- Our new patient Sleep Surgery consultations are booked for 30mins to allow time for detailed history, and complete physical assessment
- Physical examination will involve Nasoendoscopy (a thin, fibre-optic camera inserted via your nose and over the back of your palate/tongue whilst being projected onto our screen); where your entire upper airway will be assessed seated, lying flat and on your side. Some manoeuvres will be performed to imitate sleep and obstruction.
This part of the examination takes approximately 3-5 mins and is uncomfortable rather than painful. We use some decongestant/local anaesthetic nasal spray prior to minimise discomfort
- We ask that you complete the questionnaires PRIOR to attending your appointment (and return via email, so we can view prior to Consultation):
- Snoring Severity Scale
- Epworth Sleepiness Score
- FOSQ (Quality of Life Questionnaire)
Please bring with you:
- YOUR SLEEP PARTNER, OR SOMEBODY NEAR YOU WHEN YOU SLEEP. Ideally this person will attend with you, but having them available via phone contact can be useful if they are not able to attend
- Any devices currently being used during sleep including CPAP machine/Mandibular Splint/Lateral sleeping device
- Any previous sleep studies
- List of current medications (including herbal/supplements) if not included in your referral letter
Before your Consultation – consider you goals for treatment. Include your partner in the discussion.
Is your main objective snoring cessation?
Or is it reducing the risks and symptoms of OSA?
It may be all of the above.
Our new patient Sleep Surgery consultations for children are heavily reliant on the history from parents, and supplemented by examination findings.
If you have any video footage of your little one sleeping on an average night (when well) that documents the snoring, working hard to breathe, gasping/pauses in breathing and are happy to share with us this can greatly enhance our assessment. If not, we ask that you take some time to observe your child asleep for a few minutes each night prior to your consultation so we get an accurate history of their sleep breathing patterns.
Other things to bring if relevant:
- List of current medications including any nasal sprays used currently or in the past
- Details of any previous surgery (most importantly tonsillectomy and adenoidectomy)
- Details of any other concurrent conditions, letters from previous doctors/Paediatricians
- iPhone/iPad/Toys for the little one to play with while we talk
Our assessment will involve a look in the throat at the tonsils, in the nose, a feel of the neck and inspection of the ears.
(Always good to pre-warn the little ones we will be having a look – there are lolly rewards!)
If things are unclear – sometimes we might discuss looking in the nose with our nasoendoscope (a thin, fibre-optic camera inserted via nose and over the back of palate/tongue). Most children do not tolerate this and we would never perform this if you or your child are uncomfortable with the idea.
If there are still some unknowns in terms of the cause of the snoring/OSA we have the option of performing a Drug Induced Sleep Endoscopy (DISE).
DISE is a day procedure where we examine the airway of the child with some sedation (mimicking sleep) in the operating room of the hospital. It is a great way of investigating the cause of snoring/OSA in children, particularly where the child has previously had tonsillectomy and adenoidectomy, or has other concurrent medical conditions.