Improvement in Obstructive Sleep Apnea Diagnosis and Management Wait Times: A Retrospective Analysis of a Home Management Pathway for Obstructive Sleep Apnea

Obstructive sleep apnea is a common condition within the Canadian population. The current gold standard for diagnosis and management of patients is in-laboratory (in-lab) polysomnography; however, the limited availability of testing options for patients has led to long wait times and increased disease burden within the population. The Sleep Research Laboratory in Saskatoon (Saskatchewan) implemented a home management program to run in parallel with the in-lab system several years ago in an effort to increase their capacity and reduce wait times. The present study was a retrospective analysis of all patients referred to the program between 2009 and 2012. The home management system has improved wait times by diagnosing and managing up to one-half of the referred patient population, reducing the wait for in-lab treatment from a median of 152 days in 2009 to 92 days in 2012 (P<0.0001). Moving forward, home management can provide a viable alternative to in-lab testing for patients who meet strict entry criteria, reducing the in-lab workload and, ultimately, reducing wait times.

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Initiation of therapy for obstructive sleep apnea syndrome: a randomized comparison of outcomes of telemetry-supported home-based vs. sleep lab-based therapy initiation

Sleep And Breathing ◽

10.1007/s11325-021-02371-7 ◽

2021 ◽

Author(s):

Ingo Fietze ◽

Sebastian Herberger ◽

Gina Wewer ◽

Holger Woehrle ◽

Katharina Lederer ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Control Group ◽

Sleep Laboratory ◽

Home Therapy ◽

Home Management ◽

Therapy Initiation ◽

Home Based ◽

Obstructive Sleep ◽

At Home

Abstract Purpose Diagnosis and treatment of obstructive sleep apnea are traditionally performed in sleep laboratories with polysomnography (PSG) and are associated with significant waiting times for patients and high cost. We investigated if initiation of auto-titrating CPAP (APAP) treatment at home in patients with obstructive sleep apnea (OSA) and subsequent telemonitoring by a homecare provider would be non-inferior to in-lab management with diagnostic PSG, subsequent in-lab APAP initiation, and standard follow-up regarding compliance and disease-specific quality of life. Methods This randomized, open-label, single-center study was conducted in Germany. Screening occurred between December 2013 and November 2015. Eligible patients with moderate-to-severe OSA documented by polygraphy (PG) were randomized to home management or standard care. All patients were managed by certified sleep physicians. The home management group received APAP therapy at home, followed by telemonitoring. The control group received a diagnostic PSG, followed by therapy initiation in the sleep laboratory. The primary endpoint was therapy compliance, measured as average APAP usage after 6 months. Results The intention-to-treat population (ITT) included 224 patients (110 home therapy, 114 controls); the per-protocol population (PP) included 182 patients with 6-month device usage data (89 home therapy, 93 controls). In the PP analysis, mean APAP usage at 6 months was not different in the home therapy and control groups (4.38 ± 2.04 vs. 4.32 ± 2.28, p = 0.845). The pre-specified non-inferiority margin (NIM) of 0.3 h/day was not achieved (p = 0.130); statistical significance was achieved in a post hoc analysis when NIM was set at 0.5 h/day (p < 0.05). Time to APAP initiation was significantly shorter in the home therapy group (7.6 ± 7.2 vs. 46.1 ± 23.8 days; p < 0.0001). Conclusion Use of a home-based telemonitoring strategy for initiation of APAP in selected patients with OSA managed by sleep physicians is feasible, appears to be non-inferior to standard sleep laboratory procedures, and facilitates faster access to therapy.

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A retrospective analysis on patients at high-risk for obstructive sleep apnea undergoing ear, nose, and throat surgeries

Laryngoscope Investigative Otolaryngology ◽

10.1002/lio2.131 ◽

2017 ◽

Vol 3 (1) ◽

pp. 16-21

Author(s):

Karina Woodling ◽

Juan Fiorda-Diaz ◽

Bradley A. Otto ◽

Christie A. Barnes ◽

Alberto A. Uribe ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Retrospective Analysis ◽

Obstructive Sleep ◽

Nose And Throat

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AWARENESS AND KNOWLEDGE OF OBSTRUCTIVE SLEEP APNEA AMONG THE MEHSANA POPULATION

10.36106/gjra/8304773 ◽

2021 ◽

pp. 53-55

Author(s):

Darshan SodhaSodha ◽

Shrish Srivastava ◽

Ajay Kubavat

Keyword(s):

Risk Factors ◽

Social Media ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Disorders ◽

Diagnosis And Management ◽

Knowledge Questionnaire ◽

Obstructive Sleep ◽

Level Of Knowledge

Obstructive sleep apnea is one of the most common sleep disorders and is an increasingky prevalent condition that remains largely undiagnosed. An observational crosssectional survey conducted in Orthodontic department of Narsinhbhai Patel Dental College using OSA knowledge containing 24 questions including knowledge. questionnaire consisting 24 questions was prepared and circulated to mehsana population across mehsana via google forms. 1000 pediatricians were approached via various social media and whatsapp groups to ll up the google forms. We got 612 complete responses to consider in the study. The level of knowledge regarding diagnosis and management of OSA in the Mehsana population is not optimal. Large number 80.1% were not aware about OSA and 4.7% were aware about risk factors related to OSA.

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