When should I consider referring a patient with suspected OSA to a specialist for further evaluation?

Refer a patient with suspected obstructive sleep apnoea to a specialist for further evaluation if they have suspected moderate or severe OSAS, or suspected mild OSAS that is impacting on their quality of life ².

Arrange urgent referral to a sleep clinic if the patient has excessive sleepiness impacting on safety-critical work, such as professional driving, or if they have comorbid conditions like COPD, poorly controlled arrhythmia, nocturnal angina, heart failure, treatment-resistant hypertension, pulmonary hypertension, or respiratory failure ².

Refer urgently if the patient has clinical features of nasopharyngeal obstruction such as adenotonsillar hypertrophy and regular snoring at night, especially in children ².

Consider routine referral for further investigation if the patient has suspected mild OSAS that does not impact their quality of life, or if they have symptoms that require confirmation and management ².