FOLLOW-UP OF CONSERVATIVELY TREATED SLEEP-APNEA PATIENTS

Polysomnograms have been recorded at our laboratory since 1985 for the diagnosis of sleep apnoea. Until the recent availability of continuou s positive airway pressure devices in Johannesburg, it appeared that s ome of our subjects were receiving only conservative or no treatment. Structured interviews were conducted with 63 patients with positive po lysomnographic findings of sleep apnoea/hypopnoea (SAH), and, where po ssible, with sleeping partners, information was obtained about the pat ients' understanding of the diagnosis by the referring doctor, the rec ommended treatment and psychosocial consequences. The primary reason f or the initial consultation was excessive daytime sleepiness (43%). Di agnoses following polysomnography included SAH (65%) and narcolepsy (6 %), while 10% were told they had nothing to be concerned about. Some f orm of treatment was recommended to 80% of patients, usually weight lo ss (60%) or medication (59%). Psychosocial consequences were prominent and included a perception of reduced work capacity (62%) and compromi sed safety (56%), At the time of the interview 90% of patients were ex periencing one or more symptoms associated with SAH. These findings su pport the serious nature of SAH and confirm the need for adequate trea tment centres in South Africa.