Sleep disorders excluding sleep disordered breathing Referral Access Criteria

Referrers should use this page when referring patients to public adult respiratory and sleep medicine outpatient services for sleep disorders excluding sleep disordered breathing.

Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
Nil

Immediate referral
Immediately contact on-call registrar or service to arrange immediate respiratory assessment (seen within 7 days):
Nil To contact the relevant service, see Clinician Assist WA: Acute Respiratory assessment (external site).

Immediate referral

Immediately contact on-call registrar or service to arrange immediate respiratory assessment (seen within 7 days):

To contact the relevant service, see Clinician Assist WA: Acute Respiratory assessment (external site).

Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
Hypersomnia/excessive daytime sleepiness Cataplexy Parasomnia Sleep related nightmares, hallucinations Sleep related involuntary movements e.g. body jerks, stiffness in arms/legs Sleep paralysis Fatigue Somnambulism Catathrenia Restless sleep syndrome

Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason). This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
History	History of sleep disorder including frequency, duration and severity of symptoms Details of previous treatment and outcome Current medications Any known allergies Relevant past medical history Occupation
Examination	Epworth Sleepiness Scale results
Investigations	FBC Ferritin if suspected/confirmed Restless Legs Syndrome Full report from all previous sleep investigations (if already performed)

Highly desirable
History	Nil
Examination	Height, weight and BMI Lower limb neurological examination
Investigations	U&E Fasting glucose TSH Vitamin B12 Ca Magnesium

Indicative clinical urgency category
Category 1 Appointment within 30 days	Unexplained hypersomnolence (Epworth Sleepiness Scale score ≥ 16) not attributed to sleep restriction or environmental factors
Category 2 Appointment within 90 days	Suspected or confirmed narcolepsy Suspected or confirmed parasomnia or nocturnal seizures with injury to self or others Suspected or confirmed sleep related movement disorder with injury to self or others Unexplained hypersomnolence (Epworth Sleepiness Scale score ≥ 12) not attributed to inadequate sleep hygiene or environmental factors
Category 3 Appointment within 365 days	Suspected or confirmed sleep disorders including chronic insomnia, circadian rhythm disorders, parasomnias or sleep related movement disorders that do not meet criteria for Category 1 or 2 but still require specialist review

Indicative clinical urgency category

Category 1

Appointment within 30 days

Unexplained hypersomnolence (Epworth Sleepiness Scale score ≥ 16) not attributed to sleep restriction or environmental factors

Category 2

Appointment within 90 days

Suspected or confirmed narcolepsy
Suspected or confirmed parasomnia or nocturnal seizures with injury to self or others
Suspected or confirmed sleep related movement disorder with injury to self or others
Unexplained hypersomnolence (Epworth Sleepiness Scale score ≥ 12) not attributed to inadequate sleep hygiene or environmental factors

Category 3

Appointment within 365 days

Suspected or confirmed sleep disorders including chronic insomnia, circadian rhythm disorders, parasomnias or sleep related movement disorders that do not meet criteria for Category 1 or 2 but still require specialist review

Exclusions
Nil

Useful information
Referring doctor must assess immediate risk of driving and provide appropriate counselling based on Assessing Fitness to Drive Guidelines (including avoiding driving altogether if necessary) (external site). See Clinician Assist WA: Sleep (external site) Clinician resources National Sleep Diagnostics: Epworth Sleepiness Scale (external site) Australasian sleep association (external site) Australian Journal of General Practice: “Update on the assessment and investigation of adult obstructive sleep apnoea” (external site)

Useful information

Referring doctor must assess immediate risk of driving and provide appropriate counselling based on Assessing Fitness to Drive Guidelines (including avoiding driving altogether if necessary) (external site).
See Clinician Assist WA: Sleep (external site)

Clinician resources

National Sleep Diagnostics: Epworth Sleepiness Scale (external site)
Australasian sleep association (external site)
Australian Journal of General Practice: “Update on the assessment and investigation of adult obstructive sleep apnoea” (external site)

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Sleep disorders excluding sleep disordered breathing Referral Access Criteria

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