than CPAP, due to higher patient compliance. The MAS is a great option for those who have had some success with the CPAP but find the noise or discomfort of the machine irritating.

Pros:

  • Comfortable and easy to wear
  • Effective treatment for snoring and sleep apnoea

Cons

  • Lower efficacy than CPAP (if CPAP is worn every night)

 

Surgery

Price: $2 000 – $10 000

In extreme cases, patients are sometimes referred to an Ear Nose and Throat doctor for surgery. There are a variety of surgeries which can be performed to ease snoring or sleep apnoea, however they do involve a considerable amount of pain and recovery time for the patient. Furthermore, the results of surgery generally last only about two years.

Pros:

  • In certain cases, surgery can be useful in resolving sleep apnoea or snoring

Cons:

  • Procedure requires a couple of weeks’ recovery time and considerable pain.
  • Results are not long lasting

 

NightLase

Price: $2 850 for 4 treatments

NightLase is a brand new laser therapy which is being used to treat sleep apnoea. It works by warming the tissue at the back of the throat, stimulating collagen tissue and causing it to contract and tighten. Generally, a course of treatments will entail 3-4 sessions over an 8-week period. Dr Mark Levi and world renowned Dr Harvey Shiffman (Florida, USA) get an average improvement of 75% or greater using the NightLase laser treatment (with the Florida protocols). One maintenance treatment per year will be required to ensure the continued efficacy of the treatment.

Pros:

  • Highly effective
  • No surgery, pain or recovery time
  • Allows patient to sleep uninhibited by devices

Cons:

  • Not suitable for all patients – must be recommended by a trained professional

 

Minor

Weight Loss

Price: Varies

Dr Levi works closely with dieticians, as a reduction in weight is one of the simplest and most effective ways to treat snoring and sleep apnoea. In fact, studies have shown that if patients lose just 10% of their body weight, they record a 25% improvement in the degree of their sleep apnoea. Losing weight may be all that is needed to more or less cure a person’s sleep disorder, it can also be used in adjunct with other treatments to enhance their efficacy.

Positional Therapy

Price: $30 – $70

The results of a sleep study will often reveal that an individual only snores when they are lying on their back. The reason for this is that gravity drags the tongue and mouth tissue backwards, obstructing the airway. Positional therapy prevents the patient from sleeping on their back, usually through a strap on device which causes them discomfort when they try to shift to their back. A more advanced positional therapy device is the Night Shift, which works similarly to a fit bit, but is worn around the neck. When the patient lies on their back, it vibrates, prompting them to roll over without disturbing their sleep. It also records sleep data which can be reviewed.

Nose Appliances

Price: Approximately $1/day

There are a variety of nose appliances including Mute, Provent and Therasnore, which all work slightly differently, but ultimately aim to open up the nostrils and allow extra air flow. These appliances are minimally effective on their own, but can be useful as an adjunct to other therapy.

Sleep Hygiene

Sleep hygiene refers to ensuring that the patient has optimal conditions for sleep. This includes things like avoiding alcohol, ensuring the room is dark, still, silent and cool, avoiding phone and laptop screens before bed and having a bed and pillow which positively affect sleep position.

While you may have seen or heard of other devices online or in stores, most of these are not recommended by sleep experts because their efficacy has not been proven or has been shown to be very low.

 

Dr Levi offers an initial consultation ($60) during which he can discuss these treatment options with you in detail and give you an idea of which might be appropriate for your unique sleep issues.

Contact us to find out more or book your consultation now.

 

 

 

 

 

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Anyone who has had trouble with their sleep has probably wondered what really goes on in their body from the moment their head hits the pillow to when they stagger out of bed in the morning. Getting to the bottom of what is causing somebody’s sleep problems is integral to devising the best treatment plan, and consequently restoring some restfulness into their lives. While many people may be diagnosed based on the symptoms they have described to their doctor or sleep physician, as with any health issue, performing tests increases the likelihood of an accurate diagnosis and effective treatment plan. If your doctor has suggested a sleep test, or you believe you might need one to solve your sleep issues, it is helpful to be well informed before taking the next steps.

What is a Sleep Test?

During a sleep test, a machine is fitted to a patient overnight, in order to collect various data about their physiology during their sleep. Generally, this will take the form of a machine placed on the patient’s forehead, with wires extending to various areas on the body including the chest, arms, legs and face. The patient will sleep with this apparatus overnight, and the data will be recorded and analysed.

Why is a Sleep Test Needed?

A sleep test is required for much the same reason that a doctor may order a blood test – as a diagnostic tool, to discover what is going on inside your body. For example, many of the symptoms of sleep apnoea mimic those of psychological disorders such as depression. To avoid a misdiagnosis and incorrect treatment where disturbed sleep is involved, a sleep test is often useful.

What Does a Sleep Test Measure?

There is some variation in the data recorded by sleep tests, but generally they record:

  • Pulse – Capturing any fluctuations in your heart rate.
  • Oxygen Saturation – This should ideally be around 96%, the test will note how often it falls below 80%. It will also record how often and for how long you hold your breath during your sleep.
  • Sleep Position – Whether you sleep on your back, front, side and how this varies.
  • Snoring Levels – The decibel level and frequency of your snoring.
  • Sleep duration – How much sleep you are actually getting while you are in bed.
  • Stages of Sleep – Documenting the entire sleep cycle, called a hypnogram.
  • Apnea Hypopnea Index – The number of apneas during the study per hour of sleep.
  • Respiratory Disturbance Index – A measurement of all breathing irregularities.

Home vs. Hospital Sleep Test: Which is Better?

Hospital

A hospital sleep test takes place in a dedicated medical or sleep testing facility. The patient brings an overnight bag, is fitted with a sleep test machine and then allowed to sleep in the room. The room is usually set up much like a hotel room, with a TV, bedside table and private bathroom. During the night the patient is monitored visually and through the sleep test machine.

Pros:

  • Very accurate.
  • Partially covered by Medicare.

Cons:

  • Many people find it difficult or impossible to sleep in the artificial setting, rendering the results void.
  • There is usually an out of pocket cost for the patient on top of the Medicare rebate.
  • There is often a considerable waiting list (4-12 week wait).

Home

In order to conduct a home sleep test, the sleep physician will give the patient a sleep machine to take home, and fit on themselves before sleeping. Dr Levi offers home sleep tests for his patients for increased ease and convenience.

Pros:

  • Sleep test performed in the comfort of the patient’s own home and own bed.
  • The data collected is more likely to show a ‘typical’ night’s sleep.
  • The cost may be entirely covered by Medicare (typically much cheaper than a hospital sleep test).

Cons:

  • Some patients may have trouble fitting the device or may fit it improperly, impacting the results.
  • If some of the equipment falls off during the night, there is nobody monitoring who can re-fit it.

 

What Happens After a Sleep Test?

If you are a patient of Dr Levi, after your home sleep test, you will bring the machine back into the office where the data will be uploaded into a portal and sent to the USA where it is read by both a computer and human technicians and then scored. These results are then interpreted by a sleep physician in the USA, then they are read and interpreted again by a sleep physician in Sydney, before finally being reviewed by Dr Levi himself. These results will allow Dr Levi to determine what is happening during the patient’s sleep and to either devise a personalised treatment plan, or refer them on to a different specialist (such as psychologist) if necessary.

Dr Levi’s Darlinghurst offers a $295 sleep test package which includes: an initial consultation with Dr Levi, and at-home sleep test, data analysis and report, a follow up consultation with a tailored treatment plan. Find out more or contact us to discuss your options.

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There are many different treatments on the market for treating snoring or sleep apnoea. All treatments are different and need to be tailored to a patient’s needs after a thorough assessment of their sleeping behavior. Patients should also be aware of all the pro’s and con’s of each treatment option.

CPAP

CPAP, which stands for continuous positive airway pressure, is a machine that uses mild air pressure to keep airways open.

Pro’s

The CPAP machine has a high efficacy rate for treatment of snoring and sleep apnoea and allows patients to get better quality sleep, resulting in increased energy during the day.

Con’s

The machine requires patients to wear a facial mask every night, which can be off putting to some patients.

MAS (Snoring Mouthguard)

MAS stands for Mandibular Advancement Splint, and takes the form of a mouth guard which is designed to fit inside your mouth while you sleep. The device bring the jaw forward and lift the soft palate while holding the tongue forward in order to open up the airway.

Pro’s

This device has a 93% success rate for snoring and sleep apnoea and is less cumbersome than the CPAP machine. It is comfortable to wear and completely safe

Con’s

The device needs to be worn every night to work.

Surgery

Surgery is usually a last resort when other treatments have failed to improve snoring or sleep apnoea. The surgery will be tailored to suit the particular blockage causing the obstruction to the airways.

Pro’s

Surgery is often an effective option for those who have not received relief from other treatments.

Cons

All surgery carries risks to the health of the patient and can also be expensive.

NightLase

Laser treatment works to tighten the soft tissue at the back of your throat which is responsible for obstructing the airway.

Pro’s

Laser treatment is painless, non-invasive and requires no downtown. Dr Mark Levi and world renowned Dr Harvey Shiffman (Florida, USA) get an average improvement of 75% or greater using the NightLase laser treatment (with the Florida protocols). The treatment is delivered in three twenty-minute sessions over a period of six weeks and, unlike other popular treatment doesn’t require you to wear any device while you sleep.

Con’s

The effects of the treatment don’t last forever and maintenance treatments are required.
At Dr Levi’s Sleep Clinic, we take great care in creating customized solutions for each individual patient through our home-based sleep study assessments. These assessments allow us to collect data while you sleep, enabling us to recommend the best possible treatment plan for you. We can choose the right treatment for your unique needs.
To receive a holistic, customised solution for your sleeplessness, using the most state of the art technology, call us on 1300 67 07 74 or email us on info@drlevis.com.au

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Those who suffer from snoring or sleep apnoea have an exciting new treatment option available to them. NightLase is a quick, non-invasive, painless laser treatment with 90% efficacy rate.

What is NightLase?

NightLase harnesses the power of the Er:YAG laser which has previously been used mainly in dentistry to remove tooth decay. However Er:YAG laser light has now been found to be extremely effective in shrinking the soft palate and uvula. Inflammation or drooping of these areas of the mouth and throat is often the cause of snoring and obstructive sleep apnoea.

How does it work?

The NightLase laser works in two phases. Firstly, the laser gently heats the tissue of the throat and mouth. It then strengthens the tissue, ultimately causing shrinkage and tightening of the swollen areas and opening up the air flow to the mouth and nose. This allows patients relief from snoring and sleep apnoea, increasing sleep quality for the sufferer and their partners.

How many treatments are needed?

The NightLase method requires just three, 20-minute treatments over a period of 45 days, meaning the entire course of treatment is completed in just 6 weeks.

What are the risks and benefits?

The NightLase method is extremely effective at reducing the frequency and volume of snoring as well as treating sleep apnoea. Dr Mark Levi and world renowned Dr Harvey Shiffman (Florida, USA) get an average improvement of 75% or greater using the NightLase laser treatment (with the Florida protocols). The procedure is quick, non-invasive and painless with no downtime and requires no anesthetic. Extensive clinical trials have not found any side effects, but like all treatments, NightLase is not the best option for all patients. At Dr Levi’s sleep clinic, we always carry out a complete sleep analysis before recommending any course of treatment, so we will only suggest NightLase if it is right for for you.

To receive a holistic, customised solution for your sleeplessness, using the most state of the art technology, call us on 1300 67 07 74 or email us on info@drlevis.com.au.

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For years, CPAP or Continuous positive airway pressure therapy had been the treatment of choice for mild to moderate obstructive sleep apnea. However, while it did do what it promised to, it had certain marked drawbacks that resulted in a decrease in its popularity in recent years. Common problems with CPAP usage include dry mouth and throat, feeling of claustrophobia when wearing the mask, trouble falling asleep, leaky mask and skin lacerations at bridge of the nose. Several studies that have been done in search of a more effective solution have shown that an MAS or Mandibular Advancement Splint is a far better alternative for sleep apnea sufferers. The MAS opens up the airways and allows the user to breathe normally and have a good, restful night’s sleep.

What Is An MAS Device?
A Mandibular Advancement Splint, also known as Mandibular Advancement Device (MAD), sleep apnea mouth guard or sleep apnea oral appliance, is a small device that is similar to a mouth guard or an orthodontic retainer. Made of acrylic, this device fits over the upper and lower teeth or tongue and is safe, user-friendly and unobtrusive.

How The MAS Device Works
When placed in the mouth, the mandibular advancement splint lowers the jaw or tongue slightly. This slight advancement of the jaw pushes the base of the tongue forward and tightens the upper respiratory muscles, hindering their ability to collapse. These actions help to open up the airway, improve breathing and significantly reduce the vibration of the airway tissues, all of which work to reduce snoring and sleep apnea.
Mandibular advancement splints are comfortable and well tolerated by the majority of patients. They are easy to place and remove, easy to clean and are convenient for travel. Modern design innovations allow dental appliance users to speak while retaining the device in their mouth.

Advantages Of Using An MAS Device V/S CPAP Treatment
MAS devices offer several advantages over the more traditional CPAP treatment. Some of the more notable benefits include:

• More user-friendly as compared to the CPAP
• Reduction in severity of symptoms especially in individuals who sleep on their stomach or their back
• No need of a battery pack or power supply
• No laceration-causing masks
• No feelings of claustrophobia
• Considerable improvement in quality and quantity of sleep
• Higher patient compliance because of the smaller size, higher portability and usability, convenience of use and lower maintenance
• Better value for money – the cost of the treatment is lower than that of CPAP therapy

Additional studies that were carried out re-assessing patients after 1 to 5 months of MAS treatment indicate that there is a reasonably high rate of sustained control even in those patients who suffered from severe OSA.

Ideally fitting an MAS appliance into the mouth is usually done by a dentist that specialises in Sleep therapies. This should also include a period of follow up to ensure the efficacy of the device and that the patient is receiving maximum benefit from the device, this should perhaps also include a further home sleep test.

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