Follow-up and monitoring for people with OSAHS (obstructive sleep apnoea/hypopnoea syndrome)
Tailor follow-up to the person's overall treatment plan, which may include lifestyle changes and treating comorbidities
Follow-up for people using continuous positive airway pressure (CPAP)
- offer face-to-face, video or phone consultations, including review of telemonitoring data (if available), to people with OSAHS having CPAP. This should include:
- an initial consultation within 1 month and
- subsequent follow-up according to the person's needs and until optimal control of symptoms and apnoea-hypopnoea index (AHI) or oxygen desaturation index (ODI) is achieved
- once CPAP is optimised, consider annual follow-up for people with OSAHS
- offer people with OSAHS having CPAP access to a sleep service for advice, support and equipment between follow-up appointments
Follow-up for people using mandibular advancement splints
- offer face-to-face, video or phone consultations, including review of downloads from the device (if available), to people with OSAHS using a mandibular advancement splint. This should include:
- initial follow-up to review adjustment of the device and symptom improvement at 3 months and
- subsequent follow-up according to the person's needs and until optimal control of symptoms and AHI or ODI is achieved
Follow-up for people using positional modifiers
- offer face-to-face, video or phone consultations, including review of downloads from the device (if available), to people with OSAHS using a positional modifier
- this should include:
- an initial consultation within 3 months and
- subsequent follow-up according to the person's needs until optimal control of symptoms and AHI or ODI is achieved
Follow-up for people who have had surgery
- offer people with OSAHS who have had surgery:
- an initial follow-up consultation with respiratory polygraphy within 3 months of the operation and
- subsequent follow-up according to the person's needs
Follow-up for drivers with excessive sleepiness
Monitoring treatment efficacy for people with obesity hypoventilation syndrome (OHS)
Assess the effectiveness of treatment with CPAP or non-invasive ventilation in people with OHS by reviewing the following:
- OHS symptoms, including the Epworth Sleepiness Scale and vigilance, for example, when driving
- severity of OSAHS, using AHI or ODI
- improvement in oxygenation and hypercapnia while awake and asleep
- adherence to therapy
- telemonitoring or download information from the device (if available)
Explore with the person their understanding and experience of treatment, and review the following:
- mask type and fit, including checking for leaks
- nasal and mouth dryness, and the need for humidification
- other factors affecting sleep disturbance such as insomnia, restless legs and shift work
- sleep hygiene
- cleaning and maintenance of equipment
For people with OHS having supplemental oxygen therapy, review whether this is still needed after treatment with non-invasive ventilation or CPAP has been optimised.
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