At-Home Sleep Test Effective and Cheaper
Reported May 20, 2010
(Ivanhoe Newswire) Patients with suspected obstructive sleep apnea (OSA) may be spared an expensive, uncomfortable night at a sleep center to monitor their sleep-disordered breathing.
Researchers have found that patients who performed sleep testing in their homes with portable monitors showed similar improvements in daytime function after three months of treatment with continuous positive airway pressure (CPAP) to patients who underwent overnight testing in a sleep center.
Furthermore, patient adherence to CPAP over the first three months of treatment was similar in patients with OSA who received in-home versus in-lab testing.
Obstructive sleep apnea is common, dangerous, and relatively easy to treat, but expensive to diagnose. “These findings represent a possible turning point for both patients with sleep-disordered breathing and the clinicians who treat them,” senior researcher Samuel T. Kuna, M.D., Chief of the pulmonary, critical care and sleep section at the Philadelphia VA Medical Center, was quoted as saying. “One of the biggest and most insurmountable barriers to treatment is the need for overnight testing in a sleep laboratory. Our research suggests that this may no longer be a mandatory for diagnosis.”
It is estimated that 4 percent of women and 9 percent of men in the U.A. have moderate to severe OSA and that 80 percent of these individuals are undiagnosed and untreated. Patients with untreated OSA are at increased risk for traffic accidents, hypertension and cardiovascular disease.
“Currently, most patients with OSA need to perform overnight sleep testing in a sleep center,” explained Dr. Kuna. “The result has been unacceptably long patient wait times and restricted access to care.”
The researchers studied nearly 300 patients who underwent either in-laboratory sleep-testing or at-home testing. Of the 223 patients who started CPAP treatment after evaluation, 185 completed three months of follow-up. Those who had undergone at-home testing showed improvements after three months of CPAP treatment similar to those who had undergone in-lab diagnosis.
“Proponents of in-laboratory testing argue that patients performing in-lab testing might have better outcomes than those performing home testing. For example, during in-lab testing, the patient spends a greater amount of time with a technologist who is able to educate the patient about OSA and CPAP and help the patient overcome any barriers to diagnosis and treatment that might arise during testing,” said Dr. Kuna. “But our results did not find a difference between home versus in-lab testing in terms of clinical outcomes. The two management pathways appear to be equivalent in terms of patients’ functional outcomes and ability to use CPAP treatment.”
SOURCE: Presented at the American Thoracic Society (ATS) 2010 International Conference, New Orleans, May 18, 2010.
