title: Management of sleep apnea: concordance between nonreference and reference centers.
abstract: BACKGROUND
  When a disorder is as prevalent as sleep apnea-hypopnea syndrome (SAHS), different medical levels and approaches should be involved in facilitating the diagnosis, at least, of patients with symptoms that disrupt social or working life, and of risk groups such as professional drivers. We sought to analyze the degree of concordance between management and treatment decisions for SAHS patients at sleep reference centers (RCs) and at non-RCs (NRCs).
  
  
  METHODS
  Eighty-eight consecutive patients with suspected SAHS were referred by family doctors to the NRC. The patients were studied randomly at the RC, using full polysomnography, and at the NRC, employing respiratory polygraphy. The concordance in the therapeutic approach between both centers was analyzed via the outcomes, and the physiologic variables of the sleep studies were also evaluated.
  
  
  RESULTS
  The concordance in the final clinical decision was substantial. There was a good agreement with respect to apnea-hypopnea index as a categoric variable and as a continuous variable.
  
  
  CONCLUSIONS
  These results suggest that respiratory physicians with simple sleep studies are able to manage a large number of patients with SAHS.
  
  
  BACKGROUND
  Clinicaltrials.gov Identifier: NCT 00424658.
authors.affiliation: Institut Clínic del Tòrax, Hospital Clínic, Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer, CibeRes, Villarroel 170, 08034 Barcelona, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Hernández
authors.forename: Marta
authors.initials: M
authors.lastname: Torrella
authors.forename: Núria
authors.initials: N
authors.lastname: Roger
authors.forename: Antonia
authors.initials: A
authors.lastname: Llunell
authors.forename: Eugeni
authors.initials: E
authors.lastname: Ballester
authors.forename: Llorenç
authors.initials: L
authors.lastname: Quinto
authors.forename: Mario
authors.initials: M
authors.lastname: Serrano
authors.forename: Fernando
authors.initials: F
authors.lastname: Masa
authors.forename: Josep M
authors.initials: JM
authors.lastname: Montserrat
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D017286:Polysomnography; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D012129:Respiratory Function Tests; D012891:Sleep Apnea Syndromes / Q000628:therapy*; D011795:Surveys and Questionnaires