NightLase
Forms & Related Material
To acquire the appropriate information, perform, and monitor NightLase Therapy requires the combining of data acquired in several different ways. Data needs to be obtained from the patient and when possible their sleep partner, both pre and post treatment, as well as their on-going assessment of the patient’s sleep patterns. This information is combined with the practitioner’s clinical evaluation of the patient’s condition to create the appropriate treatment regime.
Below are sample forms and documents in an Adobe PDF format to assist in evaluating and assessing the patients snoring and sleeping habits. There are pretreatment and post treatment forms to be completed by the patient and their sleeping partner when appropriate. Additionally, there is a variety of data that needs to be collected and recorded by the practitioner during the clinical examination to assess the patient the situation. The information obtained both pre and post treatment enables the practitioner to select, implement, and monitor the progress of the various sleep modalities available today such as oral appliances and NightLase treatment or an appropriate referral to a sleep specialist.
NightLase 7-Page Pre-Treatment Information
This 7-page document is an example of what information should be dispensed to the patient or their sleep partner when they express an interest in NightLase Therapy. This packet is designed for guidance and should be reviewed and edited for your specific philosophy and treatment protocols.
Additionally, each document can be downloaded separately as an individual document below.
This packet contains the following documents:
- Overview of NightLase Therapy to Reduce Snoring
- Overview of the SnoreLab App
- Patient's Pre-Treatment Self-Assessment Form
- Patient's Dozing and Snoring Grading Form
- Sleep Partner's Pre-Treatment Sleep Assessment Form
- NightLase Post-Treatment Instructions
- NightLase Sample Consent Form
NightLase 4-Page Post-Treatment
Instructions & Assessment Forms Packet
This 4-page document is an example of what information should be dispensed to the patient after each NightLase Treatment. This packet is designed for guidance and should be reviewed and edited for your specific philosophy and treatment protocols.
Additionally, each document can be downloaded separately as an individual document below.
This packet contains the following documents:
- NightLase Post-Treatment Instructions
- Patient's Post-Treatment Self-Assessment Form
- Patient's Post-Treatment Dozing and Snoring Grading Form
- Sleep Partner's Post-Treatment Sleep Assessment Form
Overview of NightLase Therapy to Reduce Snoring
This 1-page document is designed to give the patient and their sleep partner an overview of NightLase Therapy and the concerns about what snoring may mean. It explains the basics of the NightLase assessment and treatment process and the multiple appointments that are required to obtain the best possible outcomes. It also discusses the seriousness of Obstructive Sleep Apnea (OSA) and the potential need for a referral to their physician for a comprehensive sleep study. It also explains that NightLase Therapy is an additional adjunctive therapy that may provide an additional benefit to patients with OSA.
Click on the Adjacent Image to Preview the Document
Clinical Evaluation & Consultation for NightLase Therapy Form
Each practitioner should develop the examination and treatment protocols that they feel are appropriate for their patients and practice. This 1-page document is a guide to assist a clinician in evaluating and assessing the patient's present status and some of the data and anatomical features that should be recorded in the patient’s clinical record.
Click on the Adjacent Image to Preview the Document
This document provides the patient with an overview of the SnoreLab smartphone app that should be integrated as part of assessing the patient’s need for NightLase Therapy. The app helps in quantifying their snoring patterns both pre and post NightLase Therapy. The SnoreLab app is designed to help monitor and analyze the user’s snoring patterns during sleep. It uses the microphone of the smartphone to record and analyze snoring sounds while the user sleeps. SnoreLab helps quantify the user’s snoring by recording their snoring throughout the night and provides detailed information about the duration and intensity of each snoring episode. The data obtained can be downloaded from the patient’s smartphone into their electronic health record.
More information about the app is available on their website at www.SnoreLab.com.
Click on the Adjacent Image to Preview the Document
Patient's Post-Treatment Instructions After a NightLase Treatment
This is a sample of some of the recommended post-operative instructions to be given to the patient after they have received a NightLase treatment. Additionally, this document contains several exercises for the tongue and muscles of the oral cavity that have been shown to assist in reducing snoring.
Click on the Adjacent Image to Preview the Document
Patient's Pre-Treatment Self-Assessment Form
The purpose of this 1-page questionnaire is for the patient to self-assess their snoring and sleeping habits prior to the NightLase treatment to help determine their needs. Not only is this form used to assess their needs, but also to monitor the progress and benefits of the treatment modalities they are receiving.
Click on the Adjacent Image to Preview the Document
Patient’s Pre-Treatment Dozing and Snoring Grading Form
The purpose of this 1-page questionnaire is for the patient to self-assess how their daily activities and those around them are affected by the quality of their sleep. The form contains the Epworth Sleepiness Scale to assess how likely the patient is to dose off or fall asleep in various situations. It also contains the Thornton Snoring Scale to assess how their snoring affects the quality of life for other individuals as snoring can affect the people around them both physically and emotionally. Additionally, the form has a place to record the SnoreLab app’s “snore score” to enhance their awareness of its value. Not only is this form used to assess their status prior to treatment, but also to monitor the progress and benefits of the treatment modalities as they are receiving.
Click on the Adjacent Image to Preview the Document
Sleep Partner's Pre-Treatment Sleep Assessment
The purpose of this 1-page questionnaire is for the patient's sleep partner to assess the patient's snoring and sleeping habits before NightLase treatment to help determine the patient’s needs. Not only is this form used to assess their needs prior to treatment, but also to monitor the value and benefits of the treatment modalities as they are receiving.
Click on the Adjacent Image to Preview the Document
Patient's Post Treatment Self-Assessment Form
The purpose of this 1-page questionnaire is for the patient to self-assess their snoring and sleeping habits a few weeks after each NightLase treatment to help access the changes and improvement in their sleep patterns. Not only is this form used to assess their status after each treatment, but also to monitor the value and benefits of the treatment modalities they have implemented.
Click on the Adjacent Image to Preview the Document
Patient’s Post-Treatment Dozing and Snoring Grading Form
The purpose of this 1-page questionnaire is for the patient to self-assess how their daily activities and those around them have changed by the present quality of their sleep. It should be completed a few weeks after each of their NightLase treatments. This form contains the same questions as the similar pre-treatment form in addressing their tiredness and how their snoring affects other individuals. Additionally, the form has a place to record the SnoreLab app’s “snore score” to enhance their awareness of its value. Not only is this form used to assess their status after each treatment, but also to monitor the value and benefits of the treatment modalities they have implemented.
Click on the Adjacent Image to Preview the Document
Sleep Partner's Post Treatment Sleep Assessment
The purpose of this 1-page questionnaire is for the patient's sleep partner to assess the patient's snoring and sleeping habits a few weeks after each NightLase treatment to help determine the changes and improvements in the patient's sleep patterns. Not only is this form used to assess the patient’s status after each treatment, but also to monitor the value and benefits of the treatment modalities the patient has implemented.
Click on the Adjacent Image to Preview the Document