Authors (including presenting author) :
Lam WC (1), Ho KH (1), Ruth Lau (1), Chu YM (1), Grace Chan (1), Yeung YC (1), Jessica Yik (1), Mak KM (1)
Affiliation :
(1) Department of Medicine and Geriatrics, Princess Margaret Hospital
Introduction :
Obstructive sleep apnoea (OSA) is a breathing disorder known by recurring episodes of upper airway obstruction that lead to reduced or absent airflow at the nose or mouth. In Hong Kong, the prevalence of OSA is over 4% in male and over 2% in female ranging in age from 30 to 60 years (Chau & Wong, 2019). Polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea (OSA) in patients. Respiratory unit of Princess Margaret Hospital (PMH) has provided in-patient sleep study in the ward since 2000. Due to in-patient bed tightness and the impact of the COVID pandemic, the waiting time for sleep study in the respiratory unit is lengthened, over >3 years. Home sleep apnea test (HSAT) is a simplified version of sleep study (level 3 sleep study) to conduct testing for OSA at home. In 2024, home sleep service was set up in the respiratory unit
Objectives :
1. To reduce the waiting time of sleep study for OSA by using home sleep services 2. To improve the effectiveness of home sleep service with initiative intervention.
Methodology :
1.Service workflow : Two home sleep studies are scheduled each week, resulting in a total of 10 studies each month. Flowchart is established to direct for arranging sleep studies for patients with OSA. The STOP-BANG sleep apnea questionnaire is used to evaluate the risk of OSA. Respiratory nurses are trained to conduct home sleep studies. Sleep study data is downloaded and analyzed the next day after returning home sleep devices. Respiratory clinic follow up would be arranged within 2 weeks after completing home sleep study. 2.Patient education / educational materials: Half an hour of individual training is arranged for the demonstration of home sleep devices. A tailor made video guide is made to educate patients on how to install and operate the home sleep devices properly. Patient is instructed to conduct a return demonstration. After training, prepared QR codes of video guides and leaflets are given to patients for reference on home sleep studies.
Result & Outcome :
From Apr - Dec 24, 34 cases of home sleep studies were conducted. A total of 34 cases (88.2%) were diagnosed as OSA. The waiting time for sleep study has significantly decreased from 24 months to 2 months. No channel failure of home sleep study was reported. Patient survey showed that 69% of patients totally agreed that the home sleep study is more comfortable, as patients sleep well in their home sleep environment. Furthermore, 87.5% of patients totally agreed that the educational materials provided were clear and comprehensible, while 75% found the accompanying video guides and leaflets useful in facilitating their understanding of the home sleep study process. In addition, 62.5% of patients totally agreed that the home sleep study is more accessible. It is notable that the home sleep devices are generally less expensive than hospital sleep lab equipment, and the staffing required for home sleep studies are also reduced. Overall, the home sleep study is more cost-effective and efficient than traditional in-lab sleep studies for detecting OSA which enable early diagnosis for sleep disorder, thereby timely treatments for patients.
