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Sleep Apnoea in Children

Checked: 23-08-2021 by Vicky Ryan Next Review: 23-08-2022

Guidelines

See the Bristol Royal Hospital for Children (BRHC) guidelines on Obstructive Sleep Apnoea In Children Referral And Investigation Pathway.

Referral to ENT for the assessment and treatment of Obstructive Sleep Apnoea in children falls under the CBA section (end of page 6) of the BNSSG Tonsillectomy - Referral for Assessment Policy and criteria for referral must be met and clearly stated in a referral.

Please note that where OSA is felt to be due to recurrent URTI or where there is lack of evidence of persistent symptoms in the medical record, referrals may be returned by the funding team.

Sleep studies/Polysomnography

There is now no direct access to polysomnography from primary care.

In most cases of simple OSA with adeno-tonsillar hypertrophy then clinical assessment only is required and there is no indication for further investigations.

If the criteria for referral as stated in the tonsillectomy policy can be evidenced by the GP and parents though clinical description, videos and/or parent statements then a referral to paediatric ENT via eRS should be made.

Referral

Referrals to paediatric ENT at Bristol Children's Hospital for assessment of OSA where criteria are met should be submitted via eRS.

Should clinicians have concern regarding atypical OSA or sleep problems where criteria for ENT referral are not met, then please consider referral to paediatric respiratory clinic via eRS or request paediatric respiratory advice and guidance.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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