Assessment and management of obstructive sleep apnoea in Australian general practice

Abstract

Obstructive sleep apnoea (OSA) is a prevalent disorder managed in Australian general practice. This article aims to provide an overview of the presenting symptoms, assessment, management and referral options of OSA.

Key Points

Obstructive sleep apnoea (OSA) is a prevalent, debilitating, and costly disorder managed in Australian general practice. It is often unrecognised and underdiagnosed.

Presenting symptoms vary considerably between individuals. The most common risk factors for OSA are age, overweight/obesity, and male sex (however, OSA also occurs in women, especially after menopause).

GPs may help patients manage snoring and provide lifestyle advice regarding healthy sleep, diet and physical activity.

GPs can use brief questionnaires to identify patients with high-risk of OSA, and refer them for an overnight sleep study (home-based or laboratory), or to specialist sleep physicians (for patients with severe OSA, significant co-morbidities).

The most reliably effective treatment for moderate and severe OSA is continuous positive airway pressure (CPAP) therapy combined with lifestyle/weight management advice. Patients treated with CPAP should be provided acute and ongoing support to adapt to CPAP therapy and overcome any barriers to adherence.

Other treatments including positional therapy, dental devices, and surgery may be considered if patients do not tolerate CPAP therapy and/or depending on the nature and severity of the sleep apnoea. These non-CPAP therapies can be very effective and can be used in combination.

Our research group is currently involved in an NHMRC-funded program that aims to provide GPs with the tools, treatment and referral options to manage sleep disorders in general practice. We encourage all interested GPs to contact us for research participation (contact@ncshsr.com).