TY - JOUR
T1 - Documentation of polysomnographic and home sleep apnea test interpretations
T2 - room for improvement?
AU - Herberts, Michelle B.
AU - Morgenthaler, Timothy I.
N1 - Publisher Copyright:
Copyright 2023 American Academy of Sleep Medicine. All rights reserved.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Study Objectives: Obstructive sleep apnea (OSA), a heterogeneous disorder with many different presentations, is diagnosed with sleep studies. In standard clinical practice, test data are reviewed and scored, and interpretations are documented. Little standardization exists regarding what should be included in interpretations. We aimed to determine how consistently the documented interpretation included references to study quality parameters and accepted disease phenotypes. Methods: This study was performed at a single academic center in January 2021. From the literature, we formulated a list of test and titration quality criteria and OSA phenotypes that should be reflected in study interpretations, including total recording time, total sleep time, positionality, and supine rapid eye movement (REM) sleep during titration. We retrospectively reviewed the documentation of sleep studies to determine how often these factors were reflected in interpretation reports or clinical notes. Results: Of 134 patients in the study, 81 were diagnosed with OSA. A finding of inadequate total recording time during polysomnography or total sleep time on home sleep apnea testing was most often not documented. Positionality of OSA was not documented in 33% of applicable studies. The absence of supine REM sleep during positive airway pressure titration was not mentioned in 15% of interpretations. Conclusions: The documentation of quality concerns and clinically important OSA phenotypes in interpretations was inconsistent. Documentation of meaningful test quality information and sleep apnea phenotypes might be improved with report standardization or by developing enhanced data displays.
AB - Study Objectives: Obstructive sleep apnea (OSA), a heterogeneous disorder with many different presentations, is diagnosed with sleep studies. In standard clinical practice, test data are reviewed and scored, and interpretations are documented. Little standardization exists regarding what should be included in interpretations. We aimed to determine how consistently the documented interpretation included references to study quality parameters and accepted disease phenotypes. Methods: This study was performed at a single academic center in January 2021. From the literature, we formulated a list of test and titration quality criteria and OSA phenotypes that should be reflected in study interpretations, including total recording time, total sleep time, positionality, and supine rapid eye movement (REM) sleep during titration. We retrospectively reviewed the documentation of sleep studies to determine how often these factors were reflected in interpretation reports or clinical notes. Results: Of 134 patients in the study, 81 were diagnosed with OSA. A finding of inadequate total recording time during polysomnography or total sleep time on home sleep apnea testing was most often not documented. Positionality of OSA was not documented in 33% of applicable studies. The absence of supine REM sleep during positive airway pressure titration was not mentioned in 15% of interpretations. Conclusions: The documentation of quality concerns and clinically important OSA phenotypes in interpretations was inconsistent. Documentation of meaningful test quality information and sleep apnea phenotypes might be improved with report standardization or by developing enhanced data displays.
KW - sleep apnea
KW - sleep disorders
KW - sleep-disordered breathing
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U2 - 10.5664/jcsm.10460
DO - 10.5664/jcsm.10460
M3 - Article
C2 - 36740919
AN - SCOPUS:85166437760
SN - 1550-9389
VL - 19
SP - 1043
EP - 1049
JO - Journal of Clinical Sleep Medicine
JF - Journal of Clinical Sleep Medicine
IS - 6
ER -