Clinician Information
Download our Sleep Assessment Referral Form.
General Introduction
Cansleep provides a comprehensive, specialist sleep physician-led service incorporating clinical assessment, diagnostics, and treatment across a range of sleep disorders, including obstructive sleep apnoea, insomnia, narcolepsy and parasomnias.
Cansleep provides consultation in Christchurch and in our satellite clinic in Queenstown, and will provide couriered home-based sleep studies and CPAP provision throughout the South Island.
Cansleep is also proud to be a founding member of BMI (Body Mind Improvement), a network of health professionals who share the goal of delivering a comprehensive approach to the management of obesity.
We are committed to delivering a high quality, patient focused-service in a clinically relevant timeframe. Our aim is to keep our patients and primary care colleagues involved and informed throughout this process.
Clinical Assessment
Patients with suspected sleep disorders can be referred for either a nurse-led screening assessment, or for a full physician consultation.
Nurse-led screening visit
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for patients with suspected OSA
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30 minute targeted history and examination
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sleep questionnaires (ESS and Berlin)
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recommendations regarding appropriate next step
Physician assessment
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Formal clinical assessment
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Proceed to diagnostic testing if appropriate
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Discussion of management options
Sleep Diagnostics
Cansleep provides a range of sleep studies which will be tailored to individual patients depending on the clinical circumstances. These are generally performed as home-based studies but can be undertaken in-hospital if necessary. Sleep studies available include:
Overnight oximetry (Level 4 Sleep Study)
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Provides a continuous recording of oxygen saturations and pulse rate overnight
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Specific but not sensitive for OSA and will miss up to 40% of severe disease
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Recommended initial test for patients with high likelihood of OSA (obese, etc etc etc)
Compass study (Level 4a Sleep Study)
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Records nasal flow, oximetry, snoring, pulse rate and body position
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More sensitive for OSA than oximetry
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Suitable as initial test for most patients with suspected OSA
Embletta study (Level 3 Sleep Study)
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Comprehensive measurement of nasal flow, thoracic and abdominal movement, oximetry, snoring, pulse rate, ECG, body position and limb movements
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Most sensitive home-based test for investigation of OSA
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Distinguishes between central and obstructive sleep-disordered breathing
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Allows assessment of nocturnal movement disorders (restless legs syndrome, periodic limb movement disorder)
Cansleep Management of OSA – CPAP
The majority of patients with significant OSA are referred for a trial of CPAP. Cansleep provides a comprehensive approach to initiation and maintenance of patients on CPAP treatment. This includes several stages which include:
Initial set-up
At the start of a CPAP trial, patients have an hour-long session which includes mask fitting, education regarding use of CPAP and potential problems, and machine selection and set-up. It has been shown that long term-compliance and response to CPAP is directly related to proper mask fitting and education early on in any CPAP trial.
2 week autotitratring CPAP trial
Patients generally undergo a 2-week trial of autotitrating CPAP. This allows for early assessment of tolerance, clinical response and compliance. It also provides information regarding potential leak and therapeutic pressure requirements. During this period there is regular contact with Cansleep staff to monitor progress and adjust masks or alter machine settings as required.
Transfer to long-term CPAP treatment
Following the initial 2-week trial period patients may opt to remain on autotitrating CPAP, or transfer to a fixed pressure CPAP machine. This decision will largely depend on patient preference.
Ongoing support
Once patients are established on CPAP ongoing support is available from Cansleep as required. Patients are encouraged to return for a free annual review or sleep “warrant of fitness” to ensure ongoing optimal management of sleep-disordered breathing.
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