title: Clinical value and cost of a respiratory sleep-related breathing disorders screening service for snorers referred to a District General Hospital ENT department.
abstract: Sleep-related breathing disorders and snoring often co-exist in the community. We hypothesized that a significant proportion of patients referred from primary care to ENT surgeons for management of snoring might have significant sleep-related breathing disorders requiring medical management. The Respiratory Medicine Department at Whipps Cross Hospital, London, U.K. screened all such referrals using sleep questionnaires, overnight oximetry and diagnostic sleep studies where necessary as recommended by the Royal College of Physicians of London. Over 38 months, 115 patients were screened, of whom 43 (38%) had clinically significant sleep-disordered breathing. One-third were established on nasal continuous positive airway pressure ventilation and the remainder were mainly offered conservative treatment. The cost of the screening service is estimated at 14,000 Pounds for the initial year. The savings to the ENT service and the possible long-term benefits to the patients identified as having sleep-disordered breathing balance this. We conclude that screening all referred snorers for sleep-disordered breathing using a simple protocol identifies a significant number requiring medical management at a relatively low cost to the service provider.
authors.affiliation: Chest Clinic, Whipps Cross Hospital, Leytonstone, London, U.K.
authors.forename: S J
authors.initials: SJ
authors.lastname: Lloyd-Owen
authors.forename: A
authors.initials: A
authors.lastname: Crawford
authors.forename: M R
authors.initials: MR
authors.lastname: Partridge
authors.forename: C M
authors.initials: CM
authors.lastname: Roberts
mesh_terms: D000553:Ambulatory Care; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010036:Otolaryngology; D010092:Oximetry; D012017:Referral and Consultation; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000191:economics / Q000628:therapy; D012913:Snoring / Q000191:economics / Q000209:etiology*; D011795:Surveys and Questionnaires