Prioritising people for rapid assessment by a sleep service - for suspected COPD (chronic obstructive pulmonary disease)-OSAHS

Prioritising people for rapid assessment by a sleep service - for suspected COPD (chronic obstructive pulmonary disease)-OSAHS (obstructive sleep apnoea/hypopnoea syndrome)

When referring people with suspected COPD-OSAHS overlap syndrome to a sleep service, include the following information in the referral letter to facilitate rapid assessment:

• results of the person's sleepiness score
• how sleepiness affects the person
• body mass index (BMI)
• severity and frequency of exacerbations of COPD
• use of oxygen therapy at home
• comorbidities
• occupational risk
• oxygen saturation and blood gas values, if available
• any history of acute non-invasive ventilation

Within the sleep service, prioritise people with suspected COPD–OSAHS overlap syndrome for rapid assessment if any of the following apply:

• they have severe hypercapnia (PaCO2 [partial pressure of carbon dioxide] over 7.0 kPa when awake)
• they have hypoxaemia (arterial oxygen saturation less than 94% on air)
• they have acute ventilatory failure
• they have a vocational driving job
• they have a job for which vigilance is critical for safety
• they are pregnant
• they have unstable cardiovascular disease, for example, poorly controlled arrhythmia, nocturnal angina, heart failure or treatment-resistant hypertension
• they are undergoing preoperative assessment for major surgery
• they have non-arteritic anterior ischaemic optic neuropathy

Reference:

• NICE (August 2021). Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s