0709 The Efficacy of Home Sleep Apnea Tests Alone in Determining Optimal Treatment Modality for Sleep Disordered Breathing During the Height of the COVID-19 Pandemic

Abstract

Abstract Introduction Home sleep studies have shown strong accuracy and reliability in diagnosing obstructive sleep apnea compared to PSG. Recent studies have suggested they can accurately detect central sleep apnea as well. The combination of better technology, stricter insurance requirements for in lab polysomnograms, and a rise in telemedicine has seen their utilization rapidly increase. Specifically, at the height of the COVID pandemic many sleep practices had to shut down their labs and rely on HSATs alone to evaluate patients with potential sleep disordered breathing. Methods The Albuquerque VA Sleep Center was one of these, which provided an opportunity to reflect on the effectiveness of this diagnostic modality over that timeframe. A total of 780 patients with suspected sleep disordered breathing were studied using ResMed ApneaLink II Machines from 3/16/21 to 7/1/21 while in lab PSGs were unable to be completed due to health and safety guidelines. Results Of these 780 patients, only 34 were determined to need further evaluation with an in lab titration study once the lab reopened. Given how few of these patients ended up with titration studies, no additional criteria were used to categorize them other than a provider deciding they needed the study. The charts of these patients were reviewed in detail to identify any common characteristics that could have contributed to them needing a more detailed evaluation with an in lab polysomnogram. This provided further information about the accuracy and reliability of HSATs, as well as traits of patients who would have been ideally studied with an in lab PSG instead. Conclusion Overall such a small percentage of patients, only 4%, needing further titration speaks to both the reliability of HSATs as diagnostic studies, and the effectiveness of remote titration through cloud based monitoring systems like AirView. Support (If Any)