Diagnosis and sleep testing
As the most accessible healthcare professionals, pharmacists are ideally placed to screen patients for conditions they could be causing them to suffer. Using clinically validated screening tools you can identify patients who may be at risk of obstructive sleep apnoea (OSA).
The first step in diagnosing OSA in a patient is with a free and simple questionnaire. Patients answer a series of questions to determine their likelihood of having OSA.
Their accumulative score will help you determine if it’s necessary for them to go on to take a sleep apnoea test to confirm the initial diagnosis.
Levels of sleep testing
An overnight diagnostic sleep test is necessary to confirm a diagnosis of OSA and evaluate its severity. Sleep apnoea testing in Australia is classed across three levels. APSS offers level 3 testing which can be conducted in the comfort of a patient’s home and does not require a GP referral.
The main differences between the two main levels of sleep testing:
Level 1 sleep testing involves:
An overnight stay in a sleep hospital monitored by a sleep technologist
Capturing between 7-16 channels of data including:
- Body oxygen level by measuring light transmission through the finger with an “oximeter”
- Airflow through the nose
- Chest and abdomen movements
- Heart activity via an electrocardiogram (ECG)
- Brain activity via an electroencephalogram (EEG)
- Muscle activity via an electromyogram (EMG)
- Eye activity via an electrooculogram (EOG)
Long waiting times
$750 plus cost of hospital stay ($250-$500) and ongoing costs of post consultation meetings. Private insurance may cover some of these costs.
Level 3 sleep testing involves:
A simple test performed at home
Capturing a minimum of three key channels of data including:
- Body oxygen levels by measuring light transmission through the finger with an oximeter
- Airflow through the nose
- Respiratory effort
- Positional data
- Heart rate information from the oximeter
- Levels of snoring from the cannula/airflow
No waiting times and results from an accredited sleep physician in 7-10 days.
$99RRP and no doctor referral necessary
How does APSS’ sleep apnoea test benefit patients?
More than 1.8 million Australians suffer from OSA and 80%2 of these are currently undiagnosed. The average Australian visits a pharmacy 14 times per year making it an accessible channel to identify these undiagnosed patients.
In response to the long wait times and out-of-pocket expenses associated with level 1 and 2 sleep testing, APSS has developed a level 3 at home sleep testing model which aligns with the Pharmaceutical Society Australia strict practice standards. Plus, the APSS sleep test is always interpreted by a qualified Sleep Physician. If the Sleep Physician identifies that your patient has a sleep pathology other than obstructive sleep apnoea he or she may recommend visiting a sleep clinic for an additional level 1 or level 2 sleep test.
APSS data shows that in 97% of cases Level 3 home sleep testing is sufficient to identify patients as having OSA. This is further supported by independent research* which found that Level 3 sleep studies are safe and convenient for diagnosing obstructive sleep apnea in patients with a high pretest probability of moderate to severe forms of the condition without substantial comorbidities.
*Corral et al American Journal of Respiratory and Critical care Medicine June 2017
2Medical Services Advisory Committee, Public Summary Document, Application No. 1130 – Unattended Sleep Studies in the Diagnosis and Reassessment of Obstructive Sleep Apnoea March 2010