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Charles W. Atwood, “The Times They Are A Changin:” Home Diagnosis of Sleep Apnea Has Arrived, Sleep, Volume 35, Issue 6, 1 June 2012, Pages 735–736, https://doi.org/10.5665/sleep.1848
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Extract
As anyone in the clinical practice of sleep medicine is keenly aware, the traditional approach to the diagnosis of and initiation of continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) is undergoing a sea change. Since 2008, and the Centers for Medicare and Medicaid Services (CMS) approval of home sleep testing for the diagnosis of OSA when CPAP is to be prescribed, the door to the non-laboratory diagnosis of sleep apnea has been opening ever more steadily.1 The concern many sleep medicine practitioners have is that, while there may be some advantages to home testing for sleep apnea in terms of a more realistic “ecology” for the patient, clinical outcomes will not be as good as they are with sleep laboratory and PSG diagnosis and CPAP titration
To address the need for better evidence supporting the use of home OSA testing, the evidence base for home sleep apnea testing has been also been growing. Since 2007 we have seen clinical trials2-5 published that have begun to consistently demonstrate that clinical outcomes relevant to OSA patients are essentially the same regardless of whether the diagnosis and initiation of positive airway pressure therapy is performed in the home setting or in the laboratory setting. In this edition of SLEEP, Rosen and colleagues6 have published the latest contribution to this literature, the HomePAP study.
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