PURPOSE: The Center for Medicare and Medicaid Services has recently approved the use of limited-channel home sleep testing (HST) for the diagnosis of obstructive sleep apnea. In some cases, patients may be unable or unwilling to travel to a lab for application of a home testing device.
METHODS: A program was developed to send a HST device to the patient's home for self-application. Patients were screened for appropriateness for HST. Patients considered inappropriate for HST were referred for a facility-based study. Patients were sent the ABM ‘ARES’, a combined questionnaire and 6-channel testing device. The device provides audio/visual indicators when the device requires adjustment. The device was sent to the patient's home with instructions for self-application. The patient was phoned by a specially-trained Respiratory Therapist at the patient's bedtime to review the instructions and answer questions. Calls were placed after the 1st and 3rd nights of testing to assess success. The patient was instructed to perform 3 nights of testing and ship the device to a sleep center for scoring and interpretation. Studies were assessed for adequate signal quality. Periods with significant loss of signal were removed before the analysis. Successful testing was defined as at least 2 hours of quality recording (all data channels) on at least 2 nights.
RESULTS: Overall, 310 (94.8%) of 327 patients were successful in testing. Patients averaged 2.86 nights of testing during the 3 nights and averaged 5.93 hours of testing per night.
CONCLUSION: The vast majority of patients are able to successfully self-apply the ARES device. A direct ship, self-application program can be successful when patients are properly screened and supported.
CLINICAL IMPLICATIONS: A model utilizing self-application of a home sleep testing device can be useful in providing testing to large populations of patients suspected of having sleep apnea that may be unable or unwilling to travel to a facility-based lab.
DISCLOSURE: Gregory Spratt, No Financial Disclosure Information; No Product/Research Disclosure Information