TY - JOUR
T1 - Management of obstructive sleep apnea in Europe – A 10-year follow-up
AU - Fietze, Ingo
AU - Laharnar, Naima
AU - Bargiotas, Panagiotis
AU - Basoglu, Ozen K.
AU - Dogas, Zoran
AU - Drummond, Marta
AU - Fanfulla, Francesco
AU - Gislason, Thorarinn
AU - Gouveris, Haralampos
AU - Grote, Ludger
AU - Hein, Holger
AU - Jennum, Poul
AU - Joppa, Pavol
AU - van Kralingen, Klaas
AU - Kvamme, John Arthur
AU - Lombardi, Carolina
AU - Ludka, Ondrej
AU - Mallin, Wolfgang
AU - Marrone, Oreste
AU - McNicholas, Walter T.
AU - Mihaicuta, Stefan
AU - Montserrat, Josep
AU - Pillar, Giora
AU - Pataka, Athanasia
AU - Randerath, Winfried
AU - Riha, Renata L.
AU - Roisman, Gabriel
AU - Saaresranta, Tarja
AU - Schiza, Sophia E.
AU - Sliwinski, Pawel
AU - Svaža, Juris
AU - Steiropoulos, Paschalis
AU - Tamisier, Renauld
AU - Testelmans, Dries
AU - Trakada, Georgia
AU - Verbraecken, Johan
AU - Zablockis, Rolandas
AU - Penzel, Thomas
N1 - Funding Information:
Sleep medicine has been further established and recognized in the past 10 years. This is also shown by the fact that sleep-related diseases may receive a separate chapter in the new ICD-11 (International Classification of Diseases 11th Revision) [11]. However, the initial expansion in sleep laboratories and sleep centers seems to be over, at least in Europe, which stands in contradiction to the growing need. While sleep medical care still seems to be secured by the established structures, the gap between the increasing need and existing structures is still widening [ 12–14]. There is a lack of sleep medicine specialists, new outpatient structures, and new billing models with the sponsoring institutions. Approaches to solve these problems include the establishment and expansion of home sleep apnea testing (HSAT) [15] and telemedicine-based technologies in the diagnosis and treatment of OSA [16,17]. Telemedicine found its way into sleep medicine around 10 years ago [ 18–20]. One of the very first approaches as early as 1994 used a telephone circuit and a computer-controlled support system to improve OSA treatment by improving lifestyle through tele-guidance on nutrition and exercise [21].
Publisher Copyright:
© 2022 The Authors
PY - 2022/9
Y1 - 2022/9
N2 - Objective: In 2010, a questionnaire-based study on obstructive sleep apnea (OSA) management in Europe identified differences regarding reimbursement, sleep specialist qualification, and titration procedures. Now, 10 years later, a follow-up study was conducted as part of the ESADA (European Sleep Apnea Database) network to explore the development of OSA management over time. Methods: The 2010 questionnaire including questions on sleep diagnostic, reimbursement, treatment, and certification was updated with questions on telemedicine and distributed to European Sleep Centers to reflect European OSA management practice. Results: 26 countries (36 sleep centers) participated, representing 20 ESADA and 6 non-ESADA countries. All 21 countries from the 2010 survey participated. In 2010, OSA diagnostic procedures were performed mainly by specialized physicians (86%), whereas now mainly by certified sleep specialists and specialized physicians (69%). Treatment and titration procedures are currently quite homogenous, with a strong trend towards more Autotitrating Positive Airway Pressure treatment (in hospital 73%, at home 62%). From 2010 to 2020, home sleep apnea testing use increased (76%–89%) and polysomnography as sole diagnostic procedure decreased (24%–12%). Availability of a sleep specialist qualification increased (52%–65%) as well as the number of certified polysomnography scorers (certified physicians: 36%–79%; certified technicians: 20%–62%). Telemedicine, not surveyed in 2010, is now in 2020 used in diagnostics (8%), treatment (50%), and follow-up (73%). Conclusion: In the past decade, formal qualification of sleep center personnel increased, OSA diagnostic and treatment procedures shifted towards a more automatic approach, and telemedicine became more prominent.
AB - Objective: In 2010, a questionnaire-based study on obstructive sleep apnea (OSA) management in Europe identified differences regarding reimbursement, sleep specialist qualification, and titration procedures. Now, 10 years later, a follow-up study was conducted as part of the ESADA (European Sleep Apnea Database) network to explore the development of OSA management over time. Methods: The 2010 questionnaire including questions on sleep diagnostic, reimbursement, treatment, and certification was updated with questions on telemedicine and distributed to European Sleep Centers to reflect European OSA management practice. Results: 26 countries (36 sleep centers) participated, representing 20 ESADA and 6 non-ESADA countries. All 21 countries from the 2010 survey participated. In 2010, OSA diagnostic procedures were performed mainly by specialized physicians (86%), whereas now mainly by certified sleep specialists and specialized physicians (69%). Treatment and titration procedures are currently quite homogenous, with a strong trend towards more Autotitrating Positive Airway Pressure treatment (in hospital 73%, at home 62%). From 2010 to 2020, home sleep apnea testing use increased (76%–89%) and polysomnography as sole diagnostic procedure decreased (24%–12%). Availability of a sleep specialist qualification increased (52%–65%) as well as the number of certified polysomnography scorers (certified physicians: 36%–79%; certified technicians: 20%–62%). Telemedicine, not surveyed in 2010, is now in 2020 used in diagnostics (8%), treatment (50%), and follow-up (73%). Conclusion: In the past decade, formal qualification of sleep center personnel increased, OSA diagnostic and treatment procedures shifted towards a more automatic approach, and telemedicine became more prominent.
KW - Diagnostic
KW - Europe
KW - Follow-up
KW - HSAT
KW - Polysomnography
KW - Sleep apnea
KW - Telemedicine
KW - Therapy
UR - http://www.scopus.com/inward/record.url?scp=85133273153&partnerID=8YFLogxK
U2 - 10.1016/j.sleep.2022.06.001
DO - 10.1016/j.sleep.2022.06.001
M3 - Article
C2 - 35724441
AN - SCOPUS:85133273153
SN - 1389-9457
VL - 97
SP - 64
EP - 72
JO - Sleep Medicine
JF - Sleep Medicine
ER -