Alternative care pathways in sleep-related breathing disorders—a pilot study assessing obstructive sleep apnea outpatient diagnostics in Germany

Abstract Background Telemedicine-based care pathways are increasingly explored for sleep diagnostics, offering benefits such as improved patient satisfaction facilitated by reduced travel times and enhanced access to specialized care. Objective This study evaluates the feasibility of a telemedical approach using video consultations and a single-use diagnostic device for sleep-related breathing disorders such as obstructive sleep apnea (OSA). Methods From January 2021 to January 2023, 260 of 764 patients scheduled for home sleep apnea testing (HSAT) were randomly selected and offered a telemedical workup consisting of video consultations (samedi; Berlin, Germany; and ELVI; CompuGroup Medical SE & Co. KGaA, Koblenz, Germany) and outpatient peripheral arterial tonometry-based HSAT using a disposable single-use product (WatchPAT One; Itamar Medical Inc., Caesarea, Israel). Questionnaires assessed readiness for telemedical diagnostics, practical feasibility, and satisfaction with the care pathway. Results Of the 260 selected patients, 72 (28%) could not be contacted and 102 of the remaining 188 (54%) were not interested or were ineligible, with 44% ( n = 45/102) preferring a direct physician–patient interaction. Only 54 (63%) of the 86 interested and eligible patients returned the required documents for video consultations. In 41 (88%) of these cases, HSAT was indicated and successfully completed. Both physicians (88%) and patients (100%) reported high satisfaction with the telemedical consultations. Conclusion Telemedical consultations using single-use HSAT represent a promising approach with a high satisfaction rate for a selected patient population. However, about half of the patients in the investigated region of Germany were not interested in a telemedical consultation or did not meet the technical requirements. The acceptance and feasibility of telemedical consultations for outpatient diagnostic testing could increase with future improvement and validation of telemedical infrastructure and availability.