Reliability of Telemedicine in the Diagnosis and Treatment of Sleep Apnea Syndrome

Background: Advances in information technology and telecommunications have provided the option of making it easier to diagnose and treat obstructive sleep apnea syndrome (OSAS) using telemedicine techniques. This study assessed the feasibility and reliability of respiratory polygraphy and prescription of treatment by pressure adjustment with auto-continuous positive airway pressure (CPAP) systems, both being transmitted telematically to the Sleep Unit, with teleconsultation as a support method. Subjects and Methods: Forty patients were studied from a population 80 km from the Sleep Unit using respiratory polygraphy transmitted in real time. They were divided into two groups: one was seen by conventional consultation, and the other was seen using teleconsultation. We also estimated satisfaction with this system and its costs. Results: The mean patient age was 53 +/- 10.3 years, with a body mass index of 31 +/- 6.2 kg/m(2) and an Epworth score of 12 +/- 5.3. In total, 35 patients were diagnosed with OSAS, with an Apnea-Hypopnea Index of >= 10, and CPAP treatment was started in 16 of them. The agreement in the Apnea-Hypopnea Index, total apneas and hypopneas, mean oxygen saturation, and time with an oxygen saturation <90% was greater than 90% between the studies transmitted in real time and those stored in the polygraph. The level of compliance with CPAP treatment was 85% for the patients who were seen in a conventional clinic and 75% in those seen by teleconsultation. Conclusions: The use of telematic techniques is useful to establish a diagnostic and therapeutic strategy for OSAS with the creation of a Wide Core Sleep Laboratory as a process controller.