In-person vs video hookup instructions: a comparison of home sleep apnea testing quality

Abstract

Study objectives: The high prevalence of obstructive sleep apnea (OSA) in the general population makes diagnosing OSA a high priority. Typically, patients receive in-person instructions to hook up the home sleep apnea test devices. Using recorded video instructions would save health care personnel time and improve access to OSA diagnostics for patients in remote areas. The aim of this study was to compare the quality of home sleep apnea test recordings when using in-person and video hookup instructions in a randomized study.

Methods: A total of 100 patients aged 18 to 70 years with suspected OSA were randomized to receive either in-person or video hookup instructions for the Nox T3 device (Nox Medical, Reykjavik, Iceland). The overall quality of the resulting sleep studies was analyzed by determining the number of technically invalid studies. The recording quality of 4 sensors (pulse oximeter, nasal cannula, thorax and abdominal respiratory inductance plethysmography belts) was assessed by checking for signal artifacts.

Results: No significant difference was found between the 2 groups in any quality index. Only 1 (2%) and 2 (3.9%) sleep studies were technically invalid in the in-person and video instructions group, respectively. The average ± standard deviation recording quality of the 4 sensors combined was 94.8% ± 13.6% for the in-person and 96.0% ± 11.0% for the video instructions group.

Conclusions: This study found no difference in home sleep apnea test recording quality between the 2 groups. Video hookup instructions are therefore viable and an important step toward a telemedicine-based way of diagnosing OSA.

Citation: Horne AF, Olafsdottir KA, Arnardottir ES. In-person vs video hookup instructions: a comparison of home sleep apnea testing quality. J Clin Sleep Med. 2022;18(8):2069-2074.

Keywords: home sleep apnea test; obstructive sleep apnea; telemedicine; video instructions.

Conflict of interest statement

All authors have seen and approved this manuscript. Work for this study was performed at Landspitali University Hospital (data collection) and Reykjavik University (data analysis and writing). This study was funded by a grant from the Ministry of Health in Iceland. ESA discloses lecture fees from Nox Medical, Philips and ResMed. The other authors report no conflicts of interest.

© 2022 American Academy of Sleep Medicine.

Figures

Figure 1. Instructional video for hooking up the Nox T3 device to perform an HSAT.

HSAT = home sleep apnea test.

Figure 2. Comparison of percentage of technically invalid studies and mean qualities for the different sensor recordings between the in-person and video hookup instructions group.

Bars without lines represent n (%). Bars with lines represent mean ± standard error (95% confidence interval). RIP = respiratory inductance plethysmography.

Figure 3. Comparison of quality distributions and outliers for the different sensor recordings between the in-person and video hookup instructions group.

RIP = respiratory inductance plethysmography.