{
  "abstract": "Introduction OSA and narcolepsy cause excessive daytime sleepiness, a key risk factor for accidents, injuries, and impaired functioning. Both conditions are typically managed in specialist sleep services, often following referral from general practice. However, due to under-recognition, many patients remain undiagnosed and do not access appropriate care. This study therefore explored the barriers and facilitators to accessing sleep services for individuals with symptoms of OSA and narcolepsy, from the perspective of general practitioners (GP).Methods We conducted semi-structured interviews with GP working in South London, East Midlands, and South West England between November 2024 and April 2025. Interviews were conducted using an interview guide that was informed by a scoping review1 and the COM-B model of behaviour change. Data were analysed iteratively using thematic analysis. GPs volunteered to participate in the study.Results Interviews (n=31) were conducted mostly online, with one conducted face-to-face. Our data suggest that the most important factors shaping referral to sleep services are overburdened NHS sleep services (e.g. limited access to sleep services and untimely discharge by sleep services), referral pathways and guidance (e.g. limited referral pathways for narcolepsy and strict and inflexible referral requirements for OSA), interprofessional collaboration (e.g. collaborative approach between services to treating sleep disorders), and knowledge of sleep disorders (e.g. limited training on sleep disorders, perception of sleep problems as secondary symptoms).Discussion Our findings offer an in-depth view from the perspective of GPs on challenges associated with referrals between primary care and sleep services. Findings are broadly consistent with a scoping review, 1 and may be used to inform development of care pathways and educational initiatives. Although the overarching factors are context-specific and described from the perspective of GPs in three areas in England, some of these may be applicable to GPs working in other areas of the UK.Reference DOI:10.1101/2025.01.20.25320835",
  "authors": [
    {
      "affiliations": [
        "London School of Hygiene and Tropical Medicine, London, United Kingdom"
      ],
      "name": "Martina Sykorova"
    },
    {
      "affiliations": [
        "London School of Hygiene and Tropical Medicine, London, United Kingdom",
        "Narcolepsy UK, Huntingdon, United Kingdom"
      ],
      "name": "Helen Strongman"
    },
    {
      "affiliations": [
        "East and North Hertfordshire NHS Trust, Stevenage, United Kingdom"
      ],
      "name": "Frederick van Someren"
    },
    {
      "affiliations": [
        "London School of Hygiene and Tropical Medicine, London, United Kingdom"
      ],
      "name": "Ellen Nolte"
    },
    {
      "affiliations": [
        "London School of Hygiene and Tropical Medicine, London, United Kingdom"
      ],
      "name": "Charlotte Warren-Gash"
    },
    {
      "affiliations": [
        "Warwick Medical School, University of Warwick, Coventry, United Kingdom"
      ],
      "name": "Michelle Miller"
    },
    {
      "affiliations": [
        "Department of Clinical and Experimental Epilepsy and National Hospital for Neurology and Neurosurgery/University College London Hospitals NHS Foundation Trust, London, United Kingdom"
      ],
      "name": "Sofia Eriksson"
    },
    {
      "affiliations": [
        "Royal Papworth Respiratory Support and Sleep Centre, Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom"
      ],
      "name": "Ian Smith"
    }
  ],
  "title": "O20 Understanding factors influencing GP referrals to specialist sleep services for obstructive sleep apnoea (OSA) and narcolepsy: a qualitative study",
  "uid": "d15d9553-b2ba-595c-b496-55bac6aa0bb8"
}