The key element of treatment decisions is to explore health perception and chance of symptom relief.

A useful calculator related to cardiovascular health and risk can be found at: http://hjerterisiko.helsedirektoratet.no

When a sleep physician communicates a diagnosis, he or she has a brief window to explore person perspectives that may lead to change of behaviour. Within the time frame of minutes, the patient may reconsider behavioural aims, reveal barriers and be open for explicit change strategies. The core of PHC is exploring the person perspectives on health to a much larger extent than giving risk information. 

ABC of the person perspective:

• Aims: -Use open questions like «tell me why you’re here»
• Barriers for behaviour change: «Listen, and ask»
• Change of behaviour, explicit techniques (alphabetical, pick one): 
  • Nudging
  • Sleep Retraining Therapy (SRT): http://www.oslosovnsenter.no/?page_id=47
  • Step Count application
  • Tinnitus Retraining Therapy (TRT) http://tinnitus.org/

• Other links relatet to PHC:
  • Behavioural economics  https://en.wikipedia.org/wiki/Behavioral_economics
  • Harding Center of Risk Literacy: https://www.harding-center.mpg.de/en
  • Human behaviour change project http://www.ucl.ac.uk/human-behaviour-change
  • Habit formation https://en.wikipedia.org/wiki/Habit

Pre diagnostic risk estimates (general population):

• Death and cardiovascular events
  • Charlson comorbidity index: https://www.mdcalc.com/charlson-comorbidity-index-cci
  • Functional Comorbidity Index: http://www.pmidcalc.org/?sid=15878473&newtest=Y
  • Framingham index: https://www.mdcalc.com/framingham-coronary-heart-disease-risk-score
• Accidents
  • Traffic (Source https://en.wikipedia.org/wiki/Traffic_collision )
    • Highest death rate (Africa) 24.1 per 100,000 inhabitants
    • Lowest death rate (Europe) 10.3 per 100,000 inhabitants

Post diagnostic risk estimates for sleep apnoea, sleep apnea phenotypes and co-morbid disorders:

The post diagnostic risk estimates are being calculated in a current research project. They will be published here with links to scientific references.