Sleep and NIV Service - Salford Royal, Oldham Community, Fairfield Hospital [Bury], Salford Community

The sleep service at Salford Royal Hospital (SR) and Fairfield General Hospital (FGH) diagnoses and treats patients with a variety of sleep disorders. Our respiratory team looks after patients with sleep disordered breathing, particularly obstructive sleep apnoea, whilst our neurology team look after patients with narcolepsy and parasomnias. The service does not routinely assess patients whose principal symptom is that of insomnia, that is an inability to sleep.

Sleep Apnoea Service

  • Oximetry studies (FGH)
  • Polygraphy Sleep studies
  • Continuous Positive Airway Pressure therapy (CPAP/APAP – FGH and SR/Bilevel CPAP -at SR)
  • Onwards referral for mandibular repositioning devices
  • Advice on  healthy sleep
  • Complex sleep apnoea / Central sleep apnoea treatment (Adaptive Servo-Ventilation - SR)

Sleep Disorders Service

  • Full polysomnography sleep studies
  • Multiple Sleep Latency Tests
  • Actigraphy
  • Medical therapy for a range of sleep disorders

If you are referred with a suspicion of obstructive sleep apnoea (OSA) your referral will be triaged and you will be booked to have a home sleep study. This will involve collecting equipment from either the cardiorespiratory investigations (CRI) department in the hospital (Salford Royal (SR) or Fairfield General (FGH)) or from our diagnostic hub at Swinton Gateway (SWG) or Oldham Community Diagnostic Hub (ODH).

You will wear this whilst sleeping and will need to return the equipment the following day. You should discuss with the staff before taking the equipment if this is not going to be possible. Some of the equipment has set recording times and can only be used on the night of the appointment. If you do not attend the sleep study or fail to return the equipment you will be discharged from the service and will need your GP to refer you back in. Failure to return the equipment may delay other people’s treatment as well as your own since we only have limited equipment and we may charge you for its replacement.

The equipment we currently use is WatchPAT (SR, SWG), oximetry (FGH)  Nox (FGH, ODH and SR).

Once your sleep study has been returned it will be analysed and the results together with the answers from the questionnaire you will be asked to complete will be used to determine the best clinic for you. Therefore, it is important that you give us as much detail as possible so we can best support your needs.

If you are a professional driver and are having difficulties with sleepiness, please contact us to expedite your referral.

Assessment and treatment of OSA

The service at FGH predominantly offers face to face clinic assessment with same day set up of CPAP regardless of severity of OSA.

The service at SR will usually offer a telephone assessment appointment followed by a face to face set up of CPAP if required. However, for those that are particularly severe or with severe symptoms you may be offered a face to face clinic assessment with same day set up for CPAP therapy.

If your results show no sleep apnoea or only very mild sleep apnoea and you are not very symptomatic according to your Epworth Sleepiness Score or other questionnaire answers we may write to you and your GP with advice around lifestyle measures.

If your results are negative for OSA but you have other symptoms you will be offered a telephone assessment clinic appointment. You may be offered a more in-depth sleep study (polysomnography) if felt appropriate.

If you have been referred to the sleep disorders clinic with no suspicion of OSA you will usually be offered a sleep clinic appointment before any further testing is done. This will usually be on the telephone in the first instance.

Polysomnography (PSG)

This test involves a night’s stay at the Oaklands Private Hospital on Lancaster Road, just around the corner from Salford Royal. Our physiologist will wire you up with electrodes on your head and face to measure sleep as well as similar equipment to the home studies (finger probe, nasal canula and belts to measure breathing effort) electrodes on the legs to measure limb movements and video.

Multiple Sleep Latency Test (MSLT)

If there is a suspicion of narcolepsy you will either have a PSG followed by a multiple sleep latency test (MSLT) or an ambulatory electroencephalogram (EEG) and MSLT. The MSLT will take place in the neurophysiology department of Salford Royal.

The MSLT involves being wired up with electrodes on the head and face to measure sleep and then been given 4 or 5 opportunities throughout the day to have a nap whilst being monitored. The physiologist will be watching to see how quickly you fall asleep and if you go into Rapid Eye Movement (REM) sleep during the nap.

Patients should be referred via eRs from GPs or for internal referrals please order a sleep study via EPR.

GP referrals should include Epworth Sleepiness Score, symptoms, whether the patient drives and if they are having sleepiness that is impacting driving, whether they are a professional driver or have a high vigilance job, and any other risk factors such as cardiovascular disease and type 2 diabetes.

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