Obstructive sleep apnoea _ hypopnoea syndrome -NICE guidance summary

OSAHS is a condition in which the upper airway is narrowed or closes during sleep when muscles relax, causing under breathing ( hypopnoea ) or stopping breathing ( apnoea ) .

When to suspect OSAHS - if they have 2 or more of the following features snores witnessed apnoeas unrefreshing sleep waking headaches unexplained excessive sleepiness , tiredness or fatigue nocturia clocking during sleep sleep fragmentation or insomnia cognitive dysfunction or memory impairment

Risk of OSAHS increases in people with obesity obesity or overweight in pregnancy treatment resistant hypertension type 2 diabetes cardiac arrhythmia - particularly AF stroke ot TIA chronic heart failure moderate or severe asthma polycystic ovary syndrome Down's syndrome non- arterial anterior ischaemic optic neuropathy - sudden loss of vision in 1 eye due to decreased blood flow to the optic nerve hypothyroidism acromegaly

Assessment scales -Use Epworth Sleepiness Scale for initial assessment Consider using the SOP - Bang as well as the the ESS Do not use the Epworth Sleepiness Scale alone to determine if referral is needed as not all people with OSAHS have excessive sleepiness

Referral letter - result of assessment scores how does sleepiness affect the person comorbidities occupational risks oxygen saturation and...