Authors (including presenting author) :
Lam VKH(1), Yu MWM(2), Chan JWY(1)(2), Chan SY(1), Lam YL(1), Chan KY(1), Tiu WY(1), Or B(1), Wing YK(1)(2)
Affiliation :
(1)Sleep Assessment Unit, Department of Psychiatry, Shatin Hospital. (2)Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong
Keyword 1: :
Patient safety
Keyword 2: :
Adverse events
Keyword 3: :
Sleep laboratory management
Introduction :
Ensure patient safety is of paramount importance for effective and safe sleep laboratory management. Hence, it is important to facilitate sleep technicians in anticipating potential clinical events for timely evaluation, management and prevention.
Objectives :
To review adverse events and their consequences at a university-affiliated sleep laboratory offering comprehensive attended sleep assessment to identify risks and enhance management.
Methodology :
1. Retrospective review of medical record of adverse events occurring from 1 January 2022 to 31 March 2025 at the Sleep Assessment Unit (a four-bed facility providing diagnostic and therapeutic evaluations for various sleep disorders). 2. Data were extracted from medical records, sleep reports, Clinical Management System, and Accident and Incident Reporting System.
Result & Outcome :
A total of 1358 overnight sleep studies were performed, with 33 adverse events (2.4%, 1 per 41.2 studies). Adverse events affected 21 males (67.7%) and 10 females (32.3%), aged 28 to 85 years (mean age 65.1 15.5). Clinical background of these patients included psychiatric disorders (48.4%), hypertension (35.5%), dementia (22.6%), cardiovascular disease (19.4%), cognitive impairment (12.9%) and Parkinson disease (9.7%). Predominant adverse events included cardiovascular problems (39.4%), such as cardiac arrhythmia and hypertensive crisis. Other notable events were altered neuropsychiatric conditions (27.3%), including nocturnal confusion (24.2%) and sundowning syndrome (3.1%), altered mental state with suicidal risk (3.1%) and accidental falls (3.1%). Other issues (27.3%) included respiratory symptoms, headache, and skin rashes. Overall severity was mild, with no major injury or death. One patient (0.07%) required hospitalization, and five (0.37%) visited Accident and Emergency Department. Adverse events were more common in patients with dementia (p< 0.001) and cognitive impairment (p=0.006) (Fisher’s exact test). The notable occurrence of cardiopulmonary and neuropsychiatric issues highlights the need for vigilant monitoring to enhance patient safety such as comprehensive clinical admission assessment and emergency response plan. In conclusion, adverse events in sleep laboratory occurred in 2.4% of sleep studies with generally mild severity, no major injury or death. The predominant occurrence of cardiovascular and neuropsychiatric adverse events highlights the critical need for robust risk management to mitigate potential incidents and enhance prevention measures.
