Prioritising people for rapid assessment by a sleep service - obesity hypoventilation syndrome (OHS)
When referring people with suspected OHS 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
- BMI
- comorbidities
- occupational risk
- oxygen saturation and blood gas values, if available
- any history of emergency admissions and acute non-invasive ventilation
Within the sleep service, prioritise people with suspected OHS 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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