Obstructive sleep apnea and hypapnea syndrome : A retrospective study of referral practice

Abstract

The aim of this study was to shed light on the practice of referral to a sleep clinic with suspected obstructive sleep apnea hypapnea syndrome(OSAHS). The hypothesis was that the accuracy of referrals could be significantly improved.

We included 79 patients with suspected OSAHS, referred to a private sleep clinic. 26 patients were referred from ENT surgeons, 50 from general practitioners, 3 from others. They went through a sleep monitoring with an oesophageal pressure catheter(REGGIE).

We considered the sleep monitoring as the gold standard for the diagnosis of OSAHS. Given this assumption, we found an accuracy of 53,8% amongst the ENT surgeons, 48,0 % amongst the GPs and an overall accuracy of 50,6 %.

An accuracy of referral in this range was expected. It should be possible to raise this with better education of the medical community.

Even given such a low accuracy, it might still be economically sound to refer such volumes of patients, given the high socioeconomical cost of undiagnosed OSAHS. This is implicated in American cost-benefit studies.