Escalation must follow the patient's orders and agency policy; the following are representative thresholds.
🚩 Red flags — escalate
A sleep aid causing oversedation, confusion, or a fall — hold per parameters and notify the provider; activate emergency response (911) for unarousable sedation.
Severe untreated sleep-disordered breathing with cardiovascular risk — provider notification for evaluation.
Nocturnal dyspnea, orthopnea, or paroxysmal nocturnal dyspnea — a cardiac or respiratory contributor: evaluate per the Cardiovascular and Respiratory red flags.
Acute severe insomnia with a safety or psychiatric concern — coordinate per the Psychiatric / Mental Health pathway.
Excessive daytime sleepiness creating a safety hazard — provider notification and a safety plan.
New loud snoring with witnessed apneas and gasping — provider notification for sleep evaluation.
