P14 Remote attended home-video multiple sleep latency sleep tests: IPDiagnostics service provision audit

IntroductionMultiple sleep latency tests (MLSTs) is used widely for the diagnosis of narcolepsy and idiopathic hypersomnia. This test objectively measures the time taken to fall asleep under controlled conditions. Traditionally, MLSTs have been performed in specialised sleep laboratories or in-hospital sleep centres following the performance of nocturnal polysomnography. The methodology consists of four to five naps separated by a 2-hour interval during the day.1–3After Covid-19, most sleep providers have experienced a shortfall in hospital bed availabilities and prolonged waiting times. MethodsIPDiagnostics linked with home video technology considered implementing a service to investigate the applicability of Home-video polysomnography followed by remote attended daytime Home-video MSLT. The AASM guidelines 2.6 and AASM protocol for MSLT were followed for the recording and scoring of studies. A second camera was added to independently monitor and provide remote connectivity with patients. ResultsTable 1 presents our five consecutive illustrative cases undergoing home MSLT.Abstract P14 Table 1Descriptive statistics for patients who underwent Home Video MSLTFemale Gender 5 (100%) Age, mean ± 26.2 (Minimum: 19: Maximum:41) Smoking Status 0 (0%) Caffeine Intake 1 (20%) Comorbidities Obesity ADHD Learning disability 4 (80%) 2 (40%) 1 (20%) 1 (20%) Epworth, mean 13.75 (One result not available) Reason for referral Narcolepsy Idiopathic Hypersomnia Narcolepsy Vs Idiopathic Hypersomnia 3 (60%) 1 (20%) 1 (20%) Referring Specialisms Neurology Respiratory Physician 4 (80%) 1 (20%) Polysomnography Results Total Sleep Time, minutes Sleep Latency, minutes± Sleep efficiency%, average ± REM sleep latency, mean ± REM%TST, mean ± PLMS>15 events per hour, n (%) AHI>5 events per hour, n (%) AHI>15 events per hour, n (%) 475minutes (435–515) 8.08 minutes (0.4–14.5 minutes) 87.62% (74.5–90.7%) 175minutes (62.5–374 minutes) 17%, (2.5–23.5%) 2, (40%) 3 (60%) 1 (20%) Multiple Latency Sleep Test Number of Naps: 4 5 Mean Sleep Latency, minutes ± SOREMs≥2 4 (80%) 1 (20%) 9.72minutes, (4.7–15.9 minutes) 2 (40%) Final Diagnosis Narcolepsy Idiopathic Hypersomnia Other: PLMS OSA 2 (40%) 0 (0%) 2 (40%) 3 (60%) DiscussionTwo studies resulted in a positive diagnosis of narcolepsy. Home-video PSG and MSLT testing has the potential for patient cost savings and massively reduced in-hospital waiting lists. The presence of SOREMs in a familiar setting is perhaps the objective measure sleep labo