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Medical Technology Guidance

Ambulatory Sleep Study for diagnosing obstructive sleep apnoea Published on 2 May 2019

Guidance Recommendation
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).
    1. 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
    2. 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);
      • Severe insomnia;
      • 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 status

Subsidy for HST is recommended for the abovementioned indications only.

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