Clinical value and cost of a respiratory sleep-related breathing disordersscreening service for snorers referred to a District General Hospital ENT department

Sleep-related breathing disorders and snoring often co-exist in the communi ty. We hypothesized that a significant proportion of patients referred from primary care to ENT surgeons for management of snoring might have signific ant sleep-related breathing disorders requiring medical management. The Res piratory Medicine Department at Whipps Cross Hospital, London, U.K. screene d all such referrals using sleep questionnaires, overnight oximetry and dia gnostic sleep studies where necessary as recommended by the Royal College o f 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 a nd the remainder were mainly offered conservative treatment. The cost of th e screening service is estimated at pound 14 000 for the initial year. The: savings to the ENT service and the possible long-term benefits to the pati ents identified as having sleep-disordered breathing balance this. We concl ude that screening all referred snorers for sleep-disordered breathing usin g a simple protocol identifies a significant number requiring medical manag ement at a relatively low cast to the service provider.