Follow-up of conservatively treated sleep apnoea patients

Polysomnograms have been recorded at our laboratory since 1985 for the diagnosis of sleep apnoea. Until the recent availability of continuous positive airway pressure devices in Johannesburg, it appeared that some of our subjects were receiving only conservative or no treatment. Structured interviews were conducted with 63 patients with positive polysomnographic findings of sleep apnoea/hypopnoea (SAH), and, where possible, with sleeping partners. Information was obtained about the patients' understanding of the diagnosis by the referring doctor, the recommended treatment and psychosocial consequences. The primary reason for the initial consultation was excessive daytime sleepiness (43%). Diagnoses following polysomnography included SAH (65%) and narcolepsy (6%), while 10% were told they had nothing to be concerned about. Some form of treatment was recommended to 80% of patients, usually weight loss (60%) or medication (59%). Psychosocial consequences were prominent and included a perception of reduced work capacity (62%) and compromised safety (56%). At the time of the interview 90% of patients were experiencing one or more symptoms associated with SAH. These findings support the serious nature of SAH and confirm the need for adequate treatment centres in South Africa.