If Obstructive Sleep Apnoea is suspected (with symptoms suggestive of OSA and/or an accompanying Epworth sleepiness questionnaire score of more than 10) adults should be referred to a sleep centre for diagnosis and treatment. Some patients, may require a more urgent referral, including those:

• With features suggestive of a head and neck cancer
• Who have symptoms of daytime sleepiness whilst driving or working with machinery, or are employed in hazardous occupations (for example bus or lorry drivers)
• With signs of respiratory or heart failure
• With symptoms suggestive of severe OSAS and coexistent COPD
• For adults where there are concerns about job security
• Children should be referred to a paediatric ear, nose, and throat specialist if they have adenotonsillar hypertrophy and symptoms of persistent snoring.