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As the market changes it is rapidly becoming important to offer flexible solutions for collecting sleep studies at varied locations. With the entrance of Wireless Polysomnography, sleep study setups outside of the lab become more feasible. A comprehensive sleep diagnostic service can now come to the patient instead of the patient having to come to the lab for a PSG. Wireless PSG also brings several benefits to the traditional in-lab setting. Here’s a quick introduction to the traditional and new & upcoming, non-traditional settings for a polysomnography.

Traditional Setting:

In-lab sleep facilities offer onsite sleep techs, medical equipment, and a full bedroom set. This is an expensive set-up, but wireless PSG completely eliminates the cost of running cables throughout the facility with its ability to transmit data through multiple walls. Also, there are typically fewer components with wireless devices and lower risk of individual component failure. Sleep labs will also benefit from expanding their sleep services to include non-traditional off-site testing. Sleep labs volume will not diminish but their patient mix will differ. Typically overcrowded labs will only have deal with those who strictly require in-lab testing, and they can service a larger total volume of patients (since they do not all need to be onsite). Each patient population can then receive a faster diagnosis and therefore faster treatment initiation, cutting out the need for long waits or investing in additional beds for the lab.

Non Traditional Settings:

Home Sleep Test: While some extreme conditions strictly require in-lab sleep testing, many patient populations are well suited for home sleep diagnostic testing, like those tested for occupational reasons, or the home-bound suffering from chronic pain. Home Sleep Testing (HST) allows patients the comfort of home and a familiar environment. It is also increases affordability by cutting out the facility costs of the sleep lab, and the costs involved in moving a patient to the sleep lab which can be expensive in some cases.

Hospital Inpatient PSG: Hospital networks, wireless or intranets are used to transfer sleep studies from the bedside to the sleep lab. Technicians can monitor and respond to problems, yet the patient is still under the immediate supervision of skilled nurses. Since Sleep Disorders Breathing is a complicating factor in many surgeries, the ability to conveniently conduct a sleep study in those settings may avoid complications intraoperatively and postoperatively (particularly for bariatric and cardiac surgery patients)

Hotels: Sometimes sleep labs use hotel rooms to conduct sleep studies because of reduced costs. Some patients are better able to relax in this more familiar setting, and benefit from a reduced first-night-effect.

CleveMed offers the technologies that can expand the reach of sleep services with its wireless systems that are suitable for both HST, follow-up and in-lab sleep studies. This post draws on the experience of several experts at CleveMed and the following web page: www.clevemed.com/PSGAnywhere

In-lab sleep testing requires extensive resources: onsite staff, medical equipment, and a full bedroom set. Not only is this an additional expense for insurance payers, but the unfamiliar sleep setting can affect the patient’s normal sleep patterns and skew the test results. Expanding the labs to home sleep testing solves many of these problems.

Familiar Environment:

While some extreme conditions still require in-lab sleep testing, many patient populations are well suited for home sleep diagnostic testing. These groups include those tested for occupational reasons, patients with a high probability of sleep apnea, the home bound and those suffering from chronic pain. The unfamiliar in-lab environment can lead to increased anxiety for the patient and inconvenience to those caring for them. For patients with chronic pain who experience difficulty in traveling to a sleep lab. It also is more convenient for the patient’s caregiver who would normally be needed to accompany them during the overnight study. As the desire for home testing continues to grow, new technology will continue to improve diagnostic devices that will increase the reliability of home testing and will expand the number of patients that can be successfully tested in the home. Furthermore, moving a patient who requires a paid medical assistant can be expensive for the patient and/or the insurance payer.

Affordability:

The changing reimbursement and acceptance of home sleep testing by insurance payers and sleep professionals will open up opportunities for improved patient care and will provide sleep labs with a means to expand the reach of their sleep services.

Traditional Sleep Labs Can Expand:

In addition to these benefits for the patients, traditional sleep labs will also benefit from expanding their sleep services to include home testing. Typically overcrowded labs will only have deal with those who require in-lab testing, and they can service a larger total volume of patients since they do not all need to be onsite. Each patient population can then receive a faster diagnosis and therefore faster treatment initiation, without the need for additional beds for the sleep lab. The traditional sleep labs, by incorporating home sleep testing, dramatically improve the care for their patients and the ease of diagnosis for their staff.

Overall, home sleep testing will greatly improve the patient care, and new technologies will continue to improve the quality of at-home care.

This post draws on the experience of several experts at CleveMed and is an adaptation from “Home Sleep Testing Can Improve Patient Care,” by Sarah Weimer, as seen in Sleep Diagnosis and Therapy, January-February 2008

Sleep disordered breathing includes a group of disorders, such as obstructive and central sleep apnea, that are characterized by repeated arousals from sleep as a result of a cessation in breathing, causing highly fragmented and poor quality sleep. Many studies point to a strong link between sleep disordered breathing (SDB) and a number of disorders, particularly cardiovascular disease. Several other studies are finding that adverse surgical outcomes are more frequent in patients with sleep apnea, as both anesthesia and surgery exacerbate airway instability and affect homeostasis in that patient population.

Dr. Nancy Foldvary from Cleveland Clinic Foundation suggests that patients with sleep apnea may be at increased risk for postoperative complications with a greater need for intensive monitoring. Since SDB is a complicating factor in many surgeries, the ability to conveniently conduct a sleep study in those settings can improve the peri-operative management of care, particularly for bariatric and cardiac surgery patients who have high prevalence of obstructive sleep apnea (OSA) (Another potential application for wireless PSG is to diagnose those inpatients with cardiovascular disease who are also suspected of having OSA).

Dr. Nancy Collop with John Hopkins University summarizes that there is an urgent need to improve the diagnosis of sleep disordered breathing in surgical patients in order to avoid complications intraoperatively and postoperatively.

This post draws from the opinions of experts featured in the following news article: CleveMed receives $2.3 million in NIH funding for inpatient diagnosis of sleep disorders in cardiovascular surgery patients