Authors (including presenting author) :
Lam KHV, Ho KWC, Chan WYJ, Wing YK
Affiliation :
Sleep Assessment Unit, Department of Psychiatry, Shatin Hospital
Introduction :
Sleep disorders involve a diverse of sleep problems with disrupted quality, quantity and abnormal events during sleep, such as insomnia, sleep-disordered breathing, central hypersomnolence, and parasomnia. The gold standard for evaluation of sleep disorders is attended overnight (level 1) polysomnographic (PSG) studies in dedicated sleep laboratories. Patients undergoing PSG may experience medical incidents or adverse events. To our knowledge, there is no local data with regard to the incidence rate of the medical incidents. Further understanding of possible medical incidents during sleep study and their related management would enforce patient safety and enhance the clinical services.
Objectives :
To review the incidence of medical complaints and the related outcomes at an university-affiliated quaternary sleep laboratory that provides diagnostic tests to all range of sleep disorders for all age over a six-year period.
Methodology :
Medical incidents or adverse events during admission for sleep studies from 2013 to 2018 were reviewed. They are defined as conditions of medical complaint from patient or observation from attending staff that required attention by medical doctors. Information was collected from relevant medical records and the incidence was reported. The impact for management and training needs were also discussed.
Result & Outcome :
A total of 2,835 sleep studies for subjects with all age were reviewed. Twenty-five medical incidents (1 in 113 studies, 0.88%) were noted in 16 (64.0%) male and 9 (36.0%) female subjects of age ranged 17-84 years old. No medical incident was found in subject below 17 years of age. The major complaints were related to cardiovascular problems (n=11; 44.0%), involving chest pain (n=1) and cardiac arrhythmia (n=10). Patient fall (n=2, 8.0%), headache (n=2, 8.0%) and gastroenteritis (n=2, 8.0%) were the other common complaints. The rest were isolated incidents, including seizure, dizziness, upper respiratory tract infection, urinary tract infection, abdominal pain, skin rash, anxiety, and suicidal ideation. Three (12.0%) patients were transferred to Accident and Emergency Department and 2 of them required hospitalization for further management. No cardiopulmonary resuscitation was necessary and no fatal incident was noted. Medical incidents during sleep studies are uncommon. Attending technical staff, however, should be well trained on recognition of signs of such incidents for early intervention and management.
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