Home obstructive sleep apnea management in the usa and abroad
Download
1 / 51

HOME OBSTRUCTIVE SLEEP APNEA MANAGEMENT IN THE USA AND ABROAD - PowerPoint PPT Presentation


  • 74 Views
  • Uploaded on

HOME OBSTRUCTIVE SLEEP APNEA MANAGEMENT IN THE USA AND ABROAD. P. LYNN NICHOLS, M.D. DABSM,FCCP. MEDICAL DIRECTOR. Summitsleeptn.com. Financial disclosures. I make a living as a pulmonologist and sleep physician

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' HOME OBSTRUCTIVE SLEEP APNEA MANAGEMENT IN THE USA AND ABROAD' - hallam


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Home obstructive sleep apnea management in the usa and abroad

HOME OBSTRUCTIVE SLEEP APNEA MANAGEMENT IN THE USA AND ABROAD

P. LYNN NICHOLS, M.D.

DABSM,FCCP




Financial disclosures
Financial disclosures ABROAD

  • I make a living as a pulmonologist and sleep physician

  • No large medical company has ever offered me any money, but I am open to the idea


What is the name of this procedure anyway
WHAT IS THE NAME OF THIS PROCEDURE, ANYWAY? ABROAD

  • Home Sleep Testing (HST)

  • Out of Center Sleep Testing (OCST)

  • Portable Monitoring (PM)

  • Limited Channel Testing (LCT)

  • *proposed- Home Obstructive Sleep Apnea Management (HOSAM)


Goals
GOALS ABROAD

  • Scientific rationale for HST

  • HST experience in socialized medicine (New Zealand)

  • HST four year experience in private US Sleep Center

  • Where is sleep disorder management headed in the US?



New zealand
NEW ZEALAND ABROAD


HAKA ABROAD


The ABROADChallengeDesign and implement an obstructive sleep apnea diagnostic and treatment program for 150,000 rural New Zealanders



Other resources
OTHER RESOURCES ABROAD

  • One respiratory therapist dedicated to pulmonary function lab and sleep program (I had to hire)

  • 4 small hospitals/clinics with nursing staff

  • Chartered airplane (my favorite)

  • Support of Auckland sleep lab



It s all about the algorithm
IT’S ALL ABOUT THE ALGORITHM ABROAD

  • GP referral letter to Respiratory Consultant

  • Home sleep test with follow up at next respiratory clinic with initiation of Auto CPAP

  • Auto CPAP download next CPAP clinic and placed on cheaper fixed CPAP unit

  • CPAP clinic follow ups with RT

  • Referral to Auckland if necessary


Outcome at one year
OUTCOME AT ONE YEAR ABROAD

  • Around 70% of patients could be managed without in-lab study initially

  • Recruited a respiratory consultant from South Africa to continue the programs


Home sleep testing

Home Sleep Testing ABROAD

Technical Perspective

Nicole Line, RPSGT, RST,PSGP

Clinical Director


Disclaimer
DISCLAIMER ABROAD

The following slides are opinions derived from our experiences at Summit Sleep Services and are in no way representative of all Sleep Center situations.



Embletta gold by embla
Embletta ABROAD Gold by Embla


Embletta gold by embla1
Embletta ABROAD Gold by Embla

Features:

  • Easy application with color coded sensors

  • Pre-program multiple studies

  • Rechargeable battery

  • Internal position sensor

  • Ability to record 12 channels


Embletta gold by embla2
Embletta Gold by Embla ABROAD

Limitations:

  • Heavier unit

  • Difficult for patients to apply themselves

  • Somewhat difficult to score


Nihon kohden nomad
Nihon ABROADKohden Nomad


Nihon kohden nomad1
Nihon ABROADKohden Nomad

Features:

  • Integrates with NK system

  • Auto starts with pulse signal or can be set to start at a designated time

  • 2GB internal memory

  • Uses 2 AA batteries

  • Has ability to monitor 12 channels: thermister, pressure transducer, snore, body position, SPO2, pleth, pulse, chest effort, abdominal effort, 2 limb channels and 1 DC output


Nihon kohden nomad2
Nihon Kohden Nomad ABROAD

Limitations:

  • Larger/heavier than most units

  • Higher price point

  • Costly to repair

  • Difficult for patient to apply themselves



Sleepview by clevemed1
SleepView by CleveMed ABROAD

Features:

  • Cloud based

  • Easy patient application

  • Very light

  • Capable of recording 7 channels: Pulse oximetry, heart rate, respiratory effort, cannula based airflow, thermister based airflow, snore, and body position

  • Uses 1 AAA battery

  • All necessary study supplies included

  • 1 GB internal memory


Sleepview by clevemed2
SleepView by CleveMed ABROAD

Limitations:

  • Belt seemed to slip out of place during recording resulting in a sub-optimal signal

  • Cumbersome log in/ log out process for downloading, scoring and interpreting in one location


Apnea link plus by resmed
Apnea Link ABROADPlus by ResMed


Apnea link plus by resmed1
Apnea Link ABROADPlus by ResMed

Features:

  • 4 channels: nasal flow (and snore), pulse, oxygen saturation, and respiratory effort

  • Lightweight

  • Easy patient application

  • Uses 2 AA batteries

  • Ability to email report and recording

  • Cost effective


Apnea link plus by resmed2
Apnea Link ABROADPlus by ResMed

Limitations:

  • No body position sensor

  • No numerical values when scoring desaturations


Summit sleep services hst volume

Summit Sleep Services ABROADHST Volume


Summit hst algorithm
SUMMIT HST ALGORITHM ABROAD

Sleep physician consult and HST ordered if appropriate

HST interpreted

Sleep clinic follow-up with initiation of auto-CPAP 4-14 if indicated

In-lab CPAP titration if auto-CPAP fails to resolve symptoms

If HST nondiagnostic then either repeat HST or in-lab study ordered




Thank you
THANK YOU ABROAD


ad