Feature Article

Obstructive sleep apnoea: assessment and management in general practice

Feature Article

Obstructive sleep apnoea: assessment and management in general practice

ALEXANDER SWEETMAN, Ching Li Chai-Coetzer, Emer Van Ryswyk, Andrew Vakulin, NICOLE LOVATO, Nicholas Zwar, Stijn Soenen, R. Doug McEvoy, Robert Adams

Figures

© alpa prod/shutterstock model used for illustrative purposes only
© alpa prod/shutterstock model used for illustrative purposes only

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 for patients with OSA.

Key Points

  • Obstructive sleep apnoea (OSA) is a prevalent, debilitating and costly disorder that is underdiagnosed and undertreated.
  • Presenting symptoms vary considerably between individuals, and the most common risk factors are age, overweight or 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 a high risk of OSA and refer them for an overnight sleep study (home-based or laboratory), or to a specialist sleep physician (for patients with severe OSA or significant comorbidities).
  • The most reliably effective treatment for moderate and severe OSA is continuous positive airway pressure (CPAP) therapy combined with lifestyle and weight-management advice.
  • Patients treated with CPAP should be provided immediate and ongoing support to adapt to CPAP therapy and overcome any barriers to adherence.
  • Other treatments, including positional therapy, dental devices and surgery, can be effective and can be used in combination with CPAP; they may be considered depending on the nature and severity of OSA or if the patient does not tolerate CPAP.