A randomized controlled trial of an ambulatory approach versus the hospital-based approach in managing suspected obstructive sleep apnea syndrome

作者：Hui, David S.^*; Ng, Susanna S.; To, Kin-Wang; Ko, Fanny W.; Ngai, Jenny; Chan, Ken K. P.; Yip, Wing-Ho; Chan, Tat-On; Yiu, Karen; Tam, Wilson W. S.

来源：Scientific Reports, 2017, 7(1): 45901.

DOI：10.1038/srep45901

• POSITIVE AIRWAY PRESSURE
• BLOOD-PRESSURE
• CPAP THERAPY
• RISK-FACTOR
• DIAGNOSIS
• POLYSOMNOGRAPHY
• STROKE
• HEALTH
• HOME
• METAANALYSIS

Comparisons of home-based versus hospital-based approach in managing patients with suspected obstructive sleep apnoea syndrome(OSAS). A prospective, controlled CPAP parallel study of new referrals with suspected OSAS randomized into group A) home-based or B) hospital-based approach. Following detection of AHI >= 15/hr by Embletta sleep study (group A) or polysomnography (group B), patients received CPAP for 3 months after an overnight autoCPAP titration at home or in hospital respectively. Modified intention-to-treat analysis of those with AHI >= 15/hr on CPAP (n = 86 vs 86) showed no difference in Epworth sleepiness score, the primary endpoint, but greater improvement in Sleep-Apnoea-Quality-of-Life-Index[ difference 0.3,(95% CI 0.02, 0.6), p = 0.033] at 3 months in group A. The mean costs for the patients in group A and group B were HK$8479(989) and HK$22,248(2407) respectively. The mean difference between groups was HK$-13,769(USD 1770 equivalent) per patient with 95% CI. (-14324, -13213), p < 0.001. The waiting time of patients with AHI >= 15/hr who were started on CPAP treatment from the first clinic consultation to the diagnostic sleep test, autoCPAP titration, and CPAP treatment was 189.6, 148.8 and 145.0 days shorter in group A than group B respectively. Home-based approach is non-inferior to hospital-based approach in managing patients with suspected OSAS, with shorter waiting time, and substantial cost savings.

• 出版日期2017-4-4
• 单位香港中文大学