Home obstructive sleep apnea management in the usa and abroad
This presentation is the property of its rightful owner.
Sponsored Links
1 / 51

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


  • 39 Views
  • Uploaded on
  • Presentation posted in: General

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

Download Presentation

HOME OBSTRUCTIVE SLEEP APNEA MANAGEMENT IN THE USA AND ABROAD

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


Medical director

MEDICAL DIRECTOR


Home obstructive sleep apnea management in the usa and abroad

Summitsleeptn.com


Financial disclosures

Financial disclosures

  • 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?

  • 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

  • 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?


Scientific rationale for hst hosam

SCIENTIFIC RATIONALE FOR HST/HOSAM


New zealand

NEW ZEALAND


Home obstructive sleep apnea management in the usa and abroad

HAKA


Home obstructive sleep apnea management in the usa and abroad

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


Nz 100 000 sleep program

NZ$100,000 SLEEP PROGRAM


Other resources

OTHER RESOURCES

  • 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


Morning commute

MORNING COMMUTE


It s all about the algorithm

IT’S ALL ABOUT THE ALGORITHM

  • 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

  • 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

Technical Perspective

Nicole Line, RPSGT, RST,PSGP

Clinical Director


Disclaimer

DISCLAIMER

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


As techs our first reaction to hst

As techs, our first reaction to HST…….


Embletta gold by embla

Embletta Gold by Embla


Embletta gold by embla1

Embletta 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

Limitations:

  • Heavier unit

  • Difficult for patients to apply themselves

  • Somewhat difficult to score


Nihon kohden nomad

Nihon Kohden Nomad


Nihon kohden nomad1

Nihon Kohden 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

Limitations:

  • Larger/heavier than most units

  • Higher price point

  • Costly to repair

  • Difficult for patient to apply themselves


Sleepview by clevemed

SleepView by CleveMed


Sleepview by clevemed1

SleepView by CleveMed

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

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 Plus by ResMed


Apnea link plus by resmed1

Apnea Link Plus 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 Plus by ResMed

Limitations:

  • No body position sensor

  • No numerical values when scoring desaturations


Summit sleep services hst volume

Summit Sleep ServicesHST Volume


Summit hst algorithm

SUMMIT HST ALGORITHM

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


Hst interpretation template

HST INTERPRETATION TEMPLATE


Where is sleep medicine headed in the usa

WHERE IS SLEEP MEDICINE HEADED IN THE USA?


Thank you

THANK YOU


  • Login