“The Doctor of Nursing Practice (DNP) project is a pilot study examining the impact that a standardized staff education intervention may have on improving the timeliness of the return of home sleep apnea testing equipment used in the outpatient setting to diagnose obstructive sleep apnea (OSA). OSA is a significant health problem in our society, impacting up to 15-30% of the population in North America, between the ages of 30 and 69 years (Kline, 2023). As noted by Duong-Quy et al. (2022), OSA has been found to be both underdiagnosed and untreated in all age groups.
Obstructive sleep apnea (OSA) occurs when airflow is reduced, resulting from the collapse of the structures of the upper airway. When this occurs, there is a reduction in blood oxygen levels in the body. Symptomatically, fatigue often occurs, and cognitive function may be decreased. When these outcomes occur, the effects of untreated or undiagnosed OSA can pose a serious risk to both patients and the surrounding members of society. Resulting symptoms of untreated and undiagnosed OSA can result in a greater rate of accidents and injury. These factors underscore the importance of timely diagnosis and treatment of OSA. The effective and efficient diagnosis of the disorder can promote a safer environment for both patients and the society in which they live.
The two methods of testing for obstructive sleep apnea (OSA) are polysomnography (PSG) and home sleep apnea testing (HSAT). PSG requires an overnight stay in a sleep lab and remains the gold standard for testing. HSAT is done in the patient’s home environment and has the potential to improve quality of life through convenience and accessibility for patients who have busy lifestyles, live in remote areas, or have transportation limitations. Limitations of testing by PSG include an increased cost of testing due to the sleep lab services provided and limited access to a sleep laboratory for many patients due to clinical access and availability in some geographic regions (Li et al., 2021). HSAT is considered an acceptable alternative to PSG testing if another non-respiratory sleep disorder diagnosis is not suspected, but not supported by research to be used by all patients (Kline, 2023). Currently, limited research exists to support the widespread use of testing by HSAT, despite the greater accessibility and convenience of this testing method.
This Doctor of Nursing Practice (DNP) project’s scope is narrow and specific to one outpatient sleep medicine practice. Despite this fact, the topic has broader implications beyond this pilot study. Improvement in methods to diagnose and treat obstructive sleep apnea (OSA) effectively and expeditiously is needed. A focus on improving outcomes for diagnosis and treatment of OSA can potentially improve the health and well-being of many members of our society. Greater awareness of the benefits of home sleep apnea testing (HSAT) in testing for OSA may contribute to increased research efforts, which can have the potential to produce evidence-based data to validate greater use and acceptance of home sleep apnea testing globally. This knowledge could then be used to change healthcare policy and improve patient outcomes, create a safer environment for society, and reduce healthcare costs accompanying untreated OSA and its associated comorbidities.”
References:
Duong-Quy, S., Nguyen-Huu, H., Hoang-Chau-Bao, D., Tran-Duc, S., Nguyen-Thi-Hong, L., Nguyen-Duy, T., Tang-Thi-Thao, T., Phan, C., Bui-Diem, K., Vu-Tran-Thien, Q., Nguyen-Ngoc-Phuong, T., Nguyen-Nhu, V., Le-Thi-Minh, H., & Craig, T. (2022). Personalized medicine and obstructive sleep apnea. Journal of Personalized Medicine, 12(12), 2034. https://doi.org/10.3390/jpm12122034
Kline, LR. (2023, June 07). Clinical presentation and diagnosis of obstructive sleep apnea in adults. UpToDate. Retrieved September 24, 2023 from Clinical presentation and diagnosis of obstructive sleep apnea in adults (medilib.ir)
Li, S., Xu, L., Dong, X., Zhang, X., Keenan, B. T., Han, F., Bi, T., Chang, Y., Yu, Y., Zhou, B., Pack, A. I., & Kuna, S. T. (2021). Home sleep apnea testing of adults with chronic heart failure. Journal of Clinical Sleep Medicine: JCSM : Official Publication of the American Academy of Sleep Medicine, 17(7), 1453–1463. https://doi.org/10.5664/jcsm.9224
