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Sleep disordered breathing (suspected or confirmed)

ADULT

Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Suspected or confirmed sleep apnoea with any of the following:
      • Epworth Sleepiness Scale score ≥ 16
      • dozing while driving at least 1-2/month
      • MVA or work-related accident related to sleepiness/inattention in last 12 months
      • unstable cardiovascular disease e.g. overt heart failure
    • Suspected or confirmed sleep hypoventilation with any of the following:
      • progressive neuromuscular disorder
      • established daytime hypercapnia (as demonstrated on ABG (if performed))
      • diagnostic sleep investigation demonstrating mean sleep saturation 85-90% (Mean sleep saturation <85% should ideally be seen within 2 weeks)
  • Category 2
    (appointment within 90 calendar days)
    • Suspected or confirmed sleep apnoea with any of the following:
      • Epworth Sleepiness Scale score 12-15
      • dozing while driving in last 12 months
      • MVA or work-related accident related to sleepiness/inattention in last 5 years
      • occupation involving driving / heavy machinery operation
      • significant comorbidities for example pulmonary hypertension, previous stroke, heart failure,
      • significant cardiac arrhythmias, neurological disease, acromegaly or hypothyroidism
      • Respiratory Disturbance Index of ≥ 30 respiratory events per hour on a diagnostic sleep investigation
  • Category 3
    (appointment within 365 calendar days)
    • Suspected or confirmed sleep disorders, including chronic insomnia, circadian rhythm disorders, parasomnias or sleep related movement disorders that do not meet criteria for Category 1 or 2 but still require specialist review

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention not otherwise accessible to the patient
  • For advice regarding management
  • To engage in an ongoing shared care approach between primary and secondary care
  • Reassurance for GP/second opinion
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)

2. Essential referral information Referral will be returned without this

  • History of sleep disorder including duration and severity of symptoms, snoring, witnessed apnoeas, restless sleep, unrefreshing sleep, tiredness, inappropriate falling asleep
  • Management to date including any previously tried appliances (mandibular advancement splint, CPAP) and response
  • Current medications
  • Epworth Sleepiness Scale score
  • Full report from all previous sleep investigations (if already performed)
  • Occupation
  • Driving licence type
  • History of motor vehicle accidents or sleepiness/inattention when driving

3. Additional referral information Useful for processing the referral

No additional referral information required

4. Request

Last updated: 13 June 2023