Respiratory Physiologist

Respiratory physiologists are AHCS-registered healthcare scientists who investigate lung function and respiratory physiology. Your core diagnostic work includes spirometry (measuring airflow and lung volumes to diagnose and monitor COPD, asthma, and restrictive lung conditions), full lung function testing (body plethysmography, diffusion capacity — DLCO, gas transfer), bronchial challenge testing (measuring airway hyper-responsiveness), cardiopulmonary exercise testing (CPET), and respiratory muscle function assessment.

A major and growing component of respiratory physiology is sleep medicine. You set up and score polysomnography studies (PSG) — overnight multi-channel sleep recordings monitoring brain activity (EEG), eye movements (EOG), muscle tone (EMG), breathing effort, airflow, oxygen saturation, and heart rhythm — to diagnose obstructive sleep apnoea (OSA), central sleep apnoea, hypoventilation syndromes, and other sleep-related breathing disorders. You also administer and score home sleep apnoea testing (HSAT, formerly PolyNox) for community-based OSA assessment and set up and review CPAP (continuous positive airway pressure) therapy for OSA patients. At Band 6, you interpret and report studies, run nurse-led and physiologist-led CPAP clinics, and manage complex cases. At Band 7, senior respiratory physiologists lead services, supervise trainees, contribute to diagnostics accreditation (UKAS/ARTP), and may specialise in sleep medicine, ventilation, or pulmonary rehabilitation. The Association for Respiratory Technology and Physiology (ARTP) provides professional accreditation alongside AHCS statutory registration.

Respiratory disease is among the most prevalent and costly in the NHS — COPD, asthma, lung cancer, pulmonary fibrosis, and sleep-disordered breathing together account for a significant proportion of outpatient activity and hospital admissions. Obstructive sleep apnoea in particular is substantially under-diagnosed, and NHS sleep services face sustained and growing demand driven by population obesity, increased clinical awareness, and an ageing population.

AHCS statutory registration protects the professional title and creates an accountable quality framework. The technical complexity of polysomnography scoring, lung function interpretation, and CPET requires specialist training that cannot be replicated by less skilled workers. NHS respiratory and sleep waiting lists, and the NHS's post-COVID interest in long COVID respiratory consequences, ensure long-term structural demand for respiratory physiology skills. The ARTP accreditation framework for spirometry services also creates consultancy opportunities in primary care quality improvement.

Morning: outpatient lung function clinic — perform full lung function assessments (spirometry, body box, gas transfer) for eight patients with COPD, possible pulmonary fibrosis, and post-COVID breathlessness. Interpret results and add clinical comments for consultant review. Mid-morning: set up a home sleep apnoea testing device for a patient with suspected OSA — review technique, fit nasal cannula, pulse oximeter, and effort belt, and educate the patient on the overnight protocol. Afternoon: score and report two polysomnography studies from the previous night's sleep laboratory, identifying one patient with severe OSA and one with obesity hypoventilation syndrome. CPAP follow-up clinic — review three patients at one, three, and twelve months of CPAP therapy, checking adherence data, mask fit, and symptom response.