Obstructive sleep apnoea: assessment and management in 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 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.