目的:本研究旨在探讨家庭睡眠测试(HST)对疑似阻塞性睡眠呼吸暂停(OSA)患者的适应证和结果。与美国睡眠医学学会和欧洲睡眠研究学会制定的指导方针保持一致。具体来说,我们的目的是审核经过验证的3型测谎仪是否可以在优化资源利用的同时有效确保患者护理.
方法:对2022年1月至2022年12月在三级转诊医院因疑似OSA而接受3型息肉术的患者的数据进行了回顾性分析。人口统计,临床,并收集管理数据。评估HST在指导管理计划中的有效性,根据随后对实验室多导睡眠图的需要,将结局分为有效或无效。
结果:虽然85%的患者得到了可靠的诊断,44.4%的患者仍然需要随后的多导睡眠监测,主要是由于遵守资助条例,而不是临床上需要进一步检查。影响HST疗效的因素包括患者年龄,呼吸暂停的严重程度,并由经过认证的睡眠专科医生转诊。
结论:我们的研究强调了3型测谎的潜力,作为在门诊诊断OSA的有价值的工具。然而,由经过认证的睡眠专科医生解释结果是不够的。为了简化护理途径,测谎的转诊也必须由训练有素的专家进行。与筹资条例有关的挑战,患者人口统计学和医师培训强调需要优化诊断途径以改善患者护理和资源利用。
OBJECTIVE: This study aimed to investigate the indications and outcomes of Home Sleep Testing (HST) for patients with suspected obstructive sleep apnea (OSA), aligning with guidelines set forth by the American Academy of Sleep Medicine and the European Sleep Research Society. Specifically, we aimed to audit whether validated type 3
polygraphy could effectively ensure patient care while optimizing resource utilization.
METHODS: A retrospective analysis was conducted on data from patients undergoing type 3
polygraphy for suspected OSA in a tertiary referral hospital between January 2022 and December 2022. Demographic, clinical, and management data were collected. The efficacy of HST in guiding management plans was evaluated, with outcomes categorized as effective or ineffective based on subsequent need for in-laboratory polysomnography.
RESULTS: While 85% of patients received a reliable diagnosis, 44.4% of them still required subsequent polysomnography, primarily due to adherence to funding regulations, rather than clinical need for further testing. Factors impacting the efficacy of HST included patient age, severity of apnea, and referral by a certified sleep specialist physician.
CONCLUSIONS: Our study highlighted the potential of type 3
polygraphy, as a valuable tool for diagnosing OSA in an outpatient setting. However, having the result interpreted by a certified sleep specialist doctor was not enough. To streamline the care pathway, the referral for
polygraphy had also to be made by a trained specialist. Challenges related to funding regulations, patient demographics and physician training stress the need for optimized diagnostic pathways to improve patient care and resource utilization.