INOSA sees Home Sleep Testing as an alternative

Expert says polysomnography (PSG) done in sleep labscannot cater to the demand of testing patients for OSA

The consensus and evidence-based guidelines of the Indian Initiative on Obstructive Sleep Apnoea (INOSA) advocate Home Sleep Testing (HST) as an alternative to in-lab Polysomnography (PSG) mainly because of “convenience and lower cost”.

The guidelines say that the absence of EEG recording in HST is a disadvantage and it should therefore be done in combination with a thorough sleep evaluation by a person with training.

INOSA guidelines were developed under the auspices of the Department of Health Research, Union Ministry of Health and Family Welfare, following a series of meetings and discussions under the convenership of the Department of Medicine, AIIMS, with the support of the ICMR.

During this first Indian initiative the guidelines were developed by various national experts in the field of sleep medicine including internists, pulmonologists, neurologists,, otorhinolaryngologists, endocrinologists, bariatric and dental surgeons.

Andhra Hospitals pulmonologist and specialist in Sleep Medicine M. Ravindranath said that the disease burden of Obstructive Sleep Apnea (OSA) was very high.

OSA was reported to be 8-13 per cent in males of 35 to 65 years in urban India.

OSA prevalence in diabetics was an estimated 50 per cent, 77 per cent in obese persons and 87 per cent for obese individuals with diabetes. Given the magnitude of the problem Polysomnography(PSG) done in sleep labs could not cater to the demand, Dr Ravindranath said. INOSA guidelines accept Home Sleep Test in conjunction with a comprehensive sleep evaluation in the presence of a sleep practitioner eligible for conducting sleep studies for diagnosis of OSA in patients with high pre-test probability for sleep or medical disorders.

A high end Home Sleep Test kit will be in the size of an I-phone which was attached to a broad belt around the waist.

Finger pulse sensor

A tube connected to the device was inserted into the nose and finger pulse sensor was clipped to the index finger.

The device recorded the number of pauses in the breathing and duration of those pauses. These gadgets were priced between Rs 2,500 and Rs 4,000. ResMed gadgets were used to perform 5,000 home studies in the past 12 months.

A high end Home Sleep Test kit is in the size of an I-phone which was attached to a broad belt around the waist