Development of a primary care-coordinated sleep service to provide access to obstructive sleep apnoea diagnosis and management in an Aboriginal Community Controlled Health Organisation in far western NSW

Aboriginal and Torres Strait Islander peoples experience a higher burden of obstructive sleep apnoea (OSA) than non-Indigenous populations but face considerable barriers to diagnosis and management. In response to this unmet need, a regional/remote Aboriginal Community Controlled Health Organisation (ACCHO) in far western NSW developed a primary care-coordinated sleep service in 2016. This is a unique service model, providing primary care-coordinated, fully funded access to OSA diagnosis through at-home sleep studies, continuous positive airway pressure (CPAP) treatment, and access to sleep physician review in an ACCHO setting. This service model has facilitated improved access to diagnosis and management services and identified a significant unmet need in the community, with 100% (67/67) of people undertaking a sleep study diagnosed with OSA, and a prevalence of 52% for severe OSA in this referred cohort, higher than other published reports for Aboriginal and Torres Strait Islander populations. Despite the high prevalence of OSA in this population, significant symptom improvement and excellent disease control have been achieved in those who commenced CPAP through the service, reinforcing the need for ongoing and expanded service delivery within our region. With sufficient and sustainable funding, this innovative service model is one that could be considered in other under-serviced areas to improve access to OSA diagnosis and treatment, particularly among populations facing significant financial and geographical barriers.