PURPOSE: The capacity for performing sleep study is limited. We made a simulation to study whether a diagnosis of obstructive sleep apnoea syndrome (OSAS) and prescription of nasal continuous positive airway pressure (CPAP) therapy would be possible and cost-effective without performing a sleep study. METHODS AND OBJECTIVES: One hundred ninety-seven consecutive patients referred to a pulmonary clinic due to suspected OSAS were included. Professional drivers, patients with neurological diseases, heart failure or aged <25 years were excluded. Two experts evaluated patient records retrospectively in a stepwise manner. In step 1, they were blinded to the sleep study results, and in step 2, the results were available. RESULTS: Mean age was 51.5 ± 10.8 years, BMI 31.9 ± 7.2 kg/m(2), apnoea-hypopnoea index 19.8 ± 20.7/h and Epworth Sleepiness Scale 8.3 ± 4.7. Without sleep study results, the experts would initiate CPAP in 52.5% of patients (step 1), equalling to 74.7% of those whom they would suggest it after reviewing the sleep studies (step 2). In step 2, they suggested CPAP for 70.3% of all patients, while the clinicians responsible for the treatment for 66%. Net savings equal to the costs of CPAP device with interface for 50-100% of patients in need of this therapy depending on whether calculations are based on the costs of cardiorespiratory polygraphy or polysomnography. CONCLUSIONS: Nasal CPAP therapy would be possible to initiate without a sleep study for the majority of patients with suspected OSAS resulting in significant cost reduction.
PURPOSE: The capacity for performing sleep study is limited. We made a simulation to study whether a diagnosis of obstructive sleep apnoea syndrome (OSAS) and prescription of nasal continuous positive airway pressure (CPAP) therapy would be possible and cost-effective without performing a sleep study. METHODS AND OBJECTIVES: One hundred ninety-seven consecutive patients referred to a pulmonary clinic due to suspected OSAS were included. Professional drivers, patients with neurological diseases, heart failure or aged <25 years were excluded. Two experts evaluated patient records retrospectively in a stepwise manner. In step 1, they were blinded to the sleep study results, and in step 2, the results were available. RESULTS: Mean age was 51.5 ± 10.8 years, BMI 31.9 ± 7.2 kg/m(2), apnoea-hypopnoea index 19.8 ± 20.7/h and Epworth Sleepiness Scale 8.3 ± 4.7. Without sleep study results, the experts would initiate CPAP in 52.5% of patients (step 1), equalling to 74.7% of those whom they would suggest it after reviewing the sleep studies (step 2). In step 2, they suggested CPAP for 70.3% of all patients, while the clinicians responsible for the treatment for 66%. Net savings equal to the costs of CPAP device with interface for 50-100% of patients in need of this therapy depending on whether calculations are based on the costs of cardiorespiratory polygraphy or polysomnography. CONCLUSIONS: Nasal CPAP therapy would be possible to initiate without a sleep study for the majority of patients with suspected OSAS resulting in significant cost reduction.
Authors: Clete A Kushida; Michael R Littner; Timothy Morgenthaler; Cathy A Alessi; Dennis Bailey; Jack Coleman; Leah Friedman; Max Hirshkowitz; Sheldon Kapen; Milton Kramer; Teofilo Lee-Chiong; Daniel L Loube; Judith Owens; Jeffrey P Pancer; Merrill Wise Journal: Sleep Date: 2005-04 Impact factor: 5.849
Authors: P Lloberes; E Ballester; J M Montserrat; E Botifoll; A Ramirez; A Reolid; C Gistau; R Rodriguez-Roisin Journal: Am J Respir Crit Care Med Date: 1996-12 Impact factor: 21.405
Authors: Clete A Kushida; Michael R Littner; Max Hirshkowitz; Timothy I Morgenthaler; Cathy A Alessi; Dennis Bailey; Brian Boehlecke; Terry M Brown; Jack Coleman; Leah Friedman; Sheldon Kapen; Vishesh K Kapur; Milton Kramer; Teofilo Lee-Chiong; Judith Owens; Jeffrey P Pancer; Todd J Swick; Merrill S Wise Journal: Sleep Date: 2006-03 Impact factor: 5.849