Improving the Efficiency and Accuracy of OSA Diagnostics

Title: Improving the Efficiency and Accuracy of OSA Diagnostics
Author(s): C Gill P Coss O Gavin A Martin R McLoughlin T Matthews AM McLaughlin B Kennedy BD Kent
Institution: St James' Hospital
Poster: Click to view poster
Category: General Respiratory and Sleep
Abstract: Polysomnography (PSG) is the gold standard test for obstructive sleep apnoea (OSA), but is resource intensive. Nocturnal oximetry is often used as an initial diagnostic tool in suspected OSA because of its convenience and low cost, but it lacks sensitivity, with consequent long PSG waiting lists. We conducted a quality improvement project to expedite OSA diagnosis, using a novel sleep diagnostic device, the WatchPAT.

To gauge the impact of OSA undiagnosed by oximetry on PSG waiting lists, we initially assessed consecutive PSGs undertaken in our centre in the preceding year. Thereafter, patients awaiting PSG for suspected OSA underwent home sleep testing (HST) using WatchPAT devices, to quantify the proportion of patients that could be spared PSG by the use of more advanced HST.

PSG identified a significant burden of OSA not diagnosed by oximetry: 84% of PSG patients an AHI >5 events/hour, with 64% having at least moderately severe disease. 27 subsequent patients with non-diagnostic oximetry had HST: mean AHI was 15.65±10.74 events/hour, (74%) were identified as having OSA, with 8 (40%) having an AHI>15.

These data highlight the impact of OSA on PSG waiting lists, along with the role of emerging technologies in expediting OSA diagnosis and treatment.