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Sleep Clinic

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About us

Sleep Clinic is an outpatient department within Respiratory services at Waikato DHB. Our focus is to diagnose and treat patients with disordered breathing during sleep, including obstructive sleep apnoea (OSA).

Referrals to Sleep Clinic are done through a doctor, usually a family doctor / general practitioner. (See more information under the Referrals tab).

Key personnel

Karen Cottle
Clinical Physiologist
Team Leader, Sleep Clinic

Andrea Coxhead
Operations Manager

Dr Cat Chang
Clinical Lead

Location

Level B1 Waiora Building, Waikato Hospital

Contact

For people who have been referred to Sleep Clinic by a doctor

07 839 8899 Extension 96609 and then 

Press  1    for mask parts and equipment faults
Press  2    for appointments/speak with receptionist

A message can be left on the voicemail if phones are busy. These are checked regularly.

Email:  sleeplaboratory@waikatodhb.health.nz 

Read about healthy sleep and how to improve your sleep patterns.

Referrals to Sleep Clinic are done through a doctor, usually a family doctor / general practitioner but in some cases another doctor.

We try to process a referral, investigate, and treat people as quickly as possible, but there can be delays at times due to high volumes and we ask for your patience.

If you prefer to be seen by a private sleep service, there are some available in the Waikato. Please discuss those options with the doctor who referred you to us.

Assessment of a referral

Sleep Clinic will assess your referral and either:

  • Move to an investigation stage
  • Make a clinic appointment
  • Refer you back to the referring doctor with advice.

Investigation(s)

These may include sleep studies, blood tests, sleep diary, and other investigations and tests. Note: Sleep studies (where your sleep is monitored by sensors in our Sleep Lab or at your home) are not relevant for all patients.

Follow up clinic appointment

This will discuss the results of the investigations. Treatment may be offered.

Treatment(s)

These may include (but are not limited to) continuous positive airway pressure (CPAP), behavioural therapies, weight loss, and in some instances surgical options.

Ongoing treatment and support

People on CPAP or BiPAP may remain under the care of Waikato DHB Sleep team long term or be discharged back to their general practitioner (GP).

People who chose to attend a private sleep service and are being treated with a privately funded CPAP device can be referred for a publicly funded device once they are established and compliant on the privately funded device for 8 weeks.

Patient information about breathing during sleep, investigations and treatments.

When a person goes to sleep most of the muscles in the body become relaxed and soften. This helps you have a comfortable, relaxed sleep. The muscles of the soft palate (roof of the mouth) and tongue remain firm and toned enough to allow clear passage of air through the throat and in and out of the lungs. In this situation you are able to get quality sleep without any breathing problems and then wake in the morning feeling refreshed and able to perform during the day.

Snoring is a noise made by vibration of the soft palate and other soft tissue due to narrowing in the throat while breathing when asleep. This happens because the muscles controlling the soft palate and tongue relax too much and narrow the airway to the lungs. The breathing muscles then have to work much harder than normal to get air into the lungs.

Snoring is not generally considered a health risk but because sleep during snoring is not as relaxed and comfortable, you may feel less refreshed in the morning and more tired during the day. Snoring can also be socially disruptive and damaging to relationships.

Snoring results from a narrowing of the throat. In some people their muscles relax so much that the airway becomes completely blocked and causes the airflow to stop. This is called apnoea, meaning lack of breath.

The apnoea can last 10 seconds or more, and can be repeated hundreds of times a night.

During the apnoea the person automatically makes an effort to breathe against the blocked airway. The brain soon recognises there is a problem and rouses the body to a lighter level of sleep or wakes the person up.

This allows the muscles to firm up, which in turn opens the airway to allow breathing to begin again.

As the person relaxes back into sleep, the cycle of snoring and apnoea can repeat itself, and do so many times during the night. This repeated disruption to sleep often causes the person to feel sleepy during the daytime.

Anyone.

  • Generally more males than females
  • Older people
  • Those who may have large tonsils, a small throat or a blocked nose
  • If you are overweight you are more likely to get OSA.

Telltale signs are persistant snoring with one or more of the following:

  • Excessive daytime sleepiness (an overwhelming and irresistible need to sleep when not busy).
  • Apnoea (sudden sensation of lack of breath causing you to wake or partly wake). This is often noticed by a partner.
  • Waking with a headache.
  • Poor memory or concentration.
  • High blood pressure.
  • Sexual dysfunction.
  • Irritability, mood changes, and/or depression.

Two methods are

  • Polysomnography (Sleep Lab) sleep studies performed in a hospital-based sleep laboratory. You attend early evening for tests and you are given your own room where you sleep overnight. A number of sensors will be applied to your body so your sleep can be monitored during the night. These do not hurt but can feel a bit strange at first.
    See the information sheet What happens at a sleep study? [PDF, 85 KB] for more details about what will happen if you are booked to attend Sleep Lab at Waikato Hospital.
  • Portable (home) sleep studies can happen in your own home. You will be provided with a simple recorder and several sensors that are easy to attach to your body. The information gathered while you sleep is useful for us to identify problems you have with breathing during sleep. 
    See the information sheet What happens at a sleep study? [PDF, 85 KB] for more details.

The Sleep Clinic doctor will assess what type of sleep study is right for you.

CPAP (pronounced C-PAP) is short for Continuous Positive Airway Pressure. It is the most common and effective treatment for obstructive sleep apnoea (OSA).

A CPAP circuit is made up of an air pump, a tube and a face mask. Air is delivered through the face mask which seals over your nose and/or mouth. The air pressure effectively holds your airway open, preventing the soft tissue blocking the passage of air to and from your lungs.

CPAP is a treatment not a cure, and it needs to be worn each time you sleep.

Today, CPAP machines are compact, easy to operate and look more like a small household appliance than a medical device. Modern masks are made from silicone, modern plastics and fabrics designed to be lightweight, durable and comfortable to wear. Getting used to your CPAP can take time, and our Sleep Clinic service offers ongoing care to all CPAP users - when you start using CPAP and also on a longterm basis.

Many people using CPAP experience significant relief of symptoms and increased quality of life, and can do so without the use of medications or invasive medical procedures.

However CPAP will only treat OSA. If you have more than one reason for feeling excessively sleepy, you may still have some residual symptoms even if your OSA is well treated by using CPAP.

Replacement parts

If you are prescribed CPAP you will get two replacement masks and four replacement filters per year. If you need replacements more often you will need to purchase them.

Although they can be useful indicators of sleep disturbance, they are not valid tools for identifying obstructive sleep apnoea (OSA).

Read more about healthy sleeping.

The Troubleshooting for CPAP users [PDF, 151 KB] information sheet gives you tips about using CPAP including

  • mask leaking
  • nose blocking up
  • mouth breathing with a nasal mask
  • pulling the mask off in your sleep
  • still snoring
  • feeling claustrophobic
  • getting dry lips, mouth or throat
  • water in the mask
  • sore abdomen or bloating after using the mask
  • facial tenderness or skin irritation

Driver fatigue is one of the most common contributing factors in motor vehicle crashes in New Zealand.

  • Being tired affects driving by
  • slowing reaction times
  • making it difficult to concentrate
  • reducing your ability to judge risks.

To hold a driver's license in New Zealand you must be medically fit to drive. You are responsible for driving only when you are safe to drive - and this includes not driving if you are too tired.

There are many reasons why a driver might be too fatigued to drive such as

  • not getting enough sleep
  • taking medications that cause sleepiness
  • driving at times when you would normally be sleeping
  • untreated conditions such as obstructive sleep apnoea (OSA) or narcolepsy (a medical condition with excessive daytime sleepiness and intermittent uncontrollable episodes of falling asleep during the daytime).

Long haul truck drivers are particularly at risk of OSA because they are predominantly middle aged to older males and have long hours of sedentary work with potential weight gain. These are all risk factors of OSA. From research to date, the rate of OSA in commercial truck drivers appears to be as high as 25% to 45%.

NZTA has produced a fatigue calculator and a journey planner to make it easier to manage driver fatigue. Find this and other useful resources on the NZTA website's fatigue section.

NZTA issues driver licences based on information it receives from a number of sources. Your own general practitioner (GP) oversees your overall health and manages any medical conditions, so they are in the best position to confirm to NZTA your overall medical fitness to drive safely.

Your doctor will also receive information from other health teams involved in your health and wellbeing, including a sleep service if you are referred to one or receiving treatment from one. 

All medical practitioners have a legal obligation to advise NZTA of any relevant concerns they have about a patient's ability to drive, but only NZTA can issue or revoke a driver's licence. Doctors, nurses, physiologists do not have the power to remove or reinstate licences.

"But I'm a good driver and I never feel sleepy when I drive."

Sleepiness is a very subjective sensation - each of us experiences it differently. You may never feel sleepy when driving, but the law states if you have a medical condition associated with increased risk of driver fatigue, you need to prove you are either adhering to treatment, or that you are not at risk of falling asleep when you drive.

If you are being investigated for a sleep disorder, you may be advised by your doctor not to drive while the assessment is taking place. This is for your safety and the safety of other people, and must be taken seriously.

If you are being treated for a sleep disorder, NZTA may ask you to prove you are using your therapy (e.g. a CPAP or other PAP machine). Our Sleep Lab staff can guide you on what is required to comply with that treatment, and we can then advise NZTA of your adherence to the treatment. 

Alternatively, NZTA may ask you to provide proof that you are not at risk of driver fatigue. NZTA will specify what type of proof they need, and in some cases we can offer further testing for this purpose.

Please note: Heavy transport (HT) licence holders, taxi drivers, pilots and those who have fallen asleep behind the wheel will remain under Sleep Clinic's care indefinitely with annual reviews to check use and compliance.