INTEGRATED CARE for SLEEP DISORDERED BREATHING

Summer 2003 Sleep Surgery Centre Newsletter

The condition of sleep disordered breathing covers a wide range of clinical variability from mild snoring to severe sleep apnoea. Many patients, and their clinicians, are unaware where exactly on that continuum they stand. Moreover once accurately diagnosed, the morass of available treatment is confusing, and the advice given on management may depend more on the perspective of the consultant than on the optimal treatment for a particular patient.

The Sleep Surgery Centre and CanSleep Services have jointly formulated a solution to this problem. A centre for the diagnosis and treatment of sleep disordered breathing under one roof has been established at 2963 Glen Drive, Coquitlam, B.C. Here we offer accurate diagnosis and all modes of treatment as a complete and integrated service for physicians and the public.

Diagnosis and Treatment

Diagnosis includes a full medical history, video fiber optic examination of the upper airway to establish level of obstruction, and free home oximetry. Only on the basis of both level-of-obstruction and severity can optimal treatment be selected. Once appropriately selected, treatment is entirely available on the premises, whether by CPAP, mandibular advancement splint, weight and dietary counseling, consultation with a sleep psychologist, or out-patient surgery involving laser, radio-frequency or injection to the palate.

Some will still require non-local facilities such as polysomnography and in-hospital surgery and the centre is set up to readily facilitate these.

Referral

The Sleep Surgery Centre exists, as for many years now, to provide diagnosis, advice concerning individualised treatment selection, and where appropriate, surgery. Most referrals to CanSleep will therefore come through the Sleep Surgery Centre. However it is appropriate for physicians comfortable interpreting their own oximetry to refer to CanSleep directly for this service (which is billed neither to the patient nor MSP): the referring doctor will receive a full printout of the oximetry by fax or courier.

For patients whose diagnostic status and severity is already established (e.g. by polysomnography) and who need non-surgical treatment such as a trial of CPAP, mandibular advancement splint, weight/diet counseling or psychologic-sleep consultation, a direct referral to CanSleep is also appropriate.

True “comprehensiveness” of health-care options requires two things: integration of services and individualised selection of those services by referral and consultation. Our vision for sleep-disordered patients is to provide both. We believe that one-stop, under-one-roof, integration of care will provide the best service for sleep disordered breathing patients, and will help find and treat many who remain undiagnosed or under-treated, with the considerable personal and secondary morbidity that goes along with this condition.

Richard R.J. Smyth, M.B.B.S., F.R.C.S.

From the information lab of the Sleep Surgery Centre, Inc.

All rights reserved. July 22, 2003

Sleep Surgery Centre Inc. 303 - 2963 Glen Drive, Coquitlam, Vancouver, B.C. Canada V3B 2P7
Tel: 604-941-2344 Fax: 604-941-2455 E-mail: info@sleepsurgerycentre.com