Sleep disordered breathing (suspected or confirmed)

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

Suspected or confirmed sleep apnoea with any of the following:
- Epworth Sleepiness Scale score ≥16
- Frequent episodes of impairment when driving due to sleepiness or inattention (multiple per week)
- MVA or work related accident due to sleepiness or inattention in the last 12 months
- unstable cardiovascular disease e.g. cardiomyopathy (EF <25%)
- Sleep Disordered Breathing in pregnancy (associated with poor maternal and foetal outcomes)
Suspected or confirmed sleep hypoventilation with any of the following:
- progressive neuromuscular disorder
- established daytime hypercapnia or hypoxemia (as demonstrated on ABG, if performed
- diagnostic study with significant sleep hypoxaemia (total sleep time at oxygen saturation ≤90% of ≥20%)

Category 2

Appointment within 90 days is desirable

Suspected or confirmed sleep apnoea with any of the following clinical features:
- Epworth Sleepiness Scale score 12-15
- Episodes of impaired driving due to sleepiness or inattention (at least several per month)
- Recent accident or near-miss events while driving (in last 12 months)
Significant comorbidities that may be affected by sleep disordered breathing such as pulmonary hypertension, heart failure, significant cardiac arrhythmias, or significant neurological disease (for example unstable seizures)
Diagnostic sleep study demonstrating any of the following:
- Respiratory Disturbance Index of ≥30 respiratory events per hour
- Sleep hypoxaemia (total sleep time at oxygen saturation ≤90% of 10-20%)
- High probability of sleep apnoea and major surgery planned

Category 3

Appointment within 365 days is desirable

Suspected or confirmed sleep apnoea that does not meet criteria for Category 1 or 2 but still requires specialist review

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

Refer to HealthPathways for assessment and management information if available
Referring doctor must assess immediate risk of driving and provide appropriate counselling based on Assessing Fitness to Drive Guidelines (including avoiding driving altogether if necessary).

Referral requirements

A referral may be rejected without the following information.

Essential referral information

Full report (including all pages) for all previous sleep studies (if performed)
Previous management (mandibular advancement splint, CPAP) and response and reports of usage (if available)
Epworth Sleepiness Scale score
Occupation
Driving licence class(es) (C | LR | HR | MR | HC | MC)
History of motor vehicle accidents or sleepiness/inattention when driving

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Clinical Modifiers (where relevant)

Impact on employment
Impact on education
Impact on home
Impact on activities of daily living
Impact on ability to care for others
Impact on personal frailty or safety
Identifies as Aboriginal and/or Torres Strait Islander

Reason for Referral (essential)

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can’t order, or the patient can’t afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Clinical Information (essential)

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient’s Demographic Details (essential)

Full name (including aliases)
Date of birth
Residential and postal address
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander

Referring Practitioner Details (essential)

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature

Other Information (where relevant)

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Send referral

Hotline: 1300 364 938

Electronic:

GP Smart Referrals (preferred)
eReferral system templates

Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs

Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034

Health pathways

Access to Health Pathways is free for clinicians in Metro North Brisbane.

For login details email:
healthpathways@brisbanenorthphn.org.au

Locations

Resources

General referral criteria