Sleep Service

What are the symptoms of sleep disorders?

Below are some of the common symptoms of sleep disorders. If you have any of these symptoms and think that you may have a sleep problem, please contact your GP and discuss a referral to our service.

• Unrefreshing sleep and excessive daytime sleepiness
• Loud snoring and pauses in breathing during sleep
• Atypical sleep behaviours
• Difficulty getting to sleep and staying asleep
• Rhythmic movements / twitching of legs while asleep

What are the common sleep conditions seen at our sleep service?

• Sleep apnoea and other sleep disordered breathing
• Narcolepsy and other hypersomnia
• Parasomnias – Sleep walking, REM sleep behaviour disorder, nightmares and night terrors
• Restless Leg Syndrome
• Circadian Rhythm disorders (including delayed sleep phase disorder)

These are only the common conditions but we are happy to receive referrals from your doctor on any sleep related conditions for an initial consultation. Due to resource limitations, we cannot offer a comprehensive therapy service for established cases of insomnia but will offer initial consultation and diagnostic services for patients with all sleep problems.

What tests might I have?

The tests you are booked for will depend on your symptoms and the type of sleep problem you have – not all tests are necessary or appropriate for every patient.

Home sleep studies are tests analyse your breathing pattern overnight, which helps us diagnose obstructive sleep apnoea (OSA). These consist of the following:

• Nox study: worn at home for one night and returned to us the next day for analysis. It records your breathing, oxygen levels and movement while you sleep in your own bed.
• WatchPAT study: worn at home for one night, with data sent to us via a mobile app. It records similar information to the Nox study, using a sensor on your finger and wrist.
• Actigraphy: a small watch worn continuously for two weeks alongside a sleep diary. This is not used to diagnose OSA — it helps us understand your usual sleep and wake pattern, and is particularly useful for conditions such as circadian rhythm disorders.

Inpatient sleep studies are done at the sleep laboratory. These consist of the following:

• Full video polysomnography: an overnight stay in the sleep laboratory measuring brainwave activity, breathing and limb movements, with video recording. This gives a more detailed picture than a home study and is used when a more complex sleep problem is suspected, such as unusual behaviours or movements during sleep.
• Multiple Sleep Latency Test: a series of daytime nap tests measuring how sleepy you are at different times of day. This helps us understand causes of excessive daytime sleepiness, such as narcolepsy.
• Maintenance of Wakefulness Test: daytime tests measuring how well you can stay awake in a quiet setting. This is often used to check whether it is safe for you to drive or carry out safety-critical work.

Possible treatment options

If you are diagnosed with obstructive sleep apnoea, Continuous Positive Airway Pressure (CPAP) therapy is often recommended. Depending on your individual circumstances, other treatment options may also be considered — your clinical team will discuss what’s most suitable for you.

• CPAP therapy — we support over 8,000 patients on CPAP, with most machines monitored remotely
• Group and individual CPAP set-up sessions, followed by ongoing telephone or face-to-face review
• Advice and signposting for restless legs syndrome, parasomnias and circadian rhythm disorders

Sleep Apnoea Trust

The Sleep Apnoea Trust is a UK patient support charity providing practical information about sleep apnoea, CPAP treatment and living with the condition.

Their driving guidance explains DVLA notification requirements, excessive sleepiness, Group 1 and Group 2 licences, and returning to driving after effective treatment.

• Visit the Sleep Apnoea Trust website
• Read the Sleep Apnoea Trust driving guidance

Referral information for GPs

Referral criteria

• We accept referrals for suspected sleep apnoea and other sleep-disordered breathing as our primary focus.
• We are happy to accept referrals for an initial consultation and diagnostic assessment for other sleep-related conditions (e.g. narcolepsy, parasomnias, restless legs syndrome, circadian rhythm disorders).
• We do not accept patients under 16 years of age.
• We do not accept referrals for insomnia. Due to resource limitations, we cannot offer a comprehensive ongoing therapy service for insomnia; please do not refer patients whose primary or sole problem is insomnia.
• Referrals are usually made electronically by the patient’s GP. We also accept referrals from hospital specialists from anywhere in the country and complex cases from other sleep services.
• Before their first consultant appointment, patients are usually booked for a home sleep study; results are discussed at the consultation, which may be by telephone or as an outpatient appointment.

Contact details for referrers

• For referral and admin queries, or questions about medication: 0161 746 2700 / sleepserviceadmin@mft.nhs.uk
• For CPAP queries relating to a patient already established on treatment: 0161 746 2059 / sleep.service@mft.nhs.uk

Our Team

You may be seen by different members of our multidisciplinary team, depending on your needs — you will not always need to see a doctor:

• Sleep consultants: specialists in respiratory, ventilation and sleep medicine who review patients with all sleep disorders
• Sleep physiologists: with international polysomnography accreditation, who carry out and analyse sleep studies
• Sleep practitioners and associate practitioners: who set up and support CPAP therapy and diagnostic tests
• Sleep pharmacy: advice and support relating to medication
• Dietitian
• Administrative and secretarial support