"A comprehensive evaluation and treatment program for snoring and sleep apnea."

Over the past several years many options have emerged for the treatment of snoring and sleep apnea, resulting in a confusing array of choices for patients and their families.

SOMNOFIX™ was developed by a team of doctors with extensive experience in the evaluation and treatment of snoring and sleep apnea. This program offers the latest and most comprehensive options available, so you can feel at ease knowing that they are getting the most current and up-to-date care.

Snoring and sleep apnea are a common problem, and are really a continuum of disease. On one end of the spectrum people have what we call simple snoring. Recent studies show that over one third of adults snore at least a few night a week. If the snoring is very loud, we use the term heroic snoring to describe the intensity of the problem. As snoring becomes louder, some patients will develop sleep apnea. Sleep apnea occurs when a person stops breathing during the sleep phase, resulting in a decrease in oxygen availability to vital parts the body. Sleep apnea most often is a result of obstruction of airflow because of blockage in one or more sites in the nose and throat area. As the sleep apnea worsens, we see a range from mild to severe, depending upon the number of times a patient stops breathing for each hour of sleep. So in the continuum, we have people who have simple snoring on one end and severe sleep apnea at the other end.

Our comprehensive evaluation of the patient with this problem involves an individualized, methodical approach. The key elements include:

Focused Questionnaire

We know that when you come to a doctorís office you have to fill out forms, forms and more forms. We have devised a questionnaire that gets to the heart of the matter and lets us know the important information that helps us determine the extent of your problem in an efficient manner. Download (link to form) the form so that you can fill it out prior to your visit.

Upper Airway Evaluation

In order to determine to site of vibration and noise production in snorers, as well as the site of obstruction in sleep apnea patients, our physicians will perform a thorough upper airway evaluation. This will consist of an examination in the office and an endoscopy procedure which will be performed through the nose with a small amount of numbing solution. Most patients will feel a tickling sensation and very little discomfort. This procedure allows us to completely evaluate the upper airway and determine the various area of airflow restriction, from the nose back into the throat and larynx area. Our unique grading system is the most comprehensive available. It allows for a grid classification of each person which helps determine treatment options. This evaluation takes about 30 minutes.

Diagnostic Imaging

Most patients with simple snoring do not need xrays or other testing, unless they have associated problems such as chronis sinusitis. If sleep apnea is suspected however, xray evaluation with CT and/or cephalometrics (plain xrays looking at the skeletal and airway profile of a patient) may be ordered. This also adds to the information base needed to formulate the best treatment plan for sleep apnea patients.

In-Home Sleep Study

A sleep study is often the next important element in the evaluation. This may consist of a study performed in a sleep lab or a home based study. Over the past several years the technology for performing outpatient, at home, sleep studies has progressed to the extent that an accurate and comprehensive study can be routinely achieved. The at home study we perform utilizes the state of the art system which records up to 6 data channels. We monitor SaO2 (blood oxygen levels), EKG, respiratory effort, actual nasal and oral airflow, patient position, and sound produced. The correlation between this study and inpatient studies at a lab is extremely close and in fact we feel that given the far more typical sleep environment at the patientís home vs. a lab, the home sleep study findings are possibly more valid. The costs of a home study are a small fraction of the sleep lab fees- often even less than the deductible payment for a lab based study. The diagnosis of OSA is confirmed by observing an elevated RDI (respiratory distress index) and possible correlation with associated episodes of de saturation of SaO2 (decrease in blood oxygen values).

Classification System and Customized Treatment Plan

Once we have obtained all the necessary information on a particular patient, we will create a customized profile and classify the problem taking into account a multitude of parameters, including the anatomical grid, the results of x-rays and the sleep study if performed. For simple snoring, the treatment plan is relatively simple but still customized. For sleep apnea patients, the treatment options include weight loss, orthognathic appliances, CPAP devices and surgical management. Newer techniques such as somnoplasty offer state of the art virtually painless therapy for snoring and sleep apnea. Thus an individualized profile allows us to discuss the treatment options with the patient in the most accurate and efficient manner possible, creating the best outcome for what is potentially a serious medical disorder.