In a short consultation, the most useful signals of obstructive sleep apnoea are loud snoring, witnessed pauses in breathing, and daytime sleepiness, especially in someone with obesity, a large neck, resistant hypertension or atrial fibrillation.
Validated tools such as STOP-BANG turn these into a score. A high score justifies a sleep study; a low score in a patient without symptoms makes significant apnoea unlikely.
- Ask: Do you snore loudly? Has anyone seen you stop breathing? Do you fall asleep during the day?
- Consider sleep apnoea in resistant hypertension and atrial fibrillation even without sleepiness.
- Ask about drowsy driving and advise not to drive when sleepy.
- Use STOP-BANG or a similar score to decide who needs a sleep study.
Why it matters
Most sleep apnoea is never diagnosed, and the first chance to find it is usually in general practice.
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