Sleep Matters

HomeMembersAssemblies and SectionsAssembliesSleep and Respiratory NeurobiologySleep Matters ▶ Alternate Care Provider Management of OSA

Alternate Care Provider Management of OSA

The lack of available sleep specialists is a major problem facing sleep medicine. Incorporating non-specialists into the role of delivering OSA care may improve access to care. Recently, Pendharkar et al. published the results of their randomized control trial assessing non-inferiority of OSA care delivered by alternate care providers (ACPs) relative to sleep specialists. Non-inferiority of PAP adherence among ACP treated patients was not established, although there was a trend for lower PAP adherence among the patients cared for by ACPs (specialist treated, 61% adherence; ACP treated, 49% adherence, p=0.07). However, the authors found that ACPs delivered OSA care in a more timely manner, with patients receiving care an average of 29 days sooner. Furthermore, patients cared for by ACPs had greater improvements in daytime sleepiness and quality of life, although this may reflect more severe sleepiness at baseline in this group.

Overall, Pendharkar’s results suggest that incorporating alternate care providers into OSA care is a feasible way to improve access but use of ACPs may come at the cost of PAP adherence. Future work will be needed to monitor the deployment of non-specialist led care and understand how to ensure quality and treatment effectiveness.