Sleep Quiz & Referral Form Inside

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Sleep Quiz & Referral Form Inside Rediscover the power of sleep

Apnea solutions for all ages Mobile Sleep Services

Who We Are An experienced and well trained team of sleep care professionals consisting of Registered Sleep Technologists and Respiratory Therapists. We have expertise in timely diagnosis, education and optimal treatment of breathing related sleep disorders in patients of all ages. Our focus is to provide a high level of support to ensure your success and comfort with treatment so your sleep improves and you feel better. We have chosen to do just one thing and do it very well. Sleep Care IT S WHAT WE DO! What Makes Us Unique 1. Innovative Sleep Assure Program TM After hours telephone support 2. Mobile services available 3. Flexible scheduling including weekends (walk-ins welcome). 4. Focus on improving long-term adherence and patient outcomes 5. Continuum of care approach that encompasses screening, diagnostics, education, treatment, equipment maintenance and ongoing care. 6. Specialize In Pediatrics Over 1 in 4 (26%) adults report symptoms and risk factors that are associated with a high risk of having or developing obstructive sleep apnea. (Public Health Agency of Canada 2009) OUR PROMISE To deliver QUALITY SLEEP CARE through exceptional service, customization and convenience.

What is Obstructive Sleep Apnea (OSA)? According to the Public Health Agency of Canada, OSA is characterized by repeated episodes of airway obstruction and loud snoring which results in periods of breathing cessation (apnea) and usually is associated with a reduction in blood oxygen levels. Signs/Symptoms: Snoring, restless sleep Gasping, choking, coughing High blood pressure Irregular breathing during sleep EDS (Excessive Daytime Sleepiness) Morning headache Poor cognitive function/concentration Memory loss Irritability Frequent urination at night (nocturia) Sexual dysfunction Large neck size >17 men; >16 women Obesity Depression Treatment Have a sleep study to evaluate if you are positive for OSA CPAP therapy is the Gold Standard treatment for OSA Education and close ongoing support DID YOU KNOW? Research shows use can be largely predicted based on the level of education and Aloia, M. et al. 2007

Normal Airway freely to lungs Obstructed Airway Airway collapses (Tissue & Tongue); CPAP Treated Airway Airway is splinted open with air pressure; air Treatment of OSA with CPAP Treatment of OSA resulted in a 10mmHg reduction in blood (Becker 2003) pressure Reduce risk of stroke by 35% and coronary heart disease risk by 20% CPAP treatment reduces the need for acute hospital admission due to CVD in patients with OSAS One month of CPAP improves daytime blood pressure, heart rate and left ventricular function CPAP reduces blood glucose levels 2 nights of CPAP improves insulin sensitivity, sustained at the 3 month interval

Canadian adults who reported being diagnosed with Sleep Apnea were: 2.5 } 1.8 } 2.2 } 7 } 2.2 } times more likely to report having DIABETES times more likely to report HYPERTENSION times more likely to report HEART DISEASE times more likely to be involved in a MOTOR VEHICLE ACCIDENT times more likely to report a MOOD DISORDER such as depression, bipolar disorder, mania or dysthymia Sleep Apnea Prevalence Drug-Resistant Hypertension Logan et al. (J. Hypertension 2001) Obesity O Keefe, Patterson. (Obes Surgery 2004) Stroke Dyken, (1996) Diabetes Einhorn et al. (ADA 2005) CHF Javaheri et al. (Circulation 1999) 80% 77% 65% 50% 50%

DID YOU KNOW? Current smokers are 3 times more likely to have OSA than non-smokers 80% or greater of individuals who have OSA are not aware of it CPAP treatment can reduce glucose levels and decrease the risk of developing Type II Diabetes (Babu 2005) CPAP treatment of OSA reduces risk of stroke by 35% and coronary heart disease by 25% CPAP treatment of OSA reduces blood pressure CPAP treatment of OSA reduces the need for acute hospital admissions (Becker 2003) (Peker 1997) There is robust evidence that the best adherence only occurs if the introduction of the patient to CPAP is done with well trained experts and if the patient is closely followed and supported by those same people. - Colin Sullivan, inventor of CPAP therapy

Sleep Assure Program We understand that early and ongoing education and support is key to the long term success of our patients. That is why we created the SLEEP ASSURE PROGRAM. The program begins the day you start treatment and continues as long as you remain in our care. Included is evening care calls and ongoing remote wireless monitoring. This allows our dedicated sleep therapists to immediately and proactively solve any issues as they arise. Follow-Up An initial care call is made within 24-72 hours of starting therapy to answer any questions/concerns you may have. Remote monitoring of therapy along with as many face to face visits as necessary starting the day the patient begins treatment, and this level of support is continued as long as they are in our care. Regular 6 month visits with reports sent to family physician. Educate the patient about the risks and consequences of untreated obstructive sleep apnea (OSA). Complimentary Maintenance Program After sales, service includes regular equipment checks, scheduled adherence downloads and replacement of supplies (normally also covered by insurance). What is more valuable than ever is KNOWLEDGEABLE SERVICE. It is our intention to make exceptional customer service our product. Our underlying business philosophy is to provide quality care and specialized knowledge, not just sell medical devices.

STOP-BANG A Quick Screening Tool for Obstructive Sleep Apnea (OSA) Answer the following questions to find out if you are at risk for Obstructive Sleep Apnea (OSA). S T O P B A Y N Do you snore loudly? Louder SNORING TIRED OBSERVED (BLOOD) PRESSURE BMI AGE than talking, or to be heard through closed doors? Do you often feel tired, fatigued, or sleepy during the daytime? Has anyone observed you stop breathing during your sleep? Do you have, or are you being treated for high blood pressure? BMI greater than 35? Age over 50 years old? N NECK Is your neck circumference greater than 40 cm (16 in)? G GENDER Is your gender male? Record your total Yes answers in the space provided. High risk of OSA is YES to 3 OR MORE.

Mira Health Centre Edmonton Suite 108, 11910-111 Ave. Edmonton, AB T5G 3G6 P 780-757-1215 F 780-757-1210 info@qualitysleepcare.com Stadium Medical Centre Calgary #21, 1941 Uxbridge Dr. NW Calgary, AB T2N 2V2 P 403.220.0625 F 403.220.0038 info@qualitysleepcare.com Sleep Disorder Referral Form/Prescription Patient Name: Health Care #: Address: Phone: (H) (C) Date of Birth: Male Female Referring Physician and Clinic: Ambulatory Level III Sleep Study (No fee*) Auto CPAP Evaluation/Treatment If Indicated Overnight Oximetry (Pediatrics) CPAP Therapy with Overnight Oximetry (Follow-up testing) Auto CPAP Re-Titration/Re-Assessment 5 cmh 2 0 to 20 cmh 2 0 Other Recommendations: Reason for Referral/Medical History: Dr. Signature: Date: Phone: Fax: Additional Assistance Send a digital copy of our referral form / Send another pad of referral forms Contact our clinic to schedule an educational session with our staff Assist in referral to specialist www.qualitysleepcare.com Version 1.0 Last edited April 29, 2016

If you suspect you may have Obstructive Sleep Apnea, you may be wondering... Where Do I Start? Signed Referral from Doctor TM Sleep Assure Program Regular 6 Month Visits Level III Home Sleep Study Prescription signed for CPAP Results sent to Sleep Doctor If Positive for Sleep Apnea, Provide Education, Start CPAP Evaluation (2-4 weeks)

Ulysses St. NW Mira Health Centre Edmonton Suite 108, 11910-111 Edmonton, AB T5G 3G6 P 780.757.1215 F 780.757.1210 info@qualitysleepcare.com Edmonton South (Millwoods) 6570-28 Ave NW Edmonton, Alberta T6L 6N3 P 780.757.1490 F 780.757.1491 info@qualitysleepcare.com Millwoods Mainstreet Mall 66 St. NW 31st Ave NW 6570-28 Ave NW PrimeTime Donair & Kabab Pizza Hut Dollar Giant 28th Ave NW Wendy s Tim Horton s Youville Dr. W. NW Grey Nuns Hospital Stadium Medical Centre Calgary #21, 1941 Uxbridge Dr. NW Calgary, AB T2N 2V2 P 403.220.0625 F 403.220.0038 info@qualitysleepcare.com 1-800-QSC-5133 Call us for more Underhill Dr. SW Stadium Medical Centre Foothills Mennonite Church information. www.qualitysleepcare.com Quality Sleep Care Utah Drive NW Uxbridge Dr. SW Westmount Mid High School