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Ambulatory Sleep Study for diagnosing obstructive sleep apnoea
Published on 2 May 2019
The Ministry of Health's MTAC has recommended:
Ambulatory sleep study or home sleep test (HST) with a type 2 or type 3 device for diagnosing obstructive sleep apnoea (OSA) in adults aged ≥18 years who fulfil both (A) and (B).
High pre-test probability for moderate-severe OSA, where signs and symptoms indicating a high pre-test probability for moderate-severe OSA include:
Excessive daytime sleepiness; and
At least two of the following three criteria: (i) habitual loud snoring; (ii) witnessed apnoea, gasping, or choking; and (iii) diagnosed hypertension
No complicated conditions that include:
Awake hypoventilation or high risk of sleep-related hypoventilation;
Significant cardiopulmonary disease;
Long-term home oxygen therapy;
Chronic opiate medication use;
Parasomnias (such as REM behavioural disorder);
Sleep-related movement disorders (such as periodic limp movement disorder);
Potential respiratory muscle weakness caused by neuromuscular conditions;
History of stroke;
Disorders of central hypersomnolence;
Nocturnal seizure; and
Environmental or personal factors precluding adequate acquisition and data interpretation from HST
The patient should be assessed, and raw HST data should be reviewed and interpreted by a trained sleep specialist able to interpret a polysomnogram, according to the institution-based clinical privileging criteria.
Quality assurance procedures should have been established for data acquisition from HST.
Subsidy for HST is recommended for the abovementioned indications only.