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Sleep apnoea – Information for GPs

Referral criteria / commissioning position

All referrals and treatment for sleep apnoea must:

  • comply with NICE TAG 139
  • have an Epworth sleepiness scale of 10 or more
  • scores of less than 10 where sleep apnoea is strongly suspected are also included

Identification of risk factors for sleep apnoea:

  • male patient
  • collar size 17.5 or over
  • obesity
  • snoring
  • excessive daytime somnolence
  • witnessed Apnoea
  • Investigations prior to referral
  • completed Epworth score
  • consider TFT if suspected thyroid problem

Investigations prior to referral

  • completed Epworth score
  • consider TFT if suspected thyroid problem

Information to include in referral letter

  • Details of how the patient meets this requirement
  • Timeline, severity, impact on daily living
  • Known variation of intensity, triggers
  • Epworth score
  • Actions (medical and non-medical), treatments and interventions tried including the results
  • Patient’s understanding and expectation regarding options in a specialist service setting
  • Drug history (prescribed and non-prescribed)
  • Relevant past medical/surgical history
  • Current regular medication
  • BMI
  • Smoking status
  • Alcohol consumption

References and additional information

Murray W. Johns – A New Method For Measuring Daytime Sleepiness: The Epworth Sleepiness Scale – Sleep 1991; 14:540-5

Brietzke SE, Katz ES, Roberson DW., Can history and physical examination reliably diagnose the paediatric obstructive sleep apnoea/hypopnea syndrome? A Systematic review of the literature, 2004, Otolaryngology – Head and Neck Surgery, Elsevier http://www.ncbi.nlm.nih.gov/pubmed/15577775

NICE Clinical Knowledge Summary – Sleep Apnoea http://cks.nice.org.uk/obstructive-sleep-apnoea-syndrome#!scenario

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