Referral guideline – Obstructive adenotonsillar hyperplasia/sleep apnoea


Obstructive adenotonsillar hyperplasia is the leading cause of obstructive sleep apnoea in children.

Signs and symptoms include snoring +/- apnoeas, gasping and restlessness during sleep, frequent arousals, daytime somnolence and chronic mouth breathing.

Clinical diagnosis is reliable.

GP management

  • Observation by parents while child asleep and snoring (and/or video recording)
  • Trial of intranasal steroid for a minimum of 6-8 weeks

When to refer

  • Witnessed sleep apnoea
  • Sleep disturbance/ snoring of > 3 months
  • Tonsils meeting in the midline +/- trouble swallowing from large tonsils
  • Gagging on solid food in presence of very large tonsils

Essential referral info

  • Presenting complaint and reason for referral
  • Detailed history of symptoms
  • Patient details (name, age and gender)
  • Medicare number
  • Parent/Carer’s name and contact details
  • Referring clinician details (name, contact details, provider number, date and length of referral)

From 1 May 2019 referral criteria will apply at CHQ. This condition has minimum demographic and essential clinical referral information that is required to be included prior to submission of the referral. Visit the CPC website for the required condition. If you are unable to provide the required “essential information” please state the reason when you submit the referral.

Parent service

Otolaryngology Head and Neck Surgery

Contact details

Hospital Switchboard
(Ask for Otolaryngology (ENT) On-call Registrar)
t: 07 3068 1111