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There is a spectrum of severity increasing from mild increasing to severe obstructive sleep apnoea (OSA).
Most adults snore intermittently:
Both snoring and OSA are predominantly, but not exclusively, weight related conditions.
Please note referral criteria are applicable in this referral. Referrals submitted without this information will be returned.
Completion of a referral form including Epworth score (and Berlin for referrals to Torbay & South Devon) is a prerequisite of referral to this service.
Symptoms or signs suggestive of oropharyngeal neoplasm e.g: unilateral tonsil and tongue enlargement.
Significant OSA causes daytime somnolence. This increases the risk of personal injury, especially when driving. Hypertension, strokes and myocardial infarction rates are all increased.
Other causes of daytime somnolence need exclusion. These include:
Prior to referral please consider the following:
The available treatments for OSA are CPAP (Continuous positive airway pressure therapy) or mandibular splints (surgical treatments have unpredictable results and it is possible they might make the use of CPAP more difficult.)
These treatments are only suitable for moderate and severe cases.
Patients usually only tolerate the treatment if they have sufficient somnolence to impact on their quality of life. The degree that warrants treatment is therefore determined by the patient and their lifestyle. The Epworth score is a helpful measure in conjunction with clinical assessment, scores less than 11 suggest sleep apnoea is unlikely, 14 or more suggests moderate – severe OSA.
Occasional nocturnal apnoeas may cause alarm to the sleeping partner but if the frequency is low then there will be no ensuing daytime somnolence and no need to treat. Reassurance without referral is sufficient.
Mild or occasional symptoms of OSA do not require referral as it is unlikely that treatment will be accepted. There is no evidence of long-term health risk for this group.
It is vital that patients with OSA and daytime sleepiness sufficient to impair driving, or the use of machinery, are warned of the risks and told to cease immediately, pending treatment.
Please note referral criteria (below) are applicable in this referral.
Referrals submitted without this information will be returned.
Completion of a referral form including Epworth score (and Berlin for T&SD) is a prerequisite of referral to this service.
Completed forms must be attached when the UBRN is created.
Please only refer patients with an Epworth Sleepiness Score of 12 or more,
Torbay and South Devon also require 2 or more domains positive on the Berlin Questionnaire.
Prior to referral exacerbating factors should be considered; Obesity, alcohol, night sedation and smoking should be corrected where possible.
e-Referral Service Selection
e-Referral Service Selection
This guideline has been signed off by the Western Locality on behalf of NEW Devon CCG.
Publication date: March 2019