1.Singapore consensus statements on the management of obstructive sleep apnoea.
Leong Chai LEOW ; Chuen Peng LEE ; Sridhar VENKATESWARAN ; Michael Teik Chung LIM ; Oon Hoe TEOH ; Ruth CHANG ; Yam Cheng CHEE ; Khai Beng CHONG ; Ai Ping CHUA ; Joshua GOOLEY ; Hong Juan HAN ; Nur Izzianie KAMARUDDIN ; See Meng KHOO ; Lynn Huiting KOH ; Shaun Ray Han LOH ; Kok Weng LYE ; Mark IGNATIUS ; Yingjuan MOK ; Jing Hao NG ; Thun How ONG ; Chu Qin PHUA ; Rui Ya SOH ; Pei Rong SONG ; Adeline TAN ; Alvin TAN ; Terry TAN ; Jenny TANG ; David TAY ; Jade TAY ; Song Tar TOH ; Serene WONG ; Chiang Yin WONG ; Mimi YOW
Annals of the Academy of Medicine, Singapore 2025;54(10):627-643
INTRODUCTION:
Obstructive sleep apnoea (OSA) is common in Singapore, with moderate to severe OSA affecting around 30% of residents. These consensus statements aim to provide scientifically grounded recommendations for the management of OSA, standar-dise the management of OSA in Singapore and promote multidisciplinary collaboration.
METHOD:
An expert panel, which was convened in 2024, identified several areas of OSA management that require guidance. The expert panel reviewed the current literature and developed consensus statements, which were later independently voted on using a 3-point Likert scale (agree, neutral or disagree). Consensus (total ratings of agree and neutral) was set a priori at ≥80% agreement. Any statement not reaching consensus was excluded.
RESULTS:
The final consensus included 49 statements that provide guidance on the screening, diagnosis and management of adults with OSA. Additionally, 23 statements on the screening, diagnosis and management of paediatric OSA achieved consensus. These 72 consensus statements considered not only the latest clinical evidence but also the benefits and harms, resource implications, feasibility, acceptability and equity impact of the recommendations.
CONCLUSION
The statements presented in this paper aim to guide clinicians based on the most updated evidence and collective expert opinion from sleep specialists in Singapore. These recommendations should augment clinical judgement rather than replace it. Management decisions should be individualised, taking into account the patient's clinical characteristics, as well as patient and caregiver concerns and preferences.
Humans
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Sleep Apnea, Obstructive/diagnosis*
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Singapore
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Consensus
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Adult
2.Factors affecting falls in community-dwelling individuals with stroke in Singapore after hospital discharge.
Lay Fong CHIN ; Juliana Y Y WANG ; Cheng Hong ONG ; Wing Kuen LEE ; Keng He KONG
Singapore medical journal 2013;54(10):569-575
INTRODUCTIONThis study aimed to investigate the factors affecting the incidence of falls among individuals with stroke living in the community one year after discharge from a rehabilitation hospital in Singapore.
METHODSA cross-sectional telephone survey of individuals with stroke living in the community was carried out one year after discharge. The interview covered aspects such as incidence and circumstances of fall, use of walking aids, and presence of environmental obstacles. Each participant's case record was retrospectively reviewed using discharge Fugl-Meyer (FM) assessment of the upper and lower limbs, functional independence measure (FIM) and Berg Balance Scale (BBS).
RESULTSA total of 126 individuals with stroke were interviewed. Overall, 24% fell in the year following their discharge. Factors associated with falls were longer length of hospital stay, lower BBS and lower-limb FM scores, and lower discharge FIM scores for the Bladder and Bowel Management, Transfer, Mobility, Communication, and Social Cognition domains (p < 0.05). The fallers were more likely to use walking aids, and required help with basic activities of daily living after discharge (p < 0.05). Multivariate logistic regression analysis revealed that only the Transfer domain was an independent factor for falls.
CONCLUSIONDischarge FIM outcomes, especially for the Transfer domain, can be used to identify communitydwelling individuals with stroke who have a high fall risk after discharge. Identification of such individuals will enable early fall prevention management, which will in turn minimise fall events in the community.
Accidental Falls ; statistics & numerical data ; Cross-Sectional Studies ; Disability Evaluation ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Patient Discharge ; Postural Balance ; Retrospective Studies ; Risk Factors ; Singapore ; epidemiology ; Stroke ; complications ; epidemiology ; physiopathology ; Stroke Rehabilitation ; Surveys and Questionnaires

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