Advanced Diagnostic Capability in Respiratory & Sleep Medicine

Detecting disease earlier, more accurately, and where standard testing falls short.

Most respiratory and sleep conditions are not missed because they are rare — but because they are not measured correctly.

Why Standard Testing Often Falls Short

Many patients present with:

- Persistent cough with normal imaging

- Breathlessness with normal spirometry

- Fatigue with a “normal” sleep study

- Asthma that does not respond to treatment

These are not uncommon presentations.

Standard testing often:

- Focuses on late-stage disease

- Misses small airway dysfunction

- Relies on thresholds that may not reflect physiology

- Fails to explain symptoms when results appear “normal”

This creates diagnostic uncertainty and delays appropriate treatment.

What We Do Differently

At Western Respiratory Sleep, diagnostic testing is designed to assess underlying physiology, not just threshold-based results.

We focus on identifying:

- Small airway disease before spirometry becomes abnormal

- Subtle airflow limitation and airway resistance patterns

- Early or atypical asthma physiology

- Sleep-disordered breathing beyond standard AHI thresholds

This allows earlier diagnosis, more precise treatment decisions, and reduced reliance on trial-and-error therapy.

ADVANCED LUNG FUNCTION TESTING

We perform comprehensive lung function testing beyond standard spirometry.

Forced Oscillation Technique (FOT)

Detects small airway dysfunction and airway stiffness not visible on spirometry.

Bronchoprovocation Testing with FOT

Only lab in WA performing this.

Measures airway resistance/reactance during tidal breathing.

Detects subtle or early airway dysfunction not reflected in spirometry.

Gas Transfer & Lung Volumes

Identifies gas exchange abnormalities and air trapping.

Respiratory Muscle Testing (MIP / MEP / SNIP)

Assesses neuromuscular causes of breathlessness.

Supine vs Erect FVC

Screens for diaphragmatic weakness.

ADVANCED SLEEP DIAGNOSTICS

Comprehensive polysomnography with flow limitation and REM analysis.

Overnight oximetry for monitoring.

Integrated therapy:

- Positional therapy trials

- MAS pathways

FeNO

Identifies eosinophilic inflammation.

Rhinometry

Assesses nasal obstruction.

Explanation of symptoms when standard tests are normal

- Earlier diagnosis

Clinical Impact

Advanced diagnostics allows:

Reduced uncertainty

- Targeted therapy

Improved adherence

When to Refer

Refer when:

- Chronic cough with normal imaging
- Breathlessness with normal spirometry
- Unexplained fatigue
- Low screening but suspected OSA
- Poor asthma response
- Symptom-test mismatch

Refer a Patient