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Introduction Effective follow-up for patients with OSA/OSAHS on CPAP therapy is crucial for treatment efficacy and adherence. The Southern Trust Sleep Service in Northern Ireland (NI) faces challenges in maintaining review schedules for CPAP patients, compounded by an increasing number of new patients. This has led to a ‘Sleep Service Snowball,’ where demands on the service continue to escalate.To address these challenges, a survey was conducted to determine whether other sleep services in NI face similar issues and to explore effective solutions. The survey initially aimed to benchmark the Southern Trust Sleep Service against others in NI, but was later extended to include seven NHS trusts in England for comparative insights.Methods The survey, consisting of 24 questions focused on service size, waiting lists, and review schedules. The survey was sent via email to Lead Respiratory and Sleep Physiologists across the five Northern Ireland HSC trusts. Following this, the survey’s scope was expanded to include seven NHS trusts in England. The results were segmented and analysed by region to provide insights into the different practices and challenges faced.Results Results indicated significant challenges in NI, with an average wait time of 71 weeks for routine CPAP initiation and 12.5 weeks for urgent setups. Staffing shortages and high patient volumes were key factors contributing to difficulties in maintaining review schedules. Remote monitoring was widely implemented in Northern Ireland (3 out of 5 services), while in England, the use of remote monitoring was less consistent. English services surveyed reported shorter wait times (10.3 weeks for routine setups, 6.1 weeks for urgent setups) and more frequent use of patient-initiated follow-up pathways. Despite these differences, successful strategies identified across both regions included remote monitoring, CPAP support groups, streamlined follow-up appointments, and educational materials.Conclusion The study concludes that NI’s sleep services face significant strain, primarily due to staffing and increasing patient numbers. Recommendations include expanding remote monitoring, adopting patient-initiated follow-up systems, and increasing staffing levels to improve service efficiency. A national survey is suggested to better understand the challenges faced by sleep services across the UK and to support improvements in care delivery.