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Effect of a targeted obstructive sleep apnea consult to improve access and quality at a sleep disorders center.
J Clin Sleep Med. 2006 Jan 15; 2(1):49-56.JC

Abstract

STUDY OBJECTIVES

We sought to evaluate whether a targeted obstructive sleep apnea (OSA) consult (TOSAC) protocol that reduced sleep-specialist time spent with patients suspected of having OSA would improve quality of care compared with the previous clinical method for evaluation of patients internally referred for suspected OSA.

METHODS

Prospective cohort design. TOSAC patients received oximetry and criteria screening prior to a split-night polysomnography and a 45-minute sleep-specialist consult, while control patients received consult, testing, and a follow-up visit (90 minutes of sleep-specialist time).

RESULTS

We enrolled 186 TOSAC and 94 control patients. TOSAC patients completed their evaluation in a median of 7.0 days compared with 60.0 days for the controls (p < .001). At baseline, the TOSAC group was sleepier (Epworth Sleepiness Scale 13.9+/-4.5 vs 11.0+/-4.3; p < .001) and had a slightly lower quality of life (Functional Outcomes of Sleep Questionnaire 15.0+/-3.0 vs 16.8+/-2.2, p < .001) than controls. The apnea-hypopnea index noted at polysomnography was similar in TOSAC and control patients (28.6+/-29.5 vs 23.1+/-23.9, p = .156), and the prevalence of OSA was similar in both groups (75% vs 72%, p = .616). At 1 month of therapy, improvement in the Epworth Sleepiness Scale and overall patient satisfaction were similar between groups (all p > .10), while TOSAC patients had a slightly greater improvement on the Functional Outcomes of Sleep Questionnaire (p = .010). TOSAC patients reported better subjective continuous positive airway pressure compliance (median 42.0 vs 32.5 hours/week; p = .037).

CONCLUSIONS

A protocol-driven evaluation pathway for OSA that used screening with oximetry and less sleep-specialist time shortened access and produced similar diagnoses, improvements in sleepiness and quality of life, and overall satisfaction.

Authors+Show Affiliations

Mayo Clinic Sleep Disorders Center, 200 First Street SW, Rochester, MN 55905, USA. tmorgenthaler@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17557437

Citation

Morgenthaler, Timothy I., et al. "Effect of a Targeted Obstructive Sleep Apnea Consult to Improve Access and Quality at a Sleep Disorders Center." Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, vol. 2, no. 1, 2006, pp. 49-56.
Morgenthaler TI, Olson EJ, Gay P, et al. Effect of a targeted obstructive sleep apnea consult to improve access and quality at a sleep disorders center. J Clin Sleep Med. 2006;2(1):49-56.
Morgenthaler, T. I., Olson, E. J., Gay, P., Decker, P. A., Herold, D., Moore, W., Silber, M. H., & Krahn, L. (2006). Effect of a targeted obstructive sleep apnea consult to improve access and quality at a sleep disorders center. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 2(1), 49-56.
Morgenthaler TI, et al. Effect of a Targeted Obstructive Sleep Apnea Consult to Improve Access and Quality at a Sleep Disorders Center. J Clin Sleep Med. 2006 Jan 15;2(1):49-56. PubMed PMID: 17557437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of a targeted obstructive sleep apnea consult to improve access and quality at a sleep disorders center. AU - Morgenthaler,Timothy I, AU - Olson,Eric J, AU - Gay,Peter, AU - Decker,Paul A, AU - Herold,Dan, AU - Moore,Wendy, AU - Silber,Michael H, AU - Krahn,Lois, PY - 2007/6/15/pubmed PY - 2007/7/27/medline PY - 2007/6/15/entrez SP - 49 EP - 56 JF - Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine JO - J Clin Sleep Med VL - 2 IS - 1 N2 - STUDY OBJECTIVES: We sought to evaluate whether a targeted obstructive sleep apnea (OSA) consult (TOSAC) protocol that reduced sleep-specialist time spent with patients suspected of having OSA would improve quality of care compared with the previous clinical method for evaluation of patients internally referred for suspected OSA. METHODS: Prospective cohort design. TOSAC patients received oximetry and criteria screening prior to a split-night polysomnography and a 45-minute sleep-specialist consult, while control patients received consult, testing, and a follow-up visit (90 minutes of sleep-specialist time). RESULTS: We enrolled 186 TOSAC and 94 control patients. TOSAC patients completed their evaluation in a median of 7.0 days compared with 60.0 days for the controls (p < .001). At baseline, the TOSAC group was sleepier (Epworth Sleepiness Scale 13.9+/-4.5 vs 11.0+/-4.3; p < .001) and had a slightly lower quality of life (Functional Outcomes of Sleep Questionnaire 15.0+/-3.0 vs 16.8+/-2.2, p < .001) than controls. The apnea-hypopnea index noted at polysomnography was similar in TOSAC and control patients (28.6+/-29.5 vs 23.1+/-23.9, p = .156), and the prevalence of OSA was similar in both groups (75% vs 72%, p = .616). At 1 month of therapy, improvement in the Epworth Sleepiness Scale and overall patient satisfaction were similar between groups (all p > .10), while TOSAC patients had a slightly greater improvement on the Functional Outcomes of Sleep Questionnaire (p = .010). TOSAC patients reported better subjective continuous positive airway pressure compliance (median 42.0 vs 32.5 hours/week; p = .037). CONCLUSIONS: A protocol-driven evaluation pathway for OSA that used screening with oximetry and less sleep-specialist time shortened access and produced similar diagnoses, improvements in sleepiness and quality of life, and overall satisfaction. SN - 1550-9389 UR - https://www.unboundmedicine.com/medline/citation/17557437/Effect_of_a_targeted_obstructive_sleep_apnea_consult_to_improve_access_and_quality_at_a_sleep_disorders_center_ L2 - http://www.diseaseinfosearch.org/result/6636 DB - PRIME DP - Unbound Medicine ER -