Sleep disordered breathing

Specialty: ENT
Age group: Children

Criteria for referral to public hospital service

• Disturbance of sleep and breathing that persists for more than 3 months that is impacting on the child’s behaviour, ability to attend school, or is impacting on family life
• Regular snoring, with gasping and choking witnessed by parents or carers on most nights despite nasal steroid spray use
• Co-existing craniofacial abnormality.

Information to be included in the referral

Information that must be provided

• Reason for referral and expectation or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
• Physical examination, especially the presence of tonsil hypertrophy or mouth breathing
• Description of onset, nature, progression, recurrence and duration of symptoms (somnolence, snoring, witnessed apnoea, restless sleep, unrefreshing sleep, tiredness)
• Details of previous management including the course of treatment(s) and outcome of treatment(s)
• The functional or psychological impact on quality of life or activities of daily living including impact on school, study, or social activities
• Child's age.

Provide if available

• Statement about the parent(s) or guardian’s interest in having surgical treatment if that is a possible intervention
• If the child is neurodiverse, gender diverse or has a disability
• If the child identifies as an Aboriginal and/or Torres Strait Islander
• If the child has a preferred language other than English and if they rely on cultural or linguistic support (e.g. Aboriginal cultural support, an interpreter)
• If the child lives in out-of-home care (foster care, kinship care, permanent care or residential care)
• If the child is aged 14-18 years, do they consent that their health information is shared with their parent, guardian or carer.

Additional comments

The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.

Note: there are also statewide referral criteria for Assessment for recurrent tonsillitis.

The referral should note if the request is for a second or subsequent opinion as requests for a second opinion will usually not be accepted.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

• Sleep disordered breathing that has resolved or is being managed with treatment.