In a groundbreaking advance for sleep medicine, researchers at the American Academy of Sleep Medicine (AASM) have developed a novel patient-reported outcome measure specifically designed for adults with obstructive sleep apnea (OSA). This innovative tool, called the Patient-reported Longitudinal Assessment Tool for OSA (PLATO), offers a rigorously validated means for clinicians to monitor treatment response and symptom progression over time in real-world clinical settings. Unlike previous instruments, which often fell short in clinical utility and comprehensiveness, PLATO emerges as a highly reliable, practical, and sensitive questionnaire capable of discerning subtle changes in patient status related to OSA therapies.
Obstructive sleep apnea, a chronic disorder afflicting nearly 30 million adults in the United States alone, is characterized by repeated episodes of upper airway collapse during sleep. These interruptions lead to disrupted sleep architecture, excessive daytime sleepiness, cardiovascular strain, and diminished quality of life. While continuous positive airway pressure (CPAP) therapy is the standard treatment, its effectiveness and patient adherence vary substantially. Consequently, having a sensitive, clinically feasible outcome measure to track patient experience longitudinally remains an urgent unmet need in both clinical practice and research.
The development of PLATO was guided meticulously by rigorous methodological frameworks, including the U.S. Food and Drug Administration’s (FDA) recommendations for patient-reported outcome measures. Over several phases, the tool underwent cognitive interviews to capture patient perspectives, pilot testing across ten AASM-accredited sleep centers, and psychometric validation in a diverse cohort of 560 adults diagnosed with OSA and 40 control subjects. This multi-method approach ensured that the final tool not only embodies strong internal consistency and test-retest reliability but also exhibits robust construct validity through moderate-to-strong correlations with established clinical and subjective measures.
Comprising 11 concise questions, the PLATO questionnaire probes patients’ experiences related to sleep quality and OSA symptoms over the preceding seven days and nights. This includes subjective reports of tiredness, excessive sleepiness, morning headaches, snoring, and overall sleep quality assessments. Notably, the brevity of PLATO allows completion in under four minutes, a critical factor in busy clinical environments where time constraints often impede comprehensive patient evaluations. Furthermore, the questions are formulated at a fifth-grade reading level, making the tool accessible across diverse populations and minimizing literacy barriers.
One of PLATO’s distinguishing features lies in its sensitivity to detect changes not only in symptom severity but also across varying degrees of OSA severity and body mass index groupings. Scores effectively differentiate between mild, moderate, and severe OSA statuses, providing clinicians with nuanced insights that can inform treatment modifications. Moreover, PLATO’s responsiveness to symptom improvement following therapy initiation or adjustments makes it a valuable longitudinal monitoring instrument, capturing patient-centered outcomes that were previously challenging to quantify with standard clinical metrics.
Accessibility and integration stood paramount throughout the instrument’s design. PLATO is available in both English and Spanish and can be administered via traditional paper forms or through electronic platforms seamlessly integrated into electronic health record (EHR) systems. This dual-modality enhances usability in a range of healthcare settings, from specialized sleep clinics to primary care offices. Electronic scoring tools reduce administrative burden, fostering real-time data collection and facilitating longitudinal outcome tracking necessary for research and value-based care models.
Sleep medicine experts have lauded PLATO as a transformative tool, addressing a critical gap left by earlier measures which failed to meet clinical validity, reliability, and feasibility thresholds all at once. As underscored by Dr. Douglas Kirsch, lead author and former AASM president, PLATO fills an important void by providing clinicians actionable data directly from patients in a manner that meshes with routine workflows. This patient-centered measurement is expected to not only refine clinical decision-making but also bolster patient engagement and adherence by illuminating treatment progress in tangible terms.
The creation of PLATO was a collaborative effort involving a distinguished medical expert advisory panel including Drs. Fariha Abbasi-Feinberg, Charles Davies, Charlene Gamaldo, and Carol Rosen. Development efforts were led by ICON, a contract research organization specializing in clinical outcomes research, whose team worked hand-in-hand with the AASM to ensure methodological rigor and relevance. The process reflected an iterative, evidence-based approach extending from qualitative patient interviews to quantitative psychometric analyses, exemplifying best practices in instrument development.
Importantly, PLATO is positioned not just as a research instrument but as an immediately implementable clinical tool. Its availability for free licensing in clinical practice, facilitated in partnership with Mapi Research Trust, lowers barriers to widespread adoption. This broad accessibility endorses a future where consistent, standardized patient-reported data on sleep apnea treatment responses become part of routine care, informing both individual management and large-scale health outcomes research.
As sleep apnea continues to pose substantial morbidity and healthcare costs globally, innovations such as the PLATO questionnaire signal a paradigm shift toward more personalized, data-driven treatment strategies. By enabling the collection of reliable, patient-centered data over time, PLATO empowers clinicians, health systems, payers, and policymakers to appreciate the full impact of therapy beyond polysomnographic indices alone. This holistic understanding will ultimately facilitate optimized therapy regimens, improved adherence, and better patient quality of life.
The PLATO tool and its validation findings will be formally published in the upcoming October 1 issue of the Journal of Clinical Sleep Medicine, coinciding with a complementary expert commentary that highlights the strengths and developmental rigor of the instrument. The AASM invites clinicians and researchers worldwide to explore this new resource and integrate it into their sleep apnea management protocols, heralding a new era in comprehensive, patient-focused sleep disorder care.
For inquiries, manuscript access, and interview requests with Dr. Kirsch or other sleep medicine specialists involved in PLATO’s development, interested parties can contact the AASM media relations team directly. As this innovative instrument gains momentum, it promises to become a cornerstone in advancing the science and clinical management of obstructive sleep apnea.
Subject of Research: People
Article Title: The Patient-reported Longitudinal Assessment Tool for OSA (PLATO): development and validation of a new clinical tool to assess response to obstructive sleep apnea treatment in adults
News Publication Date: 4-Jun-2025
Web References:
- https://doi.org/10.5664/jcsm.11790
- https://sleepeducation.org/sleep-disorders/obstructive-sleep-apnea
- https://sleepeducation.org/patients/cpap
- https://eprovide.mapi-trust.org
References: - Kirsch, D. et al. The Patient-reported Longitudinal Assessment Tool for OSA (PLATO): development and validation of a new clinical tool to assess response to obstructive sleep apnea treatment in adults. Journal of Clinical Sleep Medicine. 2025. DOI: 10.5664/jcsm.11790
- Commentary: Sleep apnea, how do we help thee? Let us count the ways. Journal of Clinical Sleep Medicine. 2025. DOI: 10.5664/jcsm.11816
Keywords: Clinical medicine, Sleep apnea
