عيادات سبات متخصصة في تشخيص وعلاج اضطرابات النوم والأمراض الصدرية
Subat Clinics in Riyadh accepts physician referrals for sleep disorder evaluation, and your patient stays under your care. We perform the consultation and the home sleep study, then send you a written report containing the findings, their interpretation, and a treatment recommendation within three working days of the test night, so you can complete your plan on objective data rather than clinical estimation.
Why does obstructive sleep apnea pass unnoticed in clinic?
Patients do not report what they cannot observe. They present to you with something else entirely: blood pressure that will not settle, diabetes resistant to escalating doses, depression that fails to respond, morning headache, or chronic fatigue attributed to work stress.
Nocturnal symptoms rarely surface in the consultation unless they are asked about directly, and it is usually the bed partner, not the patient, who notices them.
This makes the treating physician, not the patient, the real point of detection for obstructive sleep apnea. This page is written for referring physicians: when your patient warrants a sleep evaluation, what happens after the referral, and what comes back to you.
Your patient remains your patient: the report returns to you
What most often stops a physician from referring is not doubt about the receiving clinic, but the prospect of sending a case and never hearing about it again.
Our commitment to referring physicians is specific:
*. We send you a written report once the study is finalized, including the full scoring, the clinical interpretation, and the treatment recommendation.
*. Our role is confined to the question you referred for: is there a breathing or sleep architecture disorder that explains this presentation?
*. We do not modify your medication plan and do not open a parallel pathway for the patient away from you. Anything outside our scope is communicated back rather than managed.
*. You may contact us at any time for an update on your patient's progress after treatment begins.
The referral becomes an addition to your treatment plan, not a transfer of the patient out of your hands.
Referral criteria in cardiology
1. Resistant hypertension despite three agents at appropriate doses, one of them a diuretic.
2. Nocturnal hypertension or loss of the expected nocturnal dip on 24-hour ambulatory monitoring.
3. Recurrent atrial fibrillation, or recurrence after catheter ablation or cardioversion.
4. Heart failure with nocturnal dyspnea, paroxysmal nocturnal episodes, or periodic breathing.
5. Nocturnal bradycardia or recurrent nocturnal arrhythmia without a clear cause.
6. Post-myocardial infarction patients reporting snoring and daytime sleepiness.
Referral criteria in bariatric surgery and anesthesia
1. Preoperative assessment before bariatric surgery, since confirmed obstructive sleep apnea alters the anesthetic and recovery plan.
2. Elevated body mass index with large neck circumference and loud snoring.
3. History of difficult intubation, delayed emergence, or oxygen desaturation in recovery.
4. Suspected obesity hypoventilation syndrome, particularly with elevated serum bicarbonate.
5. Patients expected to require postoperative opioid analgesia.
Referral criteria in endocrinology and diabetes
*. Type 2 diabetes that remains poorly controlled despite full medication adherence.
*. Unexplained elevation in morning fasting glucose.
*. Marked insulin resistance with central obesity and snoring.
*. Polycystic ovary syndrome with daytime sleepiness and persistent fatigue.
*. Hypothyroidism or acromegaly, given their recognized effect on the upper airway.
Referral criteria in neurology
1. After stroke or transient ischemic attack.
2. Differentiating nocturnal seizures from parasomnias, which requires a recording that includes EEG.
3. Suspected REM sleep behavior disorder, given its early prognostic significance in neurodegenerative disease.
4. Treatment-resistant epilepsy or seizures clustering at night.
5. Excessive daytime sleepiness with suspected narcolepsy.
6. Restless legs syndrome and periodic limb movements during sleep.
7. Recurrent morning headache with morning confusion.
Referral criteria in psychiatry
1. Treatment-resistant depression with daytime fatigue and reduced concentration.
2. Chronic insomnia or long-standing dependence on hypnotics and benzodiazepines, where cognitive behavioral therapy for insomnia is available with us as an alternative pathway.
3. Disrupted sleep-wake rhythm in bipolar disorder.
4. Nocturnal panic episodes difficult to distinguish from apnea-related arousals.
5. Patients on antipsychotics with rapid weight gain and new-onset snoring.
Referral criteria in otolaryngology
*. Assessment before upper airway surgery, to determine whether surgery alone will be sufficient.
*. Postoperative assessment to verify response with data rather than patient impression.
*. Differentiating simple snoring from snoring associated with obstructive sleep apnea.
*. Adolescents from age 14 with tonsillar hypertrophy or chronic nasal obstruction and nocturnal symptoms.
*. Chronic nasal obstruction with daytime sleepiness disproportionate to the degree of obstruction.
Referral criteria in family medicine and internal medicine
1. Sleepiness while driving or micro-sleep behind the wheel. This cannot be deferred.
2. Snoring with witnessed apneas reported by a bed partner.
3. Unexplained chronic fatigue despite normal laboratory work-up.
4. Obesity with large neck circumference.
5. Recurrent nocturia without a clear urological cause.
6. Treatment-resistant nocturnal reflux.
7. Drivers, heavy equipment operators, and shift workers.
What happens after you refer?
1. Contact: the patient books an appointment or contacts us directly, naming you as the referring physician.
2. Assessment: the pathway begins with a sleep disorder consultation covering sleep history, validated questionnaires, and upper airway examination, from which the consultant determines the appropriate type of study.
3. Testing: a technician travels to the patient's home to fit the device and sensors. The patient sleeps in their own bed at their usual time, and the technician collects the device the following day.
4. Scoring: the consultant reads the recording personally and issues the treatment decision. The result is not an automated device output.
5. Report: you receive the report within three working days of the test night.
6. Treatment and follow-up: where positive airway pressure therapy or behavioral treatment is indicated, follow-up begins at the clinic while you are kept informed.
Why is every study performed in the patient's home?
This is an operational difference, not a marketing claim:
*. Home sleep testing requires no overnight laboratory stay and no waiting list governed by bed count. Capacity is determined by the number of devices, not the number of rooms.
*. The patient sleeps in their own bed at their habitual time, which makes the recording closer to a normal night than to a laboratory night.
*. Patient refusal rates fall considerably, and refusal is the single largest obstacle to referrals actually being completed.
*. The patient misses no work and requires no accompanying person.
*. The advanced study includes EEG, so respiratory events are indexed against actual sleep time and sleep stages rather than recording time, a difference that can change severity classification in borderline cases.
When is a home sleep study not sufficient?
We state the limits of the tool openly, because knowing them is part of trusting its results. A home sleep study may not be the appropriate choice in:
1. Suspected central sleep apnea in advanced heart failure.
2. Neuromuscular disease or respiratory muscle weakness.
3. Suspected nocturnal hypoventilation.
4. Suspected narcolepsy, which requires daytime multiple sleep latency testing.
5. Complex parasomnias or nocturnal events requiring full attended video recording.
In these cases we tell you directly and suggest the more appropriate pathway, rather than performing a study that will not answer your clinical question.
Scope of service | which cases do we accept?
So that no patient is referred and then turned away, these are the boundaries:
*. Age range: we accept patients from age 14 and above, including adolescents with obesity, chronic snoring, or those being assessed before upper airway surgery.
*. Geographic coverage: home sleep studies are performed within the city of Riyadh, where the technician attends the patient's home to fit and later collect the device.
*. Coordination: through the clinic numbers listed at the end of this page, with no formal referral form or additional administrative step required.
What does the report you receive contain?
1. Apnea-hypopnea index and severity classification.
2. Oxygen desaturation index, lowest oxygen saturation, and percentage of time below 90%.
3. Distribution of events between obstructive, central, and mixed.
4. The effect of sleep position and of REM sleep on event frequency.
5. Sleep stages and sleep efficiency in studies that include EEG.
6. Snoring and pulse rate with its variation during events.
7. Clinical interpretation and a treatment recommendation phrased for direct application in your clinic.
Rapid screening tools to use before referring
Your clinic staff can apply both of these in under two minutes:
1. STOP-BANG questionnaire: snoring, daytime tiredness, observed apnea, blood pressure, body mass index above 35, age over 50, large neck circumference, and gender. Higher scores indicate a greater likelihood of moderate to severe obstructive sleep apnea, and a score of 3 or more is generally considered worth evaluating.
2. Epworth Sleepiness Scale: eight everyday situations in which the patient rates their likelihood of dozing, useful for documenting daytime sleepiness before referral and after treatment begins for comparison.
The medical team handling referred cases
Dr. Ahmed Alruhaimi
Consultant in Sleep Medicine, professional classification number 06RA35423, responsible for case assessment, study interpretation, and treatment recommendations.
Dr. Sami Al-Yami
Consultant in Pulmonology, for assessment of concurrent respiratory conditions.
Specialist Kholoud Mohammed
Cognitive behavioral therapy for insomnia and anxiety.
Why do physicians choose Subat Clinics?
1. The report returns to the referring physician, and the patient remains within your treatment plan.
2. The consultant reads the recording personally and issues a treatment recommendation, not a page of numbers.
3. All studies are performed in the patient's home, including home sleep testing with EEG.
4. Saudi consultants specialized in sleep medicine and pulmonology in Riyadh.
5. An integrated pathway from assessment through testing to treatment and device follow-up.
6. Transparency about scope: we tell you when a home study is not the right fit for your patient.
What we ask you to include with the referral
No formal form is required. A brief message or a note from your clinic is sufficient, including:
1. Patient name and mobile number.
2. Reason for referral in one line.
3. Observed nocturnal symptoms, if any.
4. Comorbidities and current medications.
5. Weight, height, and neck circumference where available.
6. Results of any previous sleep study.
7. Your name and your preferred channel for receiving the report.
Frequently Asked Questions from Referring Physicians
We normally begin with the consultant's assessment, because it determines the appropriate type of study and prevents a repeat test later due to selecting a study that cannot answer the clinical question. If you have a specific view of the case, it can be discussed with us before the appointment is booked.
Yes. A previous recording or report can be reviewed within the consultation, with an opinion on whether it is adequate or requires repeating.
We accept patients from age 14 and above. Younger cases require a different diagnostic pathway at centers specialized in pediatric sleep medicine, and we make this clear at first contact rather than leaving the case pending.
Adherence monitoring and pressure titration are handled here, and you may request a report on your patient's compliance at any time to incorporate into your management of their underlying condition.
Yes. If you prefer to receive the diagnosis and continue the treatment plan yourself, we limit our involvement to assessment, testing, and sending you the report.
