P082 Management of Sleep Apnoea and Insomnia in primary care: outcomes from the obstructive sleep apnoea arm of a pilot study.

Abstract Introduction Obstructive sleep apnoea (OSA) and insomnia are prevalent but under-recognised chronic conditions. Access to timely care is limited by over-reliance on specialist-led models. A pilot study was conducted to evaluate the feasibility of implementing a guideline-based approach to general practitioner (GP) and practice nurse-led OSA and insomnia management in primary care. This abstract presents data from the OSA arm. Methods Adults at high risk for moderate–severe OSA at a single GP practice underwent ApneaLink testing. Patients with 3%ODI ≥16/hour were offered CPAP. The primary outcome was change in Epworth Sleepiness Score (ESS) at 3, 6, and 12 months from baseline. Secondary outcomes included mood (Generalised Anxiety Disorder 7 [GAD-7], Patient Health Questionnaire 9 [PHQ-9] and Kessler Psychological Distress Scale [K10]), CPAP use, and residual AHI. Results Nineteen patients (68% male, age 50.2 ± 15.2 [mean ± SD] years, BMI 33.3 ± 7.8kg/m2) were recruited. Nine (47%) patients had moderate–severe OSA (3%ODI 29.6 ± 5.8/hr). Mean ESS at 3, 6 and 12 months (5.1 ± 2.7, 4.0 ± 1.7 and 4.7 ± 2.2, respectively) was significantly reduced compared to baseline (11.2 ± 2.3, F = 45.51, p<.001). There were also significant improvements in GAD-7, PHQ-9 and K10 at all timepoints. CPAP was used by 7 (78%) patients with moderate–severe OSA at 12 months, with mean usage 4.3 ± 3.1 hrs/night and residual AHI 1.5 ± 0.8/hr. Discussion Sustained improvements in sleepiness and mood, and good CPAP acceptance/adherence provide early evidence of clinical benefit for primary care-led OSA management. This pilot study supports the feasibility of delivering OSA care as part of a structured sleep disorders management package within general practice.