scholarly journals A new tool to screen patients with severe obstructive sleep apnea in the primary care setting: a prospective multicenter study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Patricia Peñacoba ◽  
Maria Antònia Llauger ◽  
Ana María Fortuna ◽  
Xavier Flor ◽  
Gabriel Sampol ◽  
...  
Keyword(s):  
Primary Care ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Care Setting ◽  
Primary Care Setting ◽  
The Body ◽  
Clinical Test ◽  
Apnea Test ◽  
Second Stage ◽  
Obstructive Sleep

Abstract Background The coordination between different levels of care is essential for the management of obstructive sleep apnea (OSA). The objective of this multicenter project was to develop a screening model for OSA in the primary care setting. Methods Anthropometric data, clinical history, and symptoms of OSA were recorded in randomly selected primary care patients, who also underwent a home sleep apnea test (HSAT). Respiratory polygraphy or polysomnography were performed at the sleep unit to establish definite indication for continuous positive airway pressure (CPAP). By means of cross-validation, a logistic regression model (CPAP yes/no) was designed, and with the clinical variables included in the model, a scoring system was established using the β coefficients (PASHOS Test). In a second stage, results of HSAT were added, and the final accuracy of the model was assessed. Results 194 patients completed the study. The clinical test included the body mass index, neck circumference and observed apneas during sleep (AUC 0.824, 95% CI 0.763–0.886, P < 0.001). In a second stage, the oxygen desaturation index (ODI) of 3% (ODI3% ≥ 15%) from the HSAT was added (AUC 0.911, 95% CI 0.863–0.960, P < 0.001), with a sensitivity of 85.5% (95% CI 74.7–92.1) and specificity of 67.8% (95% CI 55.1–78.3). Conclusions The use of this model would prevent referral to the sleep unit for 55.1% of the patients. The two-stage PASHOS model is a useful and practical screening tool for OSA in primary care for detecting candidates for CPAP treatment. Clinical Trial Registration Registry: ClinicalTrials.gov; Name: PASHOS Project: Advanced Platform for Sleep Apnea Syndrome Assessment; URL: https://clinicaltrials.gov/ct2/show/NCT02591979; Identifier: NCT02591979. Date of registration: October 30, 2015.

scholarly journals Resistant Hypertension and Obstructive Sleep Apnea in the Primary-Care Setting

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
M. Demede ◽  
A. Pandey ◽  
F. Zizi ◽  
R. Bachmann ◽  
M. Donat ◽  
...  
Keyword(s):  
Primary Care ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Resistant Hypertension ◽  
Evaluation System ◽  
Care Setting ◽  
Primary Care Setting ◽  
Obstructive Sleep ◽  
Risk Evaluation System

We ascertained the prevalence of resistant hypertension (RH) among blacks and determined whether RH patients are at greater risk for obstructive sleep apnea (OSA) than hypertensives.Method. Data emanated from Metabolic Syndrome Outcome Study (MetSO), a study investigating metabolic syndrome among blacks in the primary-care setting. Sample of 200 patients (mean age = 63 ± 13 years; female = 61%) with a diagnosis of hypertension provided subjective and clinical data. RH was defined using the JNC 7and European Society guidelines. We assessed OSA risk using the Apnea Risk Evaluation System ARES), defining high risk as a total ARES score ≥6.Results. Overall, 26% met criteria for RH and 40% were at high OSA risk. Logistic regression analysis, adjusting for effects of age, gender, and medical co morbidities, showed that patients with RH were nearly 2.5 times more likely to be at high OSA risk, relative to those with hypertension (OR = 2.46, 95% CI: 1.03–5.88,P<.05).Conclusion. Our findings show that the prevalence of RH among blacks fell within the range of RH for the general hypertensive population (3–29%). However, patients with RH were at significantly greater risk of OSA compared to patients with hypertension.

scholarly journals 0486 PROCESS IMPROVEMENT INITIATIVE TO INCREASE RECOGNITION OF OBSTRUCTIVE SLEEP APNEA (OSA) IN THE PRIMARY CARE SETTING

SLEEP ◽  
2017 ◽  
Vol 40 (suppl_1) ◽  
pp. A181-A181
Author(s):  
S Alagheband ◽  
P Valestra ◽  
L Quintos ◽  
A Tse ◽  
M Weinstein
Keyword(s):  
Primary Care ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Process Improvement ◽  
Care Setting ◽  
Primary Care Setting ◽  
Obstructive Sleep

Cardiac arrhythmias and conduction disturbances in the obstructive sleep apnea syndrome

2018 ◽  
Vol 2 (47) ◽  
pp. 10-15
Author(s):  
Danuta Łoboda ◽  
Karolina Simionescu ◽  
Anna Szajerska-Kurasiewicz ◽  
Dorota Lasyk ◽  
Grzegorz Jarosiński ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cardiac Arrhythmias ◽  
Sleep Apnea Syndrome ◽  
The Body ◽  
Apnea Hypopnea Index ◽  
Premature Ventricular Contractions ◽  
Mortality And Morbidity ◽  
Conduction Disturbances ◽  
Obstructive Sleep

Cardiac arrhythmias during sleep are reported in almost half of the population suffering from obstructive sleep apnea (OSA). The most common are bradyarrhythmias and atrial fibrillation whereas premature ventricular contractions and nonsustained ventricular tachycardia are less frequent. The risk of arrhythmia is proportional to the body mass index (BMI), number of respiratory events per hour of sleep described with apnea/hypopnea index (AHI) and the level of oxygen desaturation during these episodes. Continuous positive airway pressure (CPAP) treatment in OSA reduces the incidence of cardiac arrhythmias therefore reduce mortality and morbidity from cardiovascular disease.

scholarly journals CPAP Treatment Adherence in Women with Obstructive Sleep Apnea

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
E. Libman ◽  
S. Bailes ◽  
C. S. Fichten ◽  
D. Rizzo ◽  
L. Creti ◽  
...  
Keyword(s):  
Primary Care ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Treatment Adherence ◽  
Positive Airway Pressure ◽  
Daytime Functioning ◽  
Research Attention ◽  
Obstructive Sleep ◽  
Health Related ◽  
Nocturnal Polysomnography

Untreated obstructive sleep apnea (OSA) has numerous negative health-related consequences. Continuous positive airway pressure (CPAP) is generally considered the treatment of choice for OSA, but rates of nonadherence are high. It is believed that OSA is more prevalent among men; therefore understanding how OSA presents among women is limited and treatment adherence has received little research attention. For this study, 29 women were recruited from primary care offices. They completed a questionnaire battery and underwent a night of nocturnal polysomnography (PSG) followed by a visit with a sleep specialist. Women diagnosed with OSA were prescribed CPAP; 2 years later CPAP adherence was evaluated. Results show that approximately half the sample was adherent. There were no significant differences between adherent and nonadherent women on OSA severity; however CPAP adherent women had worse nocturnal and daytime functioning scores at the time of diagnosis. Moreover, when the seven nocturnal and daytime variables were used as predictors in a discriminant analysis, they could predict 87% of adherent and 93% of the nonadherent women. The single most important predictor was nonrefreshing sleep. We discuss the implications of the findings for identifying women in primary care with potential OSA and offer suggestions for enhancing treatment adherence.

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