follow-up and monitoring for people with OSAHS (obstructive sleep apnoea/hypopnoea syndrome)
Last edited 09/2021 and last reviewed 09/2021
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
- ensure follow-up is in line with Driver and Vehicle Licensing Agency guidance on assessing fitness to drive
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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