Patients with obstructive sleep apnea (OSA) can achieve similar outcomes with care from a sleep specialist or a non-sleep specialist. The findings of a systematic review are published in Annals of Internal Medicine.
New treatment models have been proposed that would reduce reliance on sleep specialists by including providers not specifically trained as sleep specialists, such as nurses or primary care physicians.
Researchers from the Minneapolis Veterans Affairs Health Care System Evidence-based Synthesis Program and the University of Minnesota, School of Medicine reviewed 12 published studies to evaluate the effectiveness and harms of care by non-sleep specialists versus sleep specialists for patients with suspected or diagnosed OSA. The researchers assessed the studies to determine patient-centered outcomes (mortality, access to care, quality of life, patient satisfaction, adherence, symptom scores, and adverse events) and other outcomes, including resource use, costs, time to initiation of treatment, and case finding. The data showed low-strength evidence that OSA management outcomes are similar whether provided by primary care physicians, sleep specialist nurses, or sleep specialist physicians. The evidence was insufficient to assess for access to care or adverse events.
The researchers suggest more research to confirm these findings in other settings and among providers with different levels of experience and training and to determine how such care models should be implemented.