Update on the assessment and investigation of adult obstructive sleep apnoea

BACKGROUND: Obstructive sleep apnoea (OSA) is common. Medicare Benefits Schedule rules regarding which patients are eligible for a sleep study without first needing to see a sleep or respiratory specialist have recently changed and incorporate validated questionnaires of OSA risk and subjective sleepiness. OBJECTIVE: The aim of this article is to bring general practitioners (GPs) up to date with the key factors that should be assessed when considering whether a patient has OSA. It also highlights the strengths and weaknesses of the screening questionnaires, and the pros and cons of different types of sleep studies. DISCUSSION: OSA may significantly affect quality of life, mood, safety and cardiovascular risk. Assessment should focus on symptoms. Screening questionnaires have high sensitivity but, when used alone, poor specificity for moderate-to-severe OSA. The Epworth Sleepiness Scale (ESS) is a poor marker of OSA but does predict response to treatment when elevated. GPs can directly order sleep studies when OSA questionnaires are positive and the ESS is elevated; however, negative questionnaires do not exclude OSA or another sleep disorder.