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

Last edited 09/2021 and last reviewed 09/2021

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

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