Feasibility, Validity and Economic Impact of a Home-Based Sleep Screening Test in the Detection of Sleep-Related Breathing Disorders in Individuals Living With Spinal Cord Injury: A Multi-Method Study and Cost-Minimisation Analysis.
Julio C Furlan, Julia I Coschignano, Sarah Berger, Sander L Hitzig, James Milligan, Peter Athanasopoulos, Mark I Boulos
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Abstract
This prospective multi-method study was performed to assess the feasibility and validity of an unattended home-based sleep screening test (HBSST) in the detection of sleep-related breathing disorders (SRBDs) among individuals with spinal cord injury (SCI). Further, the economic impact of the HBSST was compared with polysomnography using cost-minimisation analysis. Adults with subacute/chronic (> 1 month) SCI were recruited for the multi-method study. Feasibility analysis included quantitative and qualitative data. A pilot validity analysis compared the apnea-hypopnea index (AHI) from the HBSST and from polysomnography in nine individuals with mild-to-severe SRBD. Notably, HBSST and polysomnography tests were separately performed. Of the 28 participants (11 females, 17 males; mean age: 54.9 years) with subacute/chronic, complete (n = 7) or incomplete SCI at cervical (n = 18), thoracic (n = 8) or lumbosacral levels, nine individuals were diagnosed with a moderate-to-severe SRBD. All participants successfully completed the HBSST. Most of the participants (60.71%) set up the device for the HBSST without any assistance. The AHI from the HBSST was significantly correlated with the AHI from the polysomnography (r = 0.717; p = 0.0248; n = 9). Finally, our results indicated that the use of HBSST was a cost-saving approach when compared with polysomnography. In conclusion, the results of our prospective multi-method study provided novel and clinically important data to support the feasibility and suggest criterion validity of a HBSST when compared with the findings from polysomnography completed during different nights. The results of our cost-minimisation analysis indicated that the HBSST is a more cost-effective strategy for detection of SRBDs in the SCI population than polysomnography.
期刊介绍：
The Journal of Sleep Research is dedicated to basic and clinical sleep research. The Journal publishes original research papers and invited reviews in all areas of sleep research (including biological rhythms). The Journal aims to promote the exchange of ideas between basic and clinical sleep researchers coming from a wide range of backgrounds and disciplines. The Journal will achieve this by publishing papers which use multidisciplinary and novel approaches to answer important questions about sleep, as well as its disorders and the treatment thereof.
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