Is sleep apnoea a specialist condition? The role of general practitioners

Educational aims

1. To identify obstructive sleep apnoea (OSA) as a public health problem of the first order that requires involvement at all levels of care, from primary to specialist.

2. To pay special attention to aspects of OSA less familiar to primary care, particularly its relationship with cardiovascular diseases.

3. To analyse the expected role of primary care in the diagnosis, treatment and follow-up of patients with OSA and its risk factors.

4. To make clear that treatment with continuous positive airway pressure (CPAP) is not the exclusive domain of specialist care, as many of the problems associated with OSA can be monitored in primary care.

Summary There is no doubt that OSA is a public health problem, on account of its great prevalence and significant negative effects on health, in both the short and long term. These effects stem from the association observed between OSA and traffic and workplace accidents, as well as its association with various cardiovascular pathologies and diseases. The growing number of patients being diagnosed and treated makes it increasingly difficult for specialists to monitor and follow them up on their own. There is therefore a growing need to involve primary care staff in the attention given to these patients. As in the case of other public health problems such as obesity and diabetes, the primary care physician must acquire sufficient knowledge and expertise both to refer a patient with suspected osa to the suitable specialist and to conduct a basic follow-up, regardless of whether the patient has been prescribed treatment with CPAP.