20-22 Underwood Street, Corrimal New South Wales 2518, Australia
SLEEP MEDICINE
- We are specifically credentialed in Respiratory & Sleep Medicine.
- We perform only full, ‘level 1’ attended polysomnograms, the highest international standard of sleep study.
- Full range of diagnostic and interventional sleep-studies.
- Comprehensive, personalised sleep-study reports for each patient.
- We are a local medical provider servicing the Illawarra & Shoalhaven region.
- Working with people of the Illawarra and South Coast Region to promote, protect and maintain their level of wellbeing in order to optimise their daily function.
- We continually improve our services to meet and exceed the needs and expectations of our patients, clinicians, local general practitioners and the community we serve.
- You are under the direct care of a respiratory & sleep physician from diagnosis to treatment options.
Don’t leave your diagnosis to just anyone.
First Visit
When you come for your appointment please remember to obtain and bring the following
- Referral letter from GP, family physician or other doctor
- Patient Information and Registration Form (If you have not received this form please call 4252 7333)
- Medicare card, DVA card, Pension Card
- Reports, X-rays, MRIs, CT scans etc. and any other relevant information
For all appointments & enquiries, please call (02) 4252 7333 We are happy to hear from you.
Specialist Doctors
Dr Virginia Oliveira
Dr Virginia Oliveira
Dr Virginia Oliveira
Consultant Paediatrician and Sleep Specialist
Virginia sees children with suspected developmental disorders, with an expertise in Autism Spectrum Disorder.
Virginia sees patients in Corrimal on Tuesdays.
Dr Sameh Samuel
Dr Virginia Oliveira
Dr Virginia Oliveira
Respiratory and Sleep Physician
Dr Samuel is a Respiratory and Sleep Physician and is a Senior Conjoint lecturer at the University of Wollongong.
His main interests include asthma, COPD, lung cancer, Interstitial lung disease, sleep medicine and respiratory failure.
Dr Samuel is widely involved in research including COPD, asthma, sleep medicine and rare lung diseases.
Sameh consults in Corrimal on Fridays.
Dr Haider Naqvi
Dr Virginia Oliveira
Dr Haider Naqvi
Respiratory and Sleep Physician
Haider consults with patients who may have sleep issues such as sleep apnoea, insonmia and excessive sleepiness.
Haider consults in Corrimal on Mondays.
Dr Peter Jones
Dr Catherine Jonas
Dr Haider Naqvi
Respiratory and Sleep Physician
Dr Peter Jones graduated from Sydney University in 1993, completed physician training at Concord and Prince of Wales Hospital, and has been in specialist clinical practice since 2000. Dr Jones moved to Canberra in 2010 and works in hospital and private practice, specialising in Respiratory and Sleep disorders. Prior to 2010, he worked in a busy solo Respiratory and Sleep practice in Central West NSW, and acute general medicine in Orange and Bathurst. He commenced regular visits to SHS clinic in 2019. In his spare time he likes travelling, flying and playing the banjo.
Peter consults in Corrimal on Fridays.
Dr Catherine Jonas
Dr Catherine Jonas
Dr Catherine Jonas
Dr Catherine Jonas is a Consultant Paediatrician and a Paediatric Sleep Physician
Catherine sees children for general consultations as well as sleep issues.
Catherine has her clinic at Southern Healthcare Specialists on Thursdays.
Content
Obstructive Sleep Apnoea
Obstructive Sleep Apnoea
Obstructive Sleep Apnoea
Sleep apnoea is a condition characterised by cessation of breathing during sleep. Obstructive sleep apnoea refers to episodes of upper airway blockage during sleep. During these episodes, breathing stops but the effort to breathe continues until the blockage is overcome and breathing resumes with a snort, gasp or jerk. Sleep apnoea can make you wake up feeling unrefreshed.
Obstructive sleep apnoea is more common in the obese and in individuals with thick necks and small, reduced or obstructed airway passages due to excessive weight, swollen tonsils, a large tongue, a deviated nasal septum or craniofacial morphology.
To diagnose obstructive sleep apnoea a sleep study such as a polysomnogram is conducted which measures breathing patterns, air flow, blood oxygen levels, electrical activity of the brain, heart rate, muscle activity and eye movements. A Polysomnogram can be performed either at a sleep laboratory or at home.
Treatment depends on the cause of airway obstruction. The aim of treatment is to restore normal breathing during sleep and prevent excessive daytime sleepiness.Having a big sale, on-site celebrity, or other event? Be sure to announce it so everybody knows and gets excited about it.
Central Sleep Apnoea
Obstructive Sleep Apnoea
Obstructive Sleep Apnoea
The term central sleep apnoea encompasses a group of sleep-related breathing disorders in which respiratory effort is diminished or absent in an intermittent or cyclical fashion during sleep. In most cases, central sleep apnoea is associated with obstructive sleep apnoea syndromes or is caused by an underlying medical condition, recent ascent to high altitude, or narcotic use. Primary central sleep apnoea is a rare condition, the etiology of which is not entirely understood.
During polysomnography (PSG), a central apnoeic event is conventionally defined as cessation of airflow for 10 seconds or longer without an identifiable respiratory effort. In contrast, an obstructive apnoeic event has a discernible ventilatory effort during the period of airflow cessation.
In general, treatment of central sleep apnoea is often more difficult than treatment of obstructive sleep apnoea and treatment varies according to the specific syndrome. Central sleep apnoea in adults includes primary central sleep apnoea, Cheyne-Stokes breathing-central sleep apnoea (CSBCSA) pattern, high-altitude periodic breathing, central sleep apnoea due to medical conditions other than Cheyne-Stokes, and central sleep apnoea due to drugs or substances.
During sleep, behavioural control is lost and chemical control is the major mechanism regulating ventilation. Central sleep apnoea is most often seen during non–rapid eye movement (NREM) sleep, when behavioural influence is least, followed by rapid eye movement (REM) sleep, while a fully awake person is least likely to manifest it. Despite these changes, ventilatory control during sleep remains similar to that during wakefulness.
The types of pathophysiologic phenomena which can cause central sleep apnoea syndromes are ventilatory instability or depression of the brainstem respiratory centres or chemoreceptors.Are your customers raving about you on social media? Share their great stories to help turn potential customers into loyal ones.
Snoring
Obstructive Sleep Apnoea
Periodic Limb Movements in Sleep (PLMs)
Snoring is the vibration of respiratory structures and the resulting sound due to obstructed air movement during breathing while sleeping. In some cases, the sound may be soft, but in most cases, it can be loud and unpleasant. Snoring during sleep may be a sign, or first alarm, of obstructive sleep apnoea (OSA).
Snoring is known to cause sleep deprivation to snorers and those around them, as well as daytime drowsiness, irritability, lack of focus and decreased libido. It has also been suggested that it can cause significant psychological and social damage to sufferers. Multiple studies reveal a positive correlation between loud snoring and risk of heart attack (+34% chance) and stroke (+67% chance).
Though snoring is often considered a minor affliction and accepted as normal, snorers can sometimes suffer severe impairment of lifestyle. Snoring is associated with the development of carotid artery atherosclerosis. It has been demonstrated that snoring vibrations are transmitted to the carotid artery, identifying a possible mechanism for snoring-associated carotid artery damage and atherosclerotic plaque development. The amplification of the snoring energy within the carotid lumen at certain frequencies, adding to this scenario. Vibration of the carotid artery with snoring also lends itself as a potential mechanism for atherosclerotic plaque rupture and consequently ischemic stroke. Researchers also hypothesise that loud snoring could create turbulence in carotid artery blood flow. Increased turbulence irritates blood cells and has previously been implicated as a cause of atherosclerosis.Running a holiday sale or weekly special? Definitely promote it here to get customers excited about getting a sweet deal.
Periodic Limb Movements in Sleep (PLMs)
Periodic Limb Movements in Sleep (PLMs)
Periodic Limb Movements in Sleep (PLMs)
Periodic limb movement disorder (PLMD) or periodic leg movements is a sleep disorder characterised by repetitive cramping or jerking movements of the legs that often disturb sleep and cause daytime sleepiness. The condition usually develops after middle age and may coexist with other sleep disorders. Periodic leg movement disorder may be primary in origin without an identified cause or may be associated with medical conditions such as diabetes, sleep apnoea (periods of reduced or arrested breathing during sleep), conditions affecting the spinal cord, and intake or withdrawal of certain medications.
The leg movements are repetitive movements that occur every 20-40 seconds during sleep and usually involve the joints of the knee, ankle and big toe. The limb jerks last about 2 seconds and are often reported by bed partners. Individuals with periodic leg movement disorder experience day time lethargy/sleepiness and restless legs syndrome (a condition characterised by unpleasant sensations in the legs when at rest and an urge to move the legs).
PLMD should not be confused with restless leg syndrome (RLS). RLS occurs while awake as well as when asleep, and when awake, there is a voluntary response to an uncomfortable feeling in the legs. PLMD on the other hand is involuntary, and the patient is often unaware of these movements altogether.
Symptoms
Patients with PLMD will complain of excessive daytime sleepiness, falling asleep during the day, trouble falling asleep at night, and difficulty staying asleep throughout the night. Patients also display involuntary limb movements that occur at periodic intervals anywhere from 20–40 seconds apart. They often only last the first half of the night during non-REM sleep stages. Movements do not occur during REM because of muscle atonia.
To diagnose periodic limb movement, your medical and drug history is reviewed and a thorough physical examination is performed. Possible neurological disorders are ruled out. An overnight sleep study called a polysomnogram may be conducted to identify periodic leg movements or any other sleep disorders. The study measures breathing patterns, air flow, blood oxygen levels, electrical activity of the brain, heart rate, muscular activity, limb and eye movements. Blood and urine tests may also be performed to diagnose underlying medical conditions or identify the presence of drugs.
Periodic leg movements due to secondary causes may be treated by addressing the underlying medical condition. Primary periodic leg movements cannot be completely cured.Your doctor will prescribe medications to reduce the leg movements or help you sleep through the jerks. These medicines usually act on the nervous system by reducing muscle contractions regulating muscle movements, or intensifying sleep.
Talk with your doctor if you have any questions about your medications or notice any side effects.
Narcolepsy
Periodic Limb Movements in Sleep (PLMs)
Hypersomnolence
Narcolepsy is a rare neurological disorder that affects the brain’s ability to regulate normal sleepwake cycles. The term narcolepsy derives from the Greek νάρκη (narkē, "numbness" or "stupor"), and λῆψις (lepsis), "attack" or "seizure". It is a chronic disease most commonly affecting adolescents and young adults. It is characterized by daytime fatigue, sleep attack (falling asleep suddenly), temporary loss of control over the muscles in response to certain emotions (such as anger and laughter), and sleep paralysis, a temporary inability to move or talk when waking or falling asleep.
Narcolepsy is often caused due to a deficiency of orexin, a chemical in the brain that regulates sleep. However the exact cause of narcolepsy is not always clear. Hormonal changes during puberty and menopause, psychological stress, a sudden change in sleep cycles or an infection may trigger narcolepsy. To confirm a diagnosis of narcolepsy, your doctor may ask you to maintain a sleep log. Your levels of orexin may be measured, and tests such as polysomnography (measures body functions during sleep) and multiple sleep latency tests (measures brain activity during the day) may be ordered.
There is no cure for narcolepsy, patients with narcolepsy can be substantially helped, but not cured. Treatment is tailored to the individual, based on symptoms and therapeutic response. The time required to achieve optimal control of symptoms is highly variable, and may take several months or longer. Medication adjustments are frequently necessary, and complete control of symptoms is seldom possible. While oral medications are the mainstay of formal narcolepsy treatment, lifestyle changes are also important.
Hypersomnolence
Periodic Limb Movements in Sleep (PLMs)
Hypersomnolence
Hypersomnolence is a condition characterised by excessive sleepiness, which interferes with your daily activities. Patients usually fall asleep during the day at inappropriate times such as during work, while conversing and eating. This condition may also be characterised by symptoms such as difficulty in waking, irritation, hallucinations, loss of appetite, and slow speech and thinking. This condition is mainly caused due to an underlying sleep disorder or neurological condition, sleep deprivation, drug or alcohol abuse, being overweight, head injuries or heredity.
Hypersomnolence can be diagnosed by evaluating your sleeping habits and sleep cycle, i.e. how much sleep you get and how often you wake up during the night. Polysomnography (measures body functions during sleep) and an electroencephalogram (measures the electrical activity of the brain) may also be ordered to confirm the diagnosis. Hypersomnolence can be treated with the help of medications such as stimulants or antidepressants. Some life style changes can also be applied to overcome this condition such as:
- Ensure scheduled sleep timings
- Avoid caffeine, alcohol, and nicotine consumption
- Schedule regular short naps during the day to avoid sleeping during activities
- Avoid sleep deprivation
- Stay fit and eat a balanced diet
Insomnia
Circadian Disorders
Circadian Disorders
Insomnia is a sleep disorder characterised by a difficulty in falling asleep or inconsistent sleep throughout the night resulting in too little or poor-quality sleep and a feeling of exhaustion when you wake up.
Insomnia can be acute or chronic. Acute insomnia lasts from one night to a few weeks while with chronic insomnia, the sleep disturbances occur at least three nights per week, for more than a month.
Acute or short term insomnia does not require any treatment and can be often prevented or cured by practicing proper sleep habits. However, if insomnia affects your functional abilities, your physician may prescribe sleep inducing medication, for a limited period of time.
To treat chronic insomnia, your doctor will first treat any underlying medical health problems that are interfering with your sleep. If insomnia continues, behavioural therapy may be recommended to modify behaviours, which can worsen insomnia, and also learn new behaviours to promote good sleep. Other behavioural techniques such as relaxation therapy sleep restriction therapy and reconditioning may also be helpful in improving your sleep.
Relaxation Therapy: This helps reduce or eliminate night-time stress, body tension and anxiety. The goal is to calm the mind so you are able to fall asleep.
Sleep Restriction Therapy: This is a type of behavioural treatment in which your sleep efficiency is improved by initially limiting your sleep time.
Reconditioning: This approach helps your body to associate bed and bedtime with sleep. The person is usually advised to use bed only for sleep and sex. You are taught to go to bed only when sleepy. During the reconditioning process you should avoid short naps and go to bed at the same time every night. If unable to sleep, leave your bedroom and do something else until you feel sleepy.
Circadian Disorders
Circadian Disorders
Circadian Disorders
Humans follow a 24-hour biological rhythm called the circadian rhythm, controlled by light and darkness of the surrounding environment. This determines the body’s temperature, hormone production and sleep cycles. Circadian disorders are caused due to the disruption of your circadian rhythm by changes in time zones, pregnancy, working in shifts, certain medications and changes in routine activities.
The different types of circadian rhythm disorders include:
- Rapid Time Zone Change Syndrome (Jet Lag): lack of alertness and excessive sleepiness during the day due to travel across time zones.
- Shift Work Sleep Disorders: caused if you work in night shifts or rotate shifts
- Delayed Sleep Phase Syndrome (DSPS): caused due to irregular sleep timings, where you fall asleep late and get up late in the mornings
- Advanced Sleep Phase Syndrome (ASPD): going to sleep early and waking up earlier than desired
- Non 24-hour Sleep-Wake Disorder: occurs in those who are completely blind as the biological clock works with the light and dark cycle. Sleep time and quality are reduced and you may feel sleepy during the day.
Some of the Treatments for Circadian Disorders Are:
- Behaviour Therapy: maintaining regular sleep cycles and avoiding naps, caffeine and nicotine. Minimising light in the evening and night to manage delayed sleep phase syndrome, and increasing light exposure during evening to control advanced sleep phase syndrome
- Bright Light Therapy: exposure to a high intensity light for about 1 or 2 hours. This time-critical therapy helps to reset the sleep cycle.
- Cronotherapy: progressive advancement or delay of the sleep cycle. Once the sleep cycle is reset, regularity should be maintained.
Parasomnias
Circadian Disorders
Parasomnias
Parasomnias are abnormal events or experiences that disrupt the sleep and include unwanted perceptions, feelings, behaviours or movements. Parasomnias mostly occur during the phase of deep sleep but can also occur while falling asleep or waking up. People who have parasomnias usually don’t remember the events the next morning. Parasomnias may prevent you from getting a good night’s sleep and can affect your daily activities.
Parasomnias may be hereditary or triggered by stress, traumatic episodes, medications, alcohol or other sleep disorders.
The most common types of parasomnias include:
Confusional Arousal: Acting in a strange and confused way when you wake up from sleep by a noise or some other stimulus. You are sluggish and may respond nonsensically to questions and have poor memory of the episode.
Sleepwalking: A parasomnia in which you arise from bed and move around or perform some activity in a state of sleep. Sleepwalkers are usually confused and angry if awoken and may respond aggressively if restrained. Sleepwalking can be dangerous as the sleepwalker is unaware of their surroundings and can injure themselves.
Night Terrors: You awake in a fearful state, confused and unable to communicate as you are not fully awake. You fall asleep again after some time and are unable to remember the event the next day.
Nightmares: You may awake from an unpleasant dream and experience feelings of fear and anxiety. The person having a nightmare has difficulty going back to sleep and usually remembers the terrible dream.
Sleep Paralysis: Sleep paralysis refers to the temporary inability to move that happens when you are going to sleep or waking up. During these episodes you will be unable to move or speak and may have hallucinations. Sleep paralysis may last a few seconds or minutes or may end when someone touches you or speaks to you.
REM Sleep Behaviour Disorder: People with REM sleep behaviour disorder act out action and sometimes violent dreams and may hurt themselves or others.
Other parasomnias include sleep-related eating disorders, bedwetting, groaning, and sleep talking.
Parasomnias can occur in individuals of all age groups but sleep walking/talking and bed wetting are more common in children.
Potentially dangerous parasomnias or those affecting your health and daily activities require medical attention. It’s important to consult with a sleep specialist to evaluate and treat the condition. Your sleep specialist may ask you to maintain a diary of your sleep habits and will review your sleep symptoms. Your specialist may also ask about your medical and social history to identify the type of parasomnia and the associated cause. A sleep study such as a polysomnogram is conducted which measures breathing patterns, air flow, blood oxygen levels, electrical activity of the brain, heart rate, muscle activity and eye movements.
To treat parasomnia, your specialist may prescribe medication or recommend lifestyle changes or behavioural therapy. You will be instructed on safety measures to reduce the risk of injury associated with some types of parasomnias. Treating the underlying sleep disorder may help improve the symptoms of parasomnias.