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Nightlase Consent

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 Nightlase Consent

  • Nightlase Laser Snoring and Sleep Apnea Reduction Informed Consent

  • I understand that I have a significant snoring issue and/or obstructive sleep apnea. I either cannot tolerate, or choose not to tolerate CPAP or oral sleep appliance therapy. I understand the health risks associated with not treating my sleep disordered breathing, such as: high blood pressure, weight gain, hormone imbalances, stroke and/or coronoary artery disease and diabetes.

    Nightlase laser treatment is for patients who cannot tolerate CPAP and/or oral sleep appliances. Nightlase has been found to be beneficial in reducing snoring and OSA by opening the airway.

    Nightlase involves the use of the Erbium:Yag laser non ablative (non cutting) treatment of the soft palate and surrounding areas.

    Nightlase consists of 3-30minute treatments, 21 days apart.

    Risks: There are no risks, other than possibly not perceiving any improvement in your symptoms.

    Possible benefits: Improved sleep, reduced fatigue, weight loss, happier spouse/family

    Length of treatment: The Nightlase treatment is a strictly a therapy to help maintain a more open airway during sleep and during waking hours. It does not cure snoring or sleep apnea. Due to patient variation, the treatment may last from 6-18 months, and may require some retreatment. Over time, simple snoring may develop into obstructive sleep apnea. Sleep apnea may also worsen. Therefore, it is important to be screened annually. If unusual symptoms occur, you are advised to schedule an office visit for evaluation.

    Alternatives to Nightlase: Lifestyle modification (weight loss), CPAP, surgery, and/or an oral sleep appliance.

    I have read this informed consent and I have had opportunity to ask questions. All my questions have been answered to my satisfaction. I consent to the taking of photographs, video and any necessary radiographs and their use in scientific papers, demonstrations or discussions of the procedure in social media, print and online.

  • Date Format: MM slash DD slash YYYY

After submitting, feel free to return to the Patient Forms page. Please note, there are multiple forms for each section.

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