Specialty: ENT
Age group: Children
Direct to an emergency department for
- Rapid progression of obstructive sleep apnoea with significant parental concerns.
Criteria for referral to public hospital service
- Disturbance of sleep and breathing that persists for more than 3 months that is impacting on the child’s behaviour, ability to attend school, or is impacting on family life
- Regular snoring, with gasping and choking witnessed by parents or carers on most nights despite nasal steroid spray use
- Co-existing craniofacial abnormality.
Information to be included in the referral
Information that must be provided
- Reason for referral and expectation or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
- Physical examination, especially the presence of tonsil hypertrophy or mouth breathing
- Description of onset, nature, progression, recurrence and duration of symptoms (somnolence, snoring, witnessed apnoea, restless sleep, unrefreshing sleep, tiredness)
- Details of previous management including the course of treatment(s) and outcome of treatment(s)
- The functional or psychological impact on quality of life or activities of daily living including impact on school, study, or social activities
- Child's age.
Provide if available
- Statement about the parent(s) or guardian’s interest in having surgical treatment if that is a possible intervention
- If the child is neurodiverse, gender diverse or has a disability
- If the child identifies as an Aboriginal and/or Torres Strait Islander
- If the child is from a culturally and linguistically diverse background
- If the child lives in out-of-home care (foster care, kinship care, permanent care or residential care)
- If the child is aged 14-18 years, do they consent that their health information is shared with their parent, guardian or carer.
Additional comments
The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.
Note: there are also statewide referral criteria for Assessment for recurrent tonsillitis.
The referral should note if the request is for a second or subsequent opinion as requests for a second opinion will usually not be accepted.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for
- Sleep disordered breathing that has resolved or is being managed with treatment.
Reviewed 25 June 2025