Sleep disordered breathing and polysomnography in australia: Trends in provision from 2005 to 2012 and the impact of home-based diagnosis

Study Objectives: To describe the growth of publicly funded polysomnography (PSG) in Australia since 2004 and to compare this with earlier growth. Methods: Longitudinal census-level data stratified by jurisdiction were retrieved from the Medicare Australia online database. Results: There has been a near doubling in provision of PSG since the introduction of publicly funded in-home PSG under the Australian national Medicare program available to all Australian citizens in 2008. Overall annual PSG rates have risen from 339 in 2005 to 608 in 2012 per 100,000. This growth has exceeded that of comparable diagnostic procedures and all Medicare services overall. Queensland remains the leading jurisdiction per 100,000 Medicare enrollees for accessing Medicare-funded PSG. Conclusion: The continued growth in publicly funded PSG provision in Australia is unlikely to abate. The disparity in Australia between the estimated prevalence of sleep disorders, particularly obstructive sleep apnea, and the number of people having PSGs would suggest there remain a large number of undiagnosed cases. Support for the development of appropriate diagnostic and screening algorithms will be key in ensuring sustainable, effective, efficient, and accessible PSG services.