Sleep disordered breathing (suspected or confirmed)

ADULT
Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Suspected or confirmed sleep apnoea with any of the following:
    • Epworth Sleepiness Scale score ≥ 16
    • frequent episodes of impairment when driving due to sleepiness or inattention (multiple per week)
    • MVA or work related accident due to sleepiness or inattention in the last 12 months
    • unstable cardiovascular disease e.g. severe cardiomyopathy (EF <25%)
    • Sleep Disordered Breathing in pregnancy (associated with poor maternal and foetal outcomes)
  • Suspected or confirmed sleep hypoventilation with any of the following:
  • Progressive neuromuscular disorder
  • Established daytime hypercapnia or hypoxemia (as demonstrated on ABG if performed)
  • Diagnostic study with significant sleep hypoxaemia (total sleep time at oxygen saturation ≤90% of ≥20%)
Category 2
(appointment within 90 calendar days)
  • Suspected or confirmed sleep apnoea with any of the following clinical features:
    • Epworth Sleepiness Scale score 12-15
    • Episodes of impaired driving due to sleepiness or inattention (at least several per month)
    • Recent accident or near-miss events while driving (in last 12 months)
  • Significant comorbidities that may be affected by sleep disordered breathing such as pulmonary hypertension, heart failure, significant cardiac arrhythmias or significant neurological disease (for example unstable seizures)
  • Diagnostic sleep study demonstrating any of the following:
    • Respiratory Disturbance Index of ≥ 30 respiratory events per hour
    • Sleep hypoxaemia (total sleep time at oxygen saturation ≤90% of 10-20%)
    • High probability of sleep apnoea and major surgery planned
Category 3
(appointment within 365 calendar days)
  • Suspected or confirmed  sleep apnoea that does not meet criteria for Category 1 or 2 but still requires specialist review

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention not otherwise accessible to the patient
  • For advice regarding management
  • To engage in an ongoing shared care approach between primary and secondary care
  • Reassurance for GP/second opinion
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)

2. Essential referral information Referral will be returned without this

  • Full report (including all pages) from all previous sleep studies (if performed)
  • Previous management (mandibular advancement splint, CPAP) and response and reports of usage (if available)
  • Epworth Sleepiness Scale score
  • Occupation
  • Driving licence class(es) (C | LR | HR | MR | HC | MC)
  • History of motor vehicle accidents or sleepiness/inattention when driving

3. Additional referral information Useful for processing the referral

  • No additional referral information required

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 3 December 2024

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