P226 Reduction of appointments after introduction of sleep symptom questionnaire into a sleep apnoea pathway

Introduction Prior to October 2018 our sleep service was offering oximetry sleep study and consultant appointment for all sleep referrals. GP referrals have increased by up to 13%. As a result of a quality improvement project we changed our pathway to incorporate a sleep symptom questionnaire at the time of study, then consultant reporting and restricting clinic appointments to those with definite sleep apnoea. Repeat studies were arranged for equivocal cases depending on the symptom questionnaire. Method 376 patients (GP referral=279) attended for home sleep study over a 6 month period were included in the analysis. Studies were either screening overnight pulse oximetry (n =310) or multi-channel respiratory tracings (n=36). An additional sleep symptom questionnaire was completed prior to performing the studies. After consultant review of the study and questionnaire, patients were either offered treatment, further investigation or discharged with advice. Results 49% of patients who attended for sleep studies required doctor follow up and CPAP treatment. 43% of patients attending for sleep studies did not require clinic appointment or CPAP. 8% of the individuals attended clinic but did not have CPAP after consultation – the majority of this group were advised lifestyle changes and/or use of MAD (CPAP not required/lifestyle advice n = 14, MAD= 10, CPAP offered but declined = 3, neurology referral =2, CBT = 2). Conclusion and Discussion Around half of patients referred to the sleep clinic have normal overnight oximetry readings and do not require clinic consultation if a symptom questionnaire is also completed. Implementation of a sleep symptom questionnaire into the sleep apnoea pathway helps preserve appointment capacity. Individuals with mild sleep apnoea may still require clinic appointment to discuss symptoms and treatments.