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 ; Sleep Apnea, Obstructive/diagnosis* ; Singapore ; Consensus ; Adult

OBJECTIVES: In this article, we report on two unusual cases of advanced nasopharyngeal cacinoma (NPC) with distant cutaneous metastases.

METHODS:
Design: Case Report
Setting: Tertiary Referral Center
Patients: Two

RESULTS: Two patients with advanced NPC developed multiple nodular skin metastases, one after completing radiotherapy and another during concurrent chemo-radiotherapy. Biopsies of these skin lesions confirmed metastatic NPC and both patients succumbed to the disease.

CONCLUSION: Nasopharyngeal carcinoma with skin metastases carries a very poor prognosis. Early detection, diagnosis and treatment are still the best management strategy for nasopharyngeal carcinoma.

Human ; Male ; Female ; Middle Aged ; Adult ; Nasopharynx ; Nasopharyngeal Neoplasms-radiotherapy, Drug Therapy, Biopsy ; Nasopharyngeal Carcinoma ; Neoplasm Metastasis ; Neoplasms ; Early Detection Of Cancer ; Diagnosis ; Therapy ; Therapeutics