How we got here
SleepNav® did not arrive fully formed. It is the product of more than thirty years in the sleep industry, seventeen years of clinical-protocol work, one independent feasibility study, and one unshakeable conviction – that the people who need sleep care are not, on the whole, in sleep clinics. They are in their local pharmacy.
Starting with dentists
Snoring is the primary symptom of obstructive sleep apnoea (OSA), and for a long time the people best placed to spot it were general dental practitioners. Dentists examine the airway, take medical histories, and see patients more regularly than most GPs. They were also the only profession allowed to provide mandibular advancement devices – which, for the right patient, treat both simple snoring and mild-to-moderate OSA.
The problem was that dentists had no agreed way to tell the difference between a simple snorer they could safely treat and a patient with undiagnosed OSA who needed onward referral. Without that distinction, the risk was real – fitting a dental appliance to someone with serious OSA could mask their symptoms and delay diagnosis.
In response, Dr Roy Dookun BDS and I co-founded the British Society of Dental Sleep Medicine (BSDSM). Through the BSDSM, I instigated a Sleep Medicine Working Party – comprising leading respiratory physicians and general dental practitioners – to develop a pre-treatment screening protocol that would let dentists triage snorers safely. The protocol the working party produced was published in the British Dental Journal in 2009 by Professor John Stradling (Oxford) and Dr Roy Dookun:
That protocol – built on the Epworth Sleepiness Scale, a structured medical history, and clinical risk thresholds – is the same protocol that, seventeen years later, underpins SleepNav®'s OSA decision logic today. It works.
The pivot – meeting people where they are
What I learned over the following decade was uncomfortable. People do not connect snoring with their dentist. The 2009 protocol was sound, but the route to it was wrong. Patients who needed help were not arriving at the dentist's chair to find it.
They were, however, walking into pharmacies – every day, in their thousands. Looking for over-the-counter sleep aids that don't work. Looking for something to stop their partner snoring. Looking for advice. And being met, too often, by a sector that had been sold expensive nonsense by suppliers who knew better.
I had a choice. I could stay frustrated with community pharmacy for selling placebo products to vulnerable people, or I could recognise that pharmacy was where the patients actually were. The screening protocol I had instigated for dentists was, with adaptation, exactly what community pharmacy needed.
SnorerPharmacy™ at Wansford
The first community pharmacy implementation of the protocol was SnorerPharmacy™, deployed at Wansford Pharmacy in Cambridgeshire from November 2020. Pharmacist Gareth Evans used the tool to screen walk-in patients, patients referred via the Community Pharmacy Consultation Service, and patients referred from neighbouring primary care.
In 2024, the British Society of Pharmacy Sleep Services (BSPSS, registered charity 1198553) commissioned an independent feasibility study by Dr Adam Pattison Rathbone, Lecturer in Clinical and Social Pharmacy at Newcastle University. The study was unfunded, declared no conflicts of interest, and was approved by Newcastle University Research Ethics Committee (ref 45289/2023).
Dr Rathbone's findings, from 50 patients screened over 42 months at a single pharmacy site:
Key findings
- 85% of patients offered screening accepted it
- 62% met the threshold for a Home Sleep Apnoea Test
- 39% of those referred to a sleep clinic received a confirmed OSA diagnosis
- A further 3% were diagnosed with central sleep apnoea
- 22% were referred to a sleep-trained dentist; 12% received weight-loss and lifestyle advice
The report's conclusion, in Dr Rathbone's own words:
Community pharmacies can feasibly provide sleep support services, leveraging their accessibility and trust within local populations. — Rathbone, EICSS Report, September 2024
The full report – Early Intervention Community Sleep Support (EICSS): An Exploratory Feasibility Study to Improve Access to Home Sleep Apnoea Testing, Newcastle University & the British Society of Pharmacy Sleep Services, September 2024, published under CC-BY 4.0 – is available here.
The case for community pharmacy as the right place for sleep screening is no longer theoretical.
SleepNav®
SleepNav® is the next iteration. The clinical foundation is unchanged – the Stradling–Dookun protocol still sits at the heart of the OSA decision engine, alongside NICE NG202, STOP-Bang adaptations, the Beers Criteria for elderly safety, the STOPP/START version 3 criteria (O'Mahony et al., 2023), and the latest NICE CKS guidance on insomnia. Every clinical recommendation traces back to a published source.
What changed is the engineering around it. SleepNav® is now a registered Class I medical device under the Medical Devices Regulations 2002. It is built around a privacy-by-design architecture: no patient names, no dates of birth, no NHS numbers, no contact details – the system processes the clinical variables the pharmacist needs and nothing else. It includes safety gates that cannot be bypassed (witnessed apnoea, Beers Criteria, orthopnoea, uncontrolled epilepsy) and structured reasoning traces so every recommendation can be explained.
The work is still the same work. A pharmacist meets a patient at the counter. A protocol that was good enough to publish in 2009 helps the pharmacist tell the difference between someone who needs lifestyle advice, someone who needs a dental appliance, someone who needs a sleep test, and someone who needs to be referred onward today. SleepNav® is what that conversation looks like in 2026.
SleepNav® is developed and maintained by Adrian Zacher of Snorer.com Ltd.