Health Issue

GPs now know that severe Obstructive Sleep Apnoea (OSA) is a major health issue and carries roughly a threefold risk of heart attack and stroke. It should not be left untreated. Like any chronic disease with potentially dangerous consequences for the individual or those around them, the first port of call for a patient is their GP, a person trusted by the patient to act in their best interest.

While one patient may have a health issue such as OSA, however, it is important to understand that another with less than severe OSA can have significantly reduced cardiovascular and cerebrovascular risk and may not require active treatment.

In that case and in the absence of other symptoms of the Four Pillars, a SleepGP may decide it is appropriate to let patients with mild or even early moderate OSA go untreated, but remain under surveillance, making sure their OSA doesn’t get worse over time.

Trained SleepGPs are able to do this with certainty. These patients appreciate that management approach to their OSA – whereas commercial CPAP sales organisations and ‘sleep shops’ would try to sell the patient a CPAP device that was not needed yet, or not needed at all.

Daytime Tiredness

Complaints of tiredness in General Practice represent 5-7% of GP consultations and after the ‘heart-sink’ feeling that often accompanies this complaint has passed, a good GP is well versed in its management.

Now, a SleepGP has added diagnoses to assist in the successful management of this disorder. The SleepGP will thoroughly evaluate the patient to identify all possible causes of their excessive daytime tiredness, including such conditions as Idiopathic Hypersomnolence, Obstructive Sleep Apnoea, Upper Airway Resistance Syndrome (UARS) and Narcolepsy – all treatable conditions.

Insomnia Issue

– Misreported, Mishandled or Just Plain Missed?

Simply stated, Insomnia is the inability to get to sleep, or to get back to sleep or have poor quality sleep. Poor sleep is reported in 70% of the population and 10% will meet the criteria of Insomnia. It is an independent co-morbidity and doesn’t respond to Sleep Hygiene counselling as many providers believe.

The causes of insomnia can be complex, but it can be managed in most cases in a primary care setting. Once identified the most successful treatment is CBTi. A referral to a psychologist may be appropriate here.

An up-skilled SleepGP will also know when it is appropriate – and when it is not – to recommend the various hypnotic agents available on the market.

Snoring Issue

“Whilst many OSA sufferers snore, not all snorers have OSA. That’s why it’s vital that a trained GP is consulted, if your patient, their partner or family say they snore.

Snoring is characterised by high-frequency vibrations of the soft palate, pharyngeal walls, tongue and epiglottis and is considered a sign of partial upper airway obstruction. *Upskilled SleepGPs are trained to assess these areas of the static airway using a flexible nasendoscope.

Never ignore a Snore^TM  though, because a possible causal relationship of snoring has been found to carotid atherosclerosis, sleepiness and other negative health effects.

For all these reasons, a doctor is the best person to consult about snoring, even if your patient thinks its just a social issue.”

*(Lee et al., 2008, Svenssonet al., 2008; Tassi et al., 2012, Ulfberg et al, 1996a,b, Pevernagie et al., 2010)