Sleep Disorder Centre

The Sleep Disorder Centre was established in 1992, and provides a comprehensive service in sleep medicine for the south east of England. It employs 25 staff, including three consultant physicians and nine technicians, supported by administrative staff and secretaries.

The centre diagnoses and treats all aspects of adult sleep medicine, but respiratory disorders during sleep constitute the largest part of the workload. These include:

  • sleep disordered breathing (SDB)
  • hypoventilation syndromes (mostly related to increased body mass index)
  • insomnia
  • NREM parasomnias
  • REM behaviour disorder
  • sleep related movement disorders
  • sleep related epilepsies and
  • circadian rhythm disorders.

The centre is one of only a few in the UK with facilities for a full range of treatments for sleep disordered breathing, including continuous positive airway pressure (CPAP), non-invasive ventilation (NIV), orthodontic services for mandibular advancement devices, and surgery including bi-maxillary osteotomy.

Although bed partners will observe and complain about sleep disordered breathing, the subject themselves is usually unaware of their condition, but may notice a decline in daytime function and motivation, often accompanied by excessive daytime sleepiness. Measuring daytime sleepiness is therefore an easy marker of symptoms. One commonly used scoring system is the Epworth Sleepiness Scale (ESS), a questionnaire that assesses the likelihood of accidently falling asleep whilst undertaking eight common daily activities.

Sleep at night is essential for good health. Excessive sleepiness during the day causes a reduction in quality of life, decreased ability to drive safely, decline in intellect, and can be an antecedent to falls in the elderly. Increasing levels of respiratory dysfunction are associated with the development of arterial hypertension and the onset of adult type II diabetes, with cardiovascular sequelae, including stroke and myocardial infarct.

Measuring effectiveness

Patient related outcome measurements (PROMs) include assessing the patient’s subjective improvement in daytime sleepiness and function using the ESS (Epworth Sleepiness Score 0-24), and is therefore an effective indicator of the efficacy of therapy.

To measure our effectiveness, a study looking at 100 randomly selected, demographically representative patients using CPAP equipment was undertaken. Our results are impressive, with patients generally seeing nearly a 60% reduction in daytime sleepiness, and amongst those patients who have a higher than 10 Sleepiness Score (Epworth Scale), their ESS has fallen by 10.3.

This is the first time this audit has been completed in this way at the QVH, and the department is continuing to invest in regularly measuring the ESS to ensure that patients continue to benefit from the treatment provided.

How to make a sleep centre referral

Pre-admission questionnaires

Please download the relevant questionnaires below. Once completed please save and email to sleepdisordercentre@qvh.nhs.uk Your personal information is confidential and in accordance with NHS and Trust policy we will keep it secure.