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Background Obstructive sleep apnoea (OSA) is a significant public health problem with large health and economic burden. Despite the existence of effective treatment, undiagnosed OSA remains a challenge. The gold standard diagnostic tool is polysomnography (PSG), yet this test is expensive, labour intensive, and time-consuming. Home-based, limited channel sleep study testing (Level 3 and 4) can advance and widen access to diagnostic services. This systematic review aims to summarise available evidence regarding the cost-effectiveness of limited channel tests compared to laboratory and home PSG in diagnosing OSA. Method Eligible studies were identified across the following databases: MEDLINE, Psychinfo, Proquest, Scopus, CINAHL, Cochrane, Emcare and Web of Science. Studies were screened, critically appraised and eligible data were extracted using a standardised template. Relevant findings were summarised using a qualitative approach adhering to economic reporting standards. Results 915 non-duplicate abstracts were identified, 82 full-text articles were retrieved for review. 32 studies met the inclusion criteria and were included in the final analysis: 28 studies investigated Level 3 and four assessed Level 4 OSA diagnostic tests. Using a dominance ranking framework to compare cost and outcomes, both Level 3 and Level 4 OSA diagnostic tests were cost-effective compared to PSG. Discussion Although study designs and methodologies differ broadly, findings indicate that using limited channel diagnostic sleep tests for OSA is associated with lower cost and non-inferior health outcomes relative to PSG. Limited channel tests also resulted in shorter waiting times and improvements in access to diagnostic services for patients with OSA.

P101 Economic evaluation of diagnostic sleep studies for obstructive sleep apnoea in the adult population: a systematic review