Sleep is hugely important for overall health and wellbeing, however while people will do anything to get a good night’s rest it has now been revealed that Aussie GPs may be regularly under-diagnosing a serious sleep condition.
Questionnaires used by GPs to screen patients for sleep apnoea could mean they are missing up to 64 per cent of people with the condition, according to research published in the Medical Journal of Australia.
Sleep apnoea impacts the airways and interrupts normal breathing throughout the night, causing a lack of oxygen entering the body. The muscles and soft tissues in the throat commonly relax and cause a blockage, resulting in periods of time where the person isn’t breathing. Sufferers commonly wake up repeatedly throughout the night because of this.
Obstructive sleep apnoea (OSA) in particular impacts up to 38 per cent of adults and is linked with higher disease rate, a higher risk of death and high health-related costs. While the condition was previously managed by sleep specialists, recent changes to the Medicare Benefits Schedule now allow primary care clinicians to refer patients for sleep studies based on results of various questionnaires. These tests – which include the Berlin questionnaire (BQ), OSA-50, the Epworth sleepiness score (ESS) and the STOP-Bang questionnaire – may be missing a significant number of OSA patients.
Researchers analysed data from 424 participants in the Tasmanian Longitudinal Health Study with OSA symptoms who each completed OSA screening questionnaires. The questionnaires are intended to identify the risk of sleep disordered breathing through a series of questions around age, weight and snoring habits.
“If used to rule out OSA in primary care settings, the three screening questionnaires would exclude 14–35 per cent of people with clinically relevant OSA,” the authors wrote. “For people likely to trigger OSA assessment in primary care, the STOP-Bang, BQ, and OSA-50 questionnaires, combined with the ESS, can be used to rule in, but not to rule out clinically relevant OSA,” researchers said.
Researchers say this combination of tests with the ESS could still miss between 49 and 64 per cent of clinically relevant OSA, meaning many patients would not be receiving the correct diagnosis or relevant treatment for their condition.
Snoring is the biggest symptom of OSA, while others notice excessive daytime sleepiness, impaired concentration, irritability, waking up with headaches, unrefreshing sleep and mood swings. Those who regularly urinate at night and have fragmented sleep may also be impacted, while being awoken by a cough or choking feeling is another major warning sign.
The condition can be impacted by obesity, smoking and alcohol consumption, but can also be caused by genes or the ageing process.
Left untreated, OSA can be linked with serious health conditions such as diabetes, heart failure, hypertension, obesity or stroke. CPAP machines can be used by many to deliver positive air pressure into the airway to allow for unblocked breathing, while surgery is an option for others.
Getting a proper diagnosis or referral is key because patients will then complete a sleep test to record sleeping patterns and sleep physicians will then offer advice on how to best manage the condition.
It’s always important to be honest with a GP about what symptoms you’re experiencing and even take along a partner or loved one who can explain what they’re seeing while you’re asleep.
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