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Retrospective review of treatment outcomes and costs in children with sleep disordered breathing assessed with multi-channel studies.
Yanney, Michael Ng, Christabella Zulkifli, Muhammad Shehata, Ahmed Chidambaram, Alagappan Tsirevelou, Paraskevi Fergie, Neil Thakkar, Pathik Crookes, Emma Dean, Roy
Yanney, Michael
Ng, Christabella
Zulkifli, Muhammad
Shehata, Ahmed
Chidambaram, Alagappan
Tsirevelou, Paraskevi
Fergie, Neil
Thakkar, Pathik
Crookes, Emma
Dean, Roy
Abstract
Current UK guidance on OSA management recommends only selective use of sleep studies - when there is diagnostic uncertainty, in children with comorbidities or to evaluate perioperative risk in those with suspected severe OSA. Routine use of sleep studies to confirm a diagnosis of obstructive sleep apnoea (OSA) in children before adenotonsillectomy is not currently recommended. We report the findings of a novel paediatric sleep service based on routine use of multi-channel sleep studies (MCSS) before adenotonsillectomy and present the results of a service evaluation assessing the impact of our practise on treatment outcomes and cost.
We conducted a retrospective study of 264 children with sleep disordered breathing seen in our centre between July 2018–June 2019, using medical records and a sleep study database to determine treatment outcomes and costs. Using responses from a questionnaire completed by otolaryngologists for a separate prospective study, we compare our costs with estimates of those associated with a standard UK model of care i.e. with selective use of sleep studies.
We estimate that our routine use of MCSS reduced the number of adenotonsillectomies by 44 % but at higher monetary costs than those estimated for the standard model of care. We note however, that reconfiguring our service to arrange a sleep study before the initial appointment, rather than after, would result in the service being cost neutral compared with the standard model. We also estimate that use of home multi-channel studies in our service would bring a significant cost saving (∼£50,000 - £80,000 per annum) compared to standard care.
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Obstructive sleep apnoea, Children, Treatment outcomes, Costs
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Yanney, M. et al. (2024) ‘Retrospective review of treatment outcomes and costs in children with sleep disordered breathing assessed with multi-channel studies’, Sleep Medicine: X [Preprint]
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Sleep Medicine: X