Guidelines for the Practice of Sleep Medicine (Online)-Guidelines for the Practice of Sleep Medicine

Guidelines for the Practice of Sleep Medicine

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The document discusses the use of home sleep apnea testing (HSAT) for the diagnosis of obstructive sleep apnea (OSA) in uncomplicated adult patients. HSAT has been found to have high diagnostic accuracy and similar clinical outcomes compared to in-laboratory polysomnography (PSG). However, it is less accurate in populations with significant cardiorespiratory disease or other comorbidities. The use of HSAT has potential benefits such as convenience and decreased cost but also potential harms such as the need for additional testing and risk of misdiagnosis. It is recommended to ensure the device used is technically adequate and that there is a minimum of 4 hours of good quality data. The decision to use a split-night protocol for HSAT should be made based on patient characteristics and the potential for inconclusive results. PSG remains the gold standard for diagnosis and may be necessary in certain cases. The article also discusses the development of quality measures for evaluating the care of patients with sleep disorders, with a focus on five common sleep disorders. The measures include outcome and process measures and aim to improve the quality of care and patient outcomes in sleep medicine. Implementation strategies include integrating the measures into electronic health records, training medical support staff, and educating healthcare providers.

Keywords

home sleep apnea testing

diagnosis

obstructive sleep apnea

uncomplicated adult patients

polysomnography

cardiorespiratory disease

convenience

cost

sleep disorders

quality measures