Obstructive sleep apnoea hypopnoea syndrome (OSAHS) is characterised by repeated episodes of pharyngeal collapse during sleep, this causes apnoeic episodes and poor quality of sleep.Patients are frequently excessively sleepy during the day.
Patients with suspected OSAHS should be referred to the Sleep Centre at the Royal Infirmary of Edinburgh for assessment
Services
The Sleep Centre has clinics for new patients and review patients on Tuesdays, Wednesdays, Thursdays and Fridays
Consultants: Dr T Mackay, Dr R Riha, Dr Killiroi Kefala, Dr Chris Derry
Speciality Doctor: Dr R Frangulyan
Nurse-led clinic for reviews
Currently there is capacity for 55 new patients per week and our waiting for first new patient review time for a routine new patient appointment is approximately 12 weeks.
Priority will be given to patients who are suspected of having excessive awake-time sleepiness and an Epworth score calculator, and who fit the following categories:
Snoring:
Who to refer:
Refer patients with:
OSAHS
Features suggesting OSAHS – Priority symptoms
- Epworth Sleepiness Score ≥11
- Witnessed frequent apnoeas by partner with loud “rescue” breaths
- Excessive Day time somnolence
- HGV or PSV driver
- Restless or disturbed sleep with frequent awakenings
Please complete the mandatory fields.
Parasomnia symptoms are listed to act as an aide memoire if this diagnosis is being considered
Use the Lothian SCI-gateway referral proforma.
Distinguish between Obstructive sleep apnoe, Hypopnoea syndrome and patients who snore.
Lothian does not have a snorers service
Narcolepsy
Sleep attacks,where the patient falls asleep suddenly and without warning. This is associated with sleep paralysis, vivid dreams and cataplexy
Sleep phase shift problems.
Circadian rhythm sleep disorder affecting the timing of sleep,
Parasomnias Deviant behavioural or physiologic events while asleep.
- Morning headaches
- Vivid dreams
- Sleep walking
- Violent behaviour overnight
- Home oxygen therapy
- Choking sensation with abrupt awakening from sleep
- Leg / arm jerks
- Sleep paralysis
- Sleep talking
- Muscular weakness associated with emotion
Who not to refer:
- Patients with Epworth score <11, unless there are clear symptoms which suggest that OSAHS may be present as patients, especially drivers, may under-estimate their Epworth score
- Patients who have a BMI >30 and who have not also been referred to weight management services
- Patients whose alcohol consumption is above safe limits (<14units/ week)
- Patients who smoke and have not also been referred to smoking cessation
- Patients who regularly smoke cannabis
- Patients with newly diagnosed metabolic disorders. (Refer if symptoms persist after the metabolic disorder is stable)
- Patients with sleep related problems secondary to psychiatric illness
- Patients with suspected chronic insomnia
How to refer:
Use Sci-Gateway to refer
Flow Chart for Sleep Apnoe (link not found)
Flow Chart Sleep Service – Supplement (link not found)
