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Introduction and Objectives The healthcare industry is a significant contributor to the UK’s carbon emissions, with respiratory medicine being a particularly high emission speciality. In alignment with the NHS’s net zero 2045 goal, this study aimed to evaluate the relative carbon footprint of a typical Obstructive Sleep Apnoea (OSA) patient journey. Gold standard treatment for OSA remains Continuous Positive Airway Pressure (CPAP) therapy; however, this long-term treatment is energy intensive which raises questions about its sustainability. To assess this, we quantified the carbon footprint of CPAP treatment at a local sleep centre, to suggest opportunities for sustainability improvement.Methods The annual CO2e for a one-year pathway from point of referral to post-CPAP initiation review was calculated, by mapping and evaluating the patient journey. Four categories were identified as contributing to the total carbon footprint: medical equipment, patient transport, and energy consumption from CPAP devices and hospital facility usage. Where individual component consumption was not directly quantifiable, published figures were used. Patient travel behaviours were taken from a trust-wide travel survey and used in conjunction with average travel distances for the sleep clinic cohort.Results The total annual departmental carbon footprint was 222tCO2e, with a mean of 300 kgCO2e per patient. Medical equipment was the primary contributor at 67%, and within this, diagnostic studies contributed the highest percentage at 31%. Machine electricity usage contributed 17%. Full face masks bore a higher carbon footprint than nasal masks, and differences in travel habits also resulted in carbon emission variation. Although travel was a minor contributor in isolation, it represents scalable opportunity for improvement.Abstract P48 Table 1Final calculations of annual CO2e contributions of CPAP therapyConclusion Our results highlight the substantial environmental impact over a one-year journey for a patient with OSA undergoing CPAP treatment. Medical equipment, particularly diagnostic studies and CPAP consumables, device energy usage, and facility energy usage were the largest contributors. These emission intensive hotspots should be targeted for environmental improvement in sleep related treatment pathways. We encourage other sleep centres to use this data to review internal service pathway choices, to support the transition to environmentally responsible care.