Introduction/Aim Obstructive sleep apnoea is increasingly prevalent, with shorter referral to treatment time being associated with improved outcomes. Current studies describe a mean wait-time from initial referral to first outpatient review of 88 days, and from first review to diagnostic polysomnography of 123 days. This quality assurance initiative assessed how our sleep disorders centre in an Australian tertiary hospital compared to existing literature, and attempted to verify how triaging affected wait-time. Methods We retrospectively reviewed patients undergoing diagnostic polysomnography from 1st January 2019 to 30th June 2021. Time from initial referral to first clinic review, plus time from initial review to polysomnography, were recorded. Patient demographics and triage category of requested polysomnography were noted. Microsoft Excel was used to collect data and derive descriptive statistics. Results 380 patients (202-male, 178-female) were included. 251 GP referrals were received. 112 patients were triaged for polysomnography within 30 days of initial review (category 4), 204 patients were triaged within 90 days (category 5), and 44 patients were non-urgent (category 6). Mean number of days between initial referral and first review was 136.13 days. Mean number of days between first review and polysomnography was 28.95 days in category 4, 93.38 days in category 5, and 180 days in category 6. Conclusion Time from initial referral to initial review appeared longer in this study compared to published standards. However, time from initial review to polysomnography appeared shorter. Adjusting patient triaging and/or our ability to see new referrals sooner is required to match the published standards.

Multiple sleep latency test (MSLT) and maintenance of wakefulness test (MWT) are objective measures of excessive daytime sleepiness, used in diagnosing and monitoring patients with sleep disorders. MSLT and MWT can be affected by substances such as psychotropics, stimulants, opioids and sedatives. Recent studies demonstrate high prevalence of positive urine drug screening (UDS) results in patients undergoing MSLT and MWT. We retrospectively audited patients who underwent UDS with MSLT/MWT at a tertiary centre from 1st January 2019 to 1st January 2020. The following data was collected: MSLT/MWT/UDS results, sleep disorder diagnosis/es, return to driving/work after testing and pre-existing and subsequent prescription of stimulants/wakefulness-promoting agents/psychotropics/sodium oxybate. Our cohort featured 32 patients (23 female). 29 MSLTs and 3 MWTs were performed. Median age was 31 years old. 13 patients were on wakefulness-promoting agents/psychotropics when tested, where 8 were on serotonin–norepinephrine reuptake inhibitors/selective serotonin reuptake inhibitors. 13 patients (~45%) had a reduced mean sleep latency (MSL), where 10 minutes was used as the cut-off. All 3 MWTs were within normal limits. 5 patients (~16%) had a positive UDS. 1 patient had a low MSL and tested positive for cannabinoids and opioids. The other 4 patients with normal MSL tested positive for benzodiazepines (2), cannabinoids (1) and opioids (1). All patients were cleared for work and 85% of patients who had a low MSL returned to work during follow-up. The rate of positive UDS in patients undergoing MSLT/MWT was comparable to existing publications and re-emphasizes the relevance of mandating UDS prior to MSLT/MWT.