Management of Snoring and Sleep Apnea in Australian Primary Care: The BEACH Study (2000-2014)

Study Objectives: To characterize the changes in management of snoring and obstructive sleep apnea (OSA) in general practice in Australia. Methods: The Bettering the Evaluation And Care of Health (BEACH) study is a nationally representative rolling cross-sectional survey of general practice activity in Australia. We analyzed all adult (age 18+ y) encounters for OSA or snoring, annually from 2000 to 2014 (approximately 1,000 general practitioners (GPs) per year recording approximately 100,000 patient encounters per year). Results: The management rate of OSA rose from 94 to 296 per 100,000 encounters, whereas management rate of snoring remained steady at approximately 15 to 25 per 100,000 encounters. The majority of patients managed for OSA were: middle-aged (25-64 y; 71.3% of all patients); overweight (90%); male (62%), although there was a trend for an increase in the proportion being female over the study period (21 to 37 per 100 encounters). Referral rates were high for both OSA (59 per 100 problems managed) and snoring (69 per 100), although medical referrals (to a sleep clinic or respiratory physician) were significantly higher for patients managed for OSA than for snoring (90% vs. 60% of all referrals). Surgical referrals were higher for snoring than for OSA (37% vs. 3% of all referrals). Conclusions: The management rate for OSA tripled from 2000 to 2014, while the rate for snoring remained steady. GPs significantly relied on the advice of other health professionals to manage OSA; however, their referral patterns aligned with what most specialists would recommend.