In 2009, we established a pilot telehealth service to a sleep laboratory in Garden City, Kansas, approximately 600 km from the Kansas University Medical Center. Videoconferencing was used for polysomnography (PSG) study follow-up, patient monitoring and sleep laboratory medical management. It allowed the sleep specialist to treat patients and collaborate with sleep laboratory personnel from a distance without extensive travel. In the first six months the telemedicine clinic was held on six occasions. There were 18 new patient evaluations and four follow up visits. The most common diagnosis was obstructive sleep apnoea. The videoconferencing equipment and the intraoral camera worked well. Interviewing and examining patients via telemedicine was very similar to doing it in-person. Telemedicine was effective for the physician-patient interaction and for visualizing airway structures. Although more research is needed, the use of videoconferencing for sleep study follow-up and laboratory oversight appears very promising.