Alternative care pathways in sleep medicine – real world data on outpatient sleep medicine diagnostics in patients with sleep-related breathing disorders

Introduction Diagnostics in sleep medicine is characterized by long waiting times and capacity issues. This study investigates whether a purely telemedical approach using video consultations and a singe-use diagnostic device is feasible in the workup of sleep-related breathing disorders.

Method Between January 2021 and March 2022, 172 out of 598 patients with an appointment for an outpatient polygraphy were offered a purely telemedical workup consisting of video consultations and a tonometry-based home-sleep test using a disposable single-use device (WatchPAT One). Readiness for telemedical diagnostics, practical feasibility, and satisfaction with the care pathway were also evaluated using questionnaires.

Results Out of the 172 patients, 27 (16%) could not be successfully contacted. 77 (53%) patients declined to participate. The most common reason given (n=35/45%) was preference for direct physician-patient contact. 46 (68%) of the remaining 68 interested patients returned the necessary documents required for the video consultations. In 35 (88%) of these patients, there was a need for outpatient home-sleep apnoea tests. In all cases, a sleep-related diagnosis or indication for further diagnostics could be made. There was a high level of satisfaction with the telemedical consultation on both physician (90%) and patient side (100%).

Conclusion Care pathways with telemedical consultations and single-use home-sleep-tests present a viable alternative with a high satisfaction rate for a selected patient population. However, about half of the patients currently still prefer an in-person patient-doctor interaction. The acceptance and feasability of telemedical consultations in outpatient diagnostics could increase with future improvement of telemedical infrastructure and availability.

Publication History

Article published online:
12 May 2023