A proposition of hybrid healthcare pathway to screen and diagnose obstructive sleep apnea: exploratory analysis of retrospective observational data.

Abstract

Objective: The aim of the study was to evaluate an integrated hybrid healthcare pathway that combines a digital screening questionnaire, teleconsultations (TC) with sleep physicians and home sleep apnea testing (HSAT), for the screening and diagnosis of obstructive sleep apnea (OSA) in France.

Methods: This exploratory retrospective study was performed on data from the SleepDoctor platform collected between July 2022 to April 2024. The OSA screening pathway included a digital Berlin Questionnaire (BQ), followed by an offer of teleconsultation for patients at risk of OSA with a registered nurse, a sleep physician and a home sleep apnea test (HSAT) when needed. Demographic data and risk scores were compared between high and low-risk subjects, with or without teleconsultation and with or without HSAT.

Results: Of 45,099 patients included (63.3% women, mean age = 43.6 ± 13.5 years and mean BMI = 28.1 ± 65 kg/m²), 26,440 (58.6%) were at high risk of OSA (60.4% female, mean age = 45.1 ± 12.5 years and mean BMI = 30.3 ± 6.7 kg/m²). Of these, 944 booked a TC with a sleep physician among whom 579 had a HSAT. Although more women were at high risk of OSA, they were less likely to have booked a TC (42.5%) and have had a HSAT (41.6%) than men (p < 0.0001).

Conclusion: These findings highlight the need for further optimization of the proposed hybrid pathway, particularly in engaging at-risk individuals to complete the full screening and diagnosis process.