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Home OSA Testing and Auto Titration No Barrier to Adherence
"Obstructive sleep apnea patients adhere to positive airway pressure treatment
just as well whether diagnosis and titration occur at home or in the sleep
laboratory, researchers found.
Every measure of adherence showed statistically similar outcomes between portable home
testing with auto-titration, and polysomnography with office-based titration,
Lt. Col. Christine Lettieri, MD, of Dewitt Army Community Hospital in Fort
Belvoir, Va., and colleagues reported here at the CHEST meeting."
Full article: http://www.medpagetoday.com/MeetingCoverage/CHEST/23156
Primary Care and home studies do it as well as the sleep labs at a much lower cost!!! (and with less bullshit).
Watch the cute lieutenant colonel in the video. She says some very important things about how PCPs doing these studies will result in the PCP becoming more aware and therefore getting many more people diagnosed and treated properly.
just as well whether diagnosis and titration occur at home or in the sleep
laboratory, researchers found.
Every measure of adherence showed statistically similar outcomes between portable home
testing with auto-titration, and polysomnography with office-based titration,
Lt. Col. Christine Lettieri, MD, of Dewitt Army Community Hospital in Fort
Belvoir, Va., and colleagues reported here at the CHEST meeting."
Full article: http://www.medpagetoday.com/MeetingCoverage/CHEST/23156
Primary Care and home studies do it as well as the sleep labs at a much lower cost!!! (and with less bullshit).
Watch the cute lieutenant colonel in the video. She says some very important things about how PCPs doing these studies will result in the PCP becoming more aware and therefore getting many more people diagnosed and treated properly.
Views: 20
Replies to This Discussion
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Permalink Reply by Neal Buckner, LRCP on
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Rooster,
I've been preaching this for several years. For the simple OSA patient, unattended home study and titration is just as effective and much cheaper than a formal sleep lab. I would be interested in seeing a formal study showing if CPAP pressure requirements derived from the "at home" APAP titration Vs sleep lab titration is different. I have found many times that a patient will be prescribed a pressure based on the results from a formal sleep study that is too high. I find that once they are put on APAP their compliance gets better and the average pressure goes down by 2 cmH2O or more. In my personal opinion, APAP is what everyone should be on. As we age things change. Some increase in weight, some decrease. Upper airway tone changes with the natural break down of elastins. Conditions change literally from night to night, week to week, month to month and year to year. The APAP is able to flex with the patients changing needs. Those changes can occur from something as simple as an allergy pill to having that extra glass of wine. Seasonal allergies and colds also play a factor.
It really frustrates me to see a patient ordered for APAP then do a down load a couple weeks later then have the doctor send a fixed CPAP Rx for that patient. Why? It makes no sense to me. The APAP is meeting the patients needs. Why mess with it? Do they really need to justify the office visit with that? Seems ridiculous to me. Do a diagnostic sleep study and if it's a simple OSA then order a darn APAP and call it good! It would save so much money to the insurance companies and free up the labs to take care of the patients who are complex.
I'll step down off my soap box now. lol
I am a fiscal conservative and I see way too much waste in some of this process. PSG techs will probably want to slap me.
Neal
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