435 Single Session CBT to Improve PAP Initiation and Adherence among Veterans with OSA

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A172-A172
Author(s):  
Todd Bishop ◽  
Patrick Walsh ◽  
Tracy Stecker ◽  
Katrina Speed ◽  
Lisham Ashrafioun ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Comparison Group ◽  
Behavioral Therapy ◽  
Subsequent Treatment ◽  
Single Session ◽  
Post Intervention ◽  
Chi Square ◽  
Treatment As Usual ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is a condition that is prevalent, pernicious, and linked to the development and exacerbation of several disease processes. Positive airway pressure (PAP) is a highly efficacious intervention; however, initiation and adherence rates are poor. This represents a critical gap in care and a missed opportunity to reduce morbidity and mortality associated with OSA. The present study piloted a single session of cognitive behavioral therapy for treatment seeking (CBT-TS) among veterans diagnosed with obstructive sleep apnea and newly prescribed PAP. Methods Participants were asked to complete assessments at baseline and at two- and four-weeks post-intervention. A sample of 40 Veterans were enrolled in the study and completed a baseline interview, 27 completed CBT-TS. A matched comparison group of 64 veterans who did not receive the intervention was constructed using electronic medical record and PAP adherence data. Mann Whitney U and Chi Square tests were used to examine group differences in initiation and adherence. Results Participants who completed the CBT-TS session were more likely to initiate PAP (at least 3 consecutive nights of use) as compared to those receiving treatment as usual (TAU) [(CBT-TS; 96.3%; 26/27) versus (TAU; 64.1%; 41/64); X2(1, N = 91) = 10.16, p = .001]. Participants in the CBT-TS group also used their PAP devices for a greater number of nights over the first month than the comparison group [(CBT-TS; M = 21.7 (SD = 8.9), Mdn = 26.0) versus (TAU; M = 14.4 (SD = 12.6), Mdn = 15.5); U = 555.0, p = .007] and were more likely to use the device in an adherent manner (i.e., ≥4 hours use in an evening); [(CBT-TS; M = 15.1 (SD = 11.2); Mdn = 15.0) versus (TAU; M = 10.3 (SD = 11.2), Mdn = 6.5); U =630.0, p = .038]. Conclusion These preliminary data suggest that CBT-TS may have utility in increasing initiation of PAP and subsequent treatment adherence among Veterans diagnosed with OSA and newly prescribed PAP. Support (if any) This work was supported by the VA Center of Excellence for Suicide Prevention in the Finger Lakes Healthcare System.

scholarly journals Obstructive Sleep Apnea Syndrome (OSAS) Decrease Concentration Levels in Young Adults

2020 ◽  
Vol 1 (2) ◽  
pp. 17-20
Author(s):  
Fidela Hanan Zivana
Keyword(s):  
Obstructive Sleep Apnea ◽  
Young Adults ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Concentration Level ◽  
Sleep Apnea Syndrome ◽  
Chi Square ◽  
Obstructive Sleep ◽  
Chi Square Test ◽  
Apnea Syndrome

Background: Obstructive Sleep Apnea Syndrome (OSAS) is sleeping-disorder that’s characterized by recurrent episodes of upper airway obstruction during sleep. Fourteen percent of world populations suffer from OSAS. OSA patients are 7,5 to 20 times more likely to have difficulties with concentration, learning new tasks, and execution of monotonous tasks.Objective: The primary objective of this study was to investigate the relationship between Obstructive Sleep Apnea Syndrome (OSAS) and concentration level in young adults.Methods: This is an analytic observational study with cross-sectional design. Sampling was carried out with total sampling. Samples that qualified the inclusion and exclusion criteria were assessed by OSAS using the Epworth Sleepiness Scale (ESS)  questionnaire and Digit Symbol Substitution Test was used to assess the concentration level. The data were analyzed, using the chi-square test and the prevalence (PR) test.Results: The Chi-square test showed that there was a significant relationship between OSAS and concentration level (p=0.033). The Prevalence Ratio test found that OSAS decreased concentration level by 1,55 compared to not OSAS.Conclusion:  There was a significant relationship between OSAS and concentration level in young adults. OSAS patients are 1,55 more likely to have a decrease concentration level when compared with healthy individuals.

scholarly journals 0340 EFFECTIVENESS OF COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA IN PATIENTS WITH COMORBID OBSTRUCTIVE SLEEP APNEA

SLEEP ◽  
2017 ◽  
Vol 40 (suppl_1) ◽  
pp. A126-A126
Author(s):  
A Sweetman ◽  
LC Lack ◽  
SS Smith ◽  
PG Catcheside ◽  
NA Antic ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Obstructive Sleep

scholarly journals Does comorbid obstructive sleep apnea impair the effectiveness of cognitive and behavioral therapy for insomnia?

2017 ◽  
Vol 39 ◽  
pp. 38-46 ◽  
Author(s):  
Alexander Sweetman ◽  
Leon Lack ◽  
Sky Lambert ◽  
Michael Gradisar ◽  
Jodie Harris
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Behavioral Therapy ◽  
Obstructive Sleep ◽  
Cognitive And Behavioral Therapy

scholarly journals Hubungan saturasi oksigen dengan risiko terjadinya obstructive sleep apnea pada pria usia 30 - 60 tahun

2020 ◽  
Vol 3 (2) ◽  
pp. 58-62
Author(s):  
Dhia Maulidya Mirwan ◽  
Eveline Margo
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pulse Oximetry ◽  
Random Sampling ◽  
Chi Square ◽  
Cross Sectional ◽  
Obstructive Sleep

LATAR BELAKANGObstructive sleep apnea (OSA) merupakan kondisi umum pada saat tidur ditandai dengan mendengkur. Di Indonesia, data prevalensi OSA masih sangat sedikit, namun pada penelitian di Jakarta tahun 2013 didapatkan 70% pada laki-laki dengan rentang usia 35-73 tahun menderita OSA. Kejadian OSA dapat mengganggu sistem pernapasan serta fungsi kognitif seseorang. Hal ini ditandai dengan hipoksia yang dapat menimbulkan fase arousal pada risiko OSA. Namun, pada beberapa penelitian ditemukan tidak terdapatnya hubungan kadar saturasi oksigen pada penderita OSA sehingga membuat peneliti hendak menilai kembali. Tujuan penelitian ini untuk mengetahui hubungan saturasi oksigen dengan risiko terjadinya OSA pada pria usia 30-60 tahun. METODEPenelitian ini menggunakan studi observasional analitik dengan desain studi potong lintang (cross-sectional) yang dilakukan pada bulan April hingga Juni 2019. Penentuan sampel menggunakan teknik random sampling, pada 64 orang pria usia 30-60 tahun. Data dikumpulkan dengan cara wawancara menggunakan kuesioner Berlin untuk mengetahui ada tidaknya OSA dan dilakukan pengukuran saturasi oksigen menggunakan pulse oximetry. Analisis hipotesis dilakukan dengan uji Chi-square dengan tingkat kemaknaan yang digunakan p < 0.05. HASILDidapatkan responden 64 orang dengan 42 orang (65.6%) memiliki risiko tinggi OSA, dan 22 orang (34.4%) lainnya memiliki risiko rendah OSA, sedangkan pada uji Chi-square untuk melihat hubungan kadar saturasi oksigen dengan resiko terjadinya OSA didapatkan p=1.000. KESIMPULANPenelitian ini menunjukan tidak ada hubungan bermakna antara kadar saturasi oksigen dengan risiko terjadinya OSA.

scholarly journals Surgical Algorithm for Obstructive Sleep Apnea: An Update

2020 ◽  
Vol 13 (3) ◽  
pp. 215-224 ◽  
Author(s):  
Stanley Yung-Chuan Liu ◽  
Robert Wayne Riley ◽  
Myeong Sang Yu
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Behavioral Therapy ◽  
Phase 1 ◽  
Treatment Success ◽  
Upper Airway ◽  
Oral Appliance ◽  
Upper Airway Surgery ◽  
Sleep Surgery ◽  
Obstructive Sleep

Sleep surgery is part of a continuum of care for obstructive sleep apnea (OSA) that involves medical, pharmacologic, and behavioral therapy. Upper airway surgery for OSA can significantly improve stability by way of modulating the critical negative closing pressure. This is the same mechanism of action as positive airway pressure or oral appliance therapy. The updated surgical algorithm in this review adds precision in three areas: patient selection, identification of previously unaddressed anatomic phenotypes with associated treatment modality, and improved techniques of previously established procedures. While the original Riley and Powell phase 1 and 2 approach to sleep surgery has focused on individual surgical success rate, this algorithm strives for an overall treatment success with multi-modal and patient-centric treatments.

scholarly journals Hubungan Berat Badan dengan Kualitas Tidur pada Mahasiswa Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Kristen Krida Wacana Angkatan 2016

2020 ◽  
Vol 26 (2) ◽  
Author(s):  
Mohamad Naim Bin Hasan ◽  
William William ◽  
Flora Rumiati
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Quality Index ◽  
Pittsburgh Sleep Quality Index ◽  
Chi Square ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Obstructive Sleep

Kelebihan berat badan merupakan faktor independen yang berkontribusi terhadap kualitas tidur yang buruk. Sleep apnea merupakan timbulnya episode abnormal pada frekuensi napas yang berhubungan dengan penyempitan saluran napas atas pada saat tidur. Sleep apnea dapat berupa henti napas (apnea) atau menurunnya ventilasi yang akan menyebabkan gangguan bernapas saat tidur. Semakin besar nilai Indeks Massa Tubuh (IMT) atau bertambahnya berat badan, kemungkinan untuk mengalami Obstructive Sleep Apnea (OSA) semakin tinggi. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara IMT dengan kualitas tidur pada mahasiswa kedokteran angkatan 2016 FKIK Ukrida. Jenis penelitian yang digunakan adalah penelitian cross sectional dengan menggunakan studi komparatif, yaitu untuk mengetahui hubungan antara IMT dengan kualitas tidur pada mahasiswa golongan berat badan lebih dan berat badan normal. Teknik sampling yang digunakan dalam penelitian ini adalah purposive sampling. Sebanyak  88 responden berpartisipasi dalam penelitian ini, terdiri dari 44 mahasiswa yang mempunyai berat badan normal dan 44 mahasiswa yang mempunyai berat badan lebih. Responden mengisi kuesioner Pittsburgh Sleep Quality Index (PSQI).   Hasil penelitian menunjukkan sebanyak 64 responden (72,7%) mempunyai kualitas tidur buruk, dan 24 responden (27,3%) memiliki kualitas tidur yang baik, serta durasi tidur terbanyak adalah < 6 jam.  Berdasarkan uji Chi-Square, disimpulkan adanya hubungan antara berat badan dengan kualitas tidur (p = 0,000, p < 0,05) pada mahasiswa Fakultas Kedokteran angkatan 2016 FKIK Ukrida.

scholarly journals Diagnosis and treatment of obstructive sleep apnea

2022 ◽  
Author(s):  
Fahad Saleh Bin Salamah ◽  
Hiba Mohammed Al Alfayez ◽  
Raghad Taha Melibary
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
English Language ◽  
Behavioral Therapy ◽  
Critical Role ◽  
Muscle Tension ◽  
Upper Airway ◽  
Diagnosis And Treatment ◽  
Treatment Modalities ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) has become a health issue of high prevalence. The prevalence is rising between 1990-2010 by approximately 30%, with absolute increases of 4.2% in women and 7.5% in men. This condition is characterized by a breathing disorder of partial or complete upper airway obstruction leading to increased resistance to airflow and potential cessation of breathing during sleep. Its multifactorial etiology Such etiologies involve obesity, craniofacial anatomy, and the use of stimulants and medications to reduce muscle tension. This review aims to summarize the recent diagnosis and treatment modalities of OSA. The database PubMed and google scholar were searched for relevant published records. A total of 39 articles were collected randomly limited to the English language. We placed no restrictions on the date of publication. Evidence from methodological studies indicate that undiagnosed OSA is associated with hypertension, cardiovascular disease, stroke, and daytime sleepiness. Thorough clinical and instrumental examinations should precede a proper diagnosis selection. The primary goal of treatment is reducing the Patient’s symptoms, depending on the severity of the patient’s condition. OSA can be treated in different ways, including behavioral therapy, medical device, surgery, and pharmacological therapies. There are limitations in dental school about education and training of OSA and oral appliances (OA). OSA teamwork must include both qualified sleep physicians and dentists. The Orthodontist plays a critical role in evaluating and treating OSA patients, choosing the right oral appliance, and assessing and adjusting the appliance.

scholarly journals 1094 Depression Is Not Associated With The Presence Of Or The Severity Of Obstructive Sleep Apnea: Retrospective Study Of 841 Polysomnography Subjects

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A416-A416
Author(s):  
K Im ◽  
L Kim ◽  
R Immen
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Significant Proportion ◽  
Chi Square ◽  
Relative Paucity ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Chi Square Analysis

Abstract Introduction Both depression and obstructive sleep apnea (OSA) are very common medical conditions. Studies showed a co-occurrence of depression and OSA with a higher prevalence of one if the other is present. However, there is relative paucity of studies assessing the rate of depression based on the OSA severity. Methods Retrospective analysis of data collected from patients undergoing polysomnography (PSG) at an academic sleep disorders center was performed. A total of 841 subjects were included and stratified into four groups using AHI. A Chi-square analysis was applied to assess the association of varying levels of AHI and the presence of depression. Results Although a significant proportion of patients with AHI greater than 5 endorsed depression (60/165 in group with AHI 15 or greater and 115/278 in group with AHI between 5 and 15), this finding was also replicated in patients with AHI less than 5 (86/202 in AHI between 1 and 5 and 88/196 in those with AHI less than 1). As there was significant difference in rate of depression among women (54.1%) and men (26.1%) (p &lt;0.0001), Chi-square analysis was performed for the rate of depression based on the level of AHI, adjusted for gender. In women the rate of depression from the most severe AHI to less severe AHI group were 0.48, 0.53, 0.60, and 0.53 respectively and in men it was 0.30, 0.27, 0.20, and 0.27 respectively, with no statistical difference between any groups. Conclusion Among patients who seek PSG assessment, depression appears to be more prevalent than the general public. Rate of depression is much higher among women than men in this group. However, the presence of OSA or severity of OSA does not have any correlation with the rate of depression in both women and men. These findings might be suggestive of the complexity of the association between depression and OSA. One limitation of this study is the dichotomous nature of depression (presence or absence of). The finding from this study warrants a future study utilizing a numerical rating scale of depression for severity measure to correlate it with the severity of OSA. Support NA.

Features of periodontal diseases in patients with obstructive sleep apnea

2020 ◽  
pp. 52-55
Author(s):  
T.V. Budina ◽  
E.G. Margaryan ◽  
A.G. Ovsienko
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Periodontal Disease ◽  
Obstructive Sleep Apnea Syndrome ◽  
Comparison Group ◽  
Periodontal Diseases ◽  
Sleep Apnea Syndrome ◽  
Periodontal Tissues ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Systemic diseases of the body, including obstructive sleep apnea (OSA), play an essential role in the pathogenesis of chronic generalized periodontitis. The main dental symptom of OSA is dry mouth due to oral breathing, which is a significant risk factor for periodontal disease. Purpose. Сlinical and laboratory assessment of periodontal tissues in patients with obstructive sleep apnea. Material and methods. The subjects of our study were patients from 35 to 65 years old. In total, 40 patients with obstructive sleep apnea syndrome and 30 patients who made up the comparison group were examined. Patients with obstructive sleep apnea syndrome were divided into three groups according to the severity of apnea. The first group included patients of women and men with mild apnea, the second group of men and women with moderate apnea, and the third with severe obstructive sleep apnea. Gum bleeding was assessed by the Mulleman-Cowell index, the degree of inflammation in the gum using the papillary-marginal-alveolar index (PMA). The hygiene index was evaluated by Quigle-Hein as modified by Tureski. Results. The hygienic condition of the oral cavity in patients with obstructive sleep apnea was rated as “unsatisfactory”. In the structure of the distribution of periodontal diseases in patients with obstructive sleep apnea, periodontitis of moderate severity prevails, while in the comparison group - periodontitis of mild severity. We also observed a correlation between the severity of apnea and the values of periodontal indices. Index data for mild severity and the data of the comparison group practically did not differ. While in severe apnea, the indices were much higher (average Muhlemann-Cowell index — 1.59±0.3, РМА — 57.49±0.87%) than the comparison group (average Muhlemann-Cowell index — 1.25±0.1, РМА — 38.84±0.93%). When assessing the qualitative composition of the oral microflora by PCR of patients with apnea, a higher number of P. gingivalis and A. Actinomycetemcomitans was revealed compared with the comparison group (p <0.02). Conclusions. According to the results of the dental examination, the prevalence of inflammatory periodontal diseases in patients with obstructive sleep apnea is higher than in the comparison group. The data obtained indicate a more severe periodontal disease in patients with obstructive sleep apnea compared with the comparison group.

scholarly journals Cognitive and behavioral therapy for insomnia increases the use of continuous positive airway pressure therapy in obstructive sleep apnea participants with comorbid insomnia: a randomized clinical trial

SLEEP ◽  
2019 ◽  
Vol 42 (12) ◽  
Author(s):  
Alexander Sweetman ◽  
Leon Lack ◽  
Peter G Catcheside ◽  
Nick A Antic ◽  
Simon Smith ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Airway Pressure ◽  
Behavioral Therapy ◽  
Comorbid Insomnia ◽  
Group Outcomes ◽  
Obstructive Sleep ◽  
Cognitive And Behavioral Therapy ◽  
Insomnia Symptoms ◽  
Insomnia Severity

Abstract Study Objectives Insomnia and obstructive sleep apnea (OSA) commonly co-occur which makes OSA difficult to treat with continuous positive airway pressure (CPAP). We conducted a randomized controlled trial in participants with OSA and co-occurring insomnia to test the hypothesis that initial treatment with cognitive and behavioral therapy for insomnia (CBT-i), versus treatment as usual (TAU) would improve insomnia symptoms and increase subsequent acceptance and use of CPAP. Methods One hundred and forty-five participants with OSA (apnea-hypopnea index ≥ 15) and comorbid insomnia were randomized to either four sessions of CBT-i, or TAU, before commencing CPAP therapy until 6 months post-randomization. Primary between-group outcomes included objective average CPAP adherence and changes in objective sleep efficiency by 6 months. Secondary between-group outcomes included rates of immediate CPAP acceptance/rejection, and changes in; sleep parameters, insomnia severity, and daytime impairments by 6 months. Results Compared to TAU, participants in the CBT-i group had 61 min greater average nightly adherence to CPAP (95% confidence interval [CI] = 9 to 113; p = 0.023, d = 0.38) and higher initial CPAP treatment acceptance (99% vs. 89%; p = 0.034). The CBT-i group showed greater improvement of global insomnia severity, and dysfunctional sleep-related cognitions by 6 months (both: p &lt; 0.001), and greater improvement in sleep impairment measures immediately following CBT-i. There were no between-group differences in sleep outcomes, or daytime impairments by 6 months. Conclusions In OSA participants with comorbid insomnia, CBT-i prior to initiating CPAP treatment improves CPAP use and insomnia symptoms compared to commencing CPAP without CBT-i. OSA patients should be evaluated for co-occurring insomnia and considered for CBT-i before commencing CPAP therapy. Clinical Trial Treating comorbid insomnia with obstructive sleep apnea (COMSIA) study: A new treatment strategy for patients with combined insomnia and sleep apnea, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365184 Australian New Zealand Clinical Trials Registry: ACTRN12613001178730. Universal Trial Number: U1111-1149-4230.

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