Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Southern Adelaide Local Health Network

Women's and Children's Health Network

Category 1 (appointment clinically indicated within 30 days)

  • infant with observed prolonged apnoeas

Category 2 (appointment clinically indicated within 90 days)

  • recurrent snoring with associated symptoms such as apnoeas, restless sleep, mouth breathing, daytime tiredness or headaches, poor concentration requiring objective evaluation to confirm the evidence of obstructive sleep apnoea 
  • recurrent snoring in children with risk factors for obstructive sleep apnoea e.g. obesity, hypotonia, facial dysmorphology, specific syndromes like Trisomy 21

Category 3 (appointment clinically indicated within 365 days)

  • nil

For more on outpatient referrals, see the general referral information page.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying within your referral if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf
  • interpreter required
  • examination:
    • body mass index (BMI)
    • large tonsils
    • nasal obstruction
    • craniofacial abnormality
  • consider six-week trial of nasal steroids
  • current medication list including non-prescription medication, herbs and supplements

History

  • past medical/surgical history
  • onset, duration, and progression of symptoms, including:
    • parental observations and description of sleep patterns
      • snoring
      • restlessness
      • snorting arousals or apnoeic episodes
      • disturbed sleep, night terrors
      • enuresis, bruxism
    • daytime symptoms
      • hypersomnolence
      • irritability
      • hyperactivity
      • poor school performance
  • management history including treatments trialled/implemented prior to referral

Additional information to assist triage categorisation

  • relevant allied health/diagnostic/imaging reports, including location of company and accession number
  • tonsillar hypertrophy grading scale

Clinical management advice

For clinical management advice regarding obstructive sleep apnoea/snoring - Ear, Nose and Throat CPC.

If a child has other sleep related concerns such as difficulty with sleep onset, frequent overnight awakenings, please consider techniques to improve sleep hygiene. If symptoms persist beyond 3 months, refer to Paediatric Respiratory & Sleep Medicine.

If child has unpleasant behaviours in sleep, e.g. night terrors, nightmares, sleepwalking, headbanging, bruxism, please ask if child has any recollections of such episodes to determine if these symptoms are occurring in the “awake” or “sleep” phase. If the child has no recollections of such episodes, reassure the family that these episodes are benign and improve beyond the preschool years.

If a child or adolescent has symptoms of excessive sleep, beyond normal standard hours for age group please refer to Paediatric Respiratory & Sleep Medicine.

Clinical resources

Consumer resources