Self-setup of home respiratory polygraphy for the diagnosis of sleep apnea syndrome: cost-efficiency study

Abstract

Purpose

To evaluate the differences in reliability and costs of home respiratory polygraphy (HRP) when installed by the patient and by a nurse, in order to determine the factors affecting and to consider the possible generalization of self-setup procedure. Several HRP devices have been validated for obstructive sleep apnea (OSA) diagnosis but convenience of a nurse intervention in HRP installation has been scarcely studied.

Methods

This is a prospective and interventional study. About 301 participants were assigned to 2 groups: self-setup and nurse intervention. Sleep study, questionnaires, and diagnostic procedures were performed following the clinical practice in 2016. Signals were considered lost above 3 min, and success of the test was established according to guidelines. Costs were calculated according to a previous multicenter study.

Results

Both groups (self-setup and nurse intervention) resulted homogeneous in age, gender, BMI, and final diagnosis of OSA. Signal losses during the test were similar in both groups. Slightly higher percentage of unsuccessful tests were obtained in the self-setup procedure (5.3 vs 2.0%, p = 0.121). The costs were similar (107 vs 105 €) in the self-setup group as compared to the nurse setup group.

Conclusions

The setup of HRP by either the patient or nurse had similar costs and data acquisition. Both installation procedures of HRP were similar regarding test reliability and costs. Main findings are that self-installation by the patient could be similarly reliable and economic as installation by a nurse, as far as consensus guidelines are followed. This study demonstrates that self-setup of HRP is a potentially viable option for the diagnosis of OSA.

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Funding

This study was funded by Fundación Burgos por la Investigación de la Salud N° 1615.

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Correspondence to Blanca Barriuso.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Barriuso, B., Martin, L., Sevilla, C. et al. Self-setup of home respiratory polygraphy for the diagnosis of sleep apnea syndrome: cost-efficiency study. Sleep Breath 24, 1067–1074 (2020). https://doi.org/10.1007/s11325-019-01959-4

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Keywords

  • Sleep apnea
  • Home respiratory polygraphy
  • Nurse
  • Cost
  • Signals