scholarly journals Assessment, referral and management of obstructive sleep apnea by Australian general practitioners: a qualitative analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicole Grivell ◽  
Jenny Haycock ◽  
Anne Redman ◽  
Andrew Vakulin ◽  
Nicholas Zwar ◽  
...  
Keyword(s):  
General Practice ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
General Practitioners ◽  
Models Of Care ◽  
Structured Interviews ◽  
Primary Responsibility ◽  
Obstructive Sleep ◽  
Depth Analysis ◽  
Increasing Demand

Abstract Background The high and increasing demand for obstructive sleep apnea (OSA) care has exceeded the capacity of specialist sleep services prompting consideration of whether general practitioners could have an enhanced role in service delivery. However, little is known about the current involvement, experiences and attitudes of Australian general practitioners towards OSA. The purpose of this study was to provide an in-depth analysis of Australian general practitioners’ experiences and opinions regarding their care of patients with OSA to inform the design and implementation of new general practice models of care. Methods Purposive sampling was used to recruit participants with maximum variation in age, experience and location. Semi-structured interviews were conducted and were analysed using Thematic Analysis. Results Three major themes were identified: (1) General practitioners are important in recognising symptoms of OSA and facilitating a diagnosis by others; (2) Inequities in access to the assessment and management of OSA; and (3) General practitioners currently have a limited role in the management of OSA. Conclusions When consulting with patients with symptoms of OSA, general practitioners see their primary responsibility as providing a referral for diagnosis by others. General practitioners working with patients in areas of greater need, such as rural/remote areas and those of socio-economic disadvantage, demonstrated interest in being more involved in OSA management. Inequities in access to assessment and management are potential drivers for change in future models of care for OSA in general practice.

scholarly journals 0888 A Peer-Based Social Media Intervention to Promote Continuous Positive Airway Pressure Adherence in Adolescents With Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A338-A338
Author(s):  
A J Watach ◽  
C T Bishop-Gilyard ◽  
H Ku ◽  
O Afolabi-Brown ◽  
E Parks Prout ◽  
...  
Keyword(s):  
Social Media ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Sense Of Community ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Structured Interviews ◽  
Obstructive Sleep ◽  
Peer Engagement

Abstract Introduction Continuous positive airway pressure (CPAP) adherence in adolescents with obstructive sleep apnea (OSA) is suboptimal. This study evaluated an innovative CPAP adherence intervention for adolescents and their caregivers delivered via private Facebook groups. Study aims: (1) determine feasibility and acceptability of the intervention and (2) assess CPAP use pre- and post-intervention. Methods A pilot cohort study design was employed (N=6 dyads). Intervention included psychoeducation, CPAP use downloads/feedback, promoting peer-engagement through posts, videos, and polls. Adolescent and caregiver groups ran separately and simultaneously over 4-weeks. Measures: demographics, engagement/participation data, CPAP use, semi-structured interviews. Analysis: descriptive statistics and thematic content analysis. Results Adolescents were Black/African American (100%), males (100%) with a median age of 16 years (range 13-17). Caregivers (n=6) were mothers (67%) and fathers (33%) with a median age of 47 years (range 38-55). Caregivers were more engaged with the intervention than adolescents, viewing content 65%, 75%, 85%, 90%, and 100% (n=2) of days versus adolescents who viewed content 0%, 20% (n=2), 40%, 75% and 100%. Semi-structured interviews revealed the intervention was perceived positively; learning/expanded knowledge, gaining a sense of community, and enjoyment in the opportunity to help others were commonly identified. Interview feedback revealed utilizing a different social media platform may be more beneficial for adolescent engagement. Participants noted the intervention promoted conversations between the adolescent and caregiver, and 4/6 teens cited increased motivation to use CPAP. Average CPAP use increased in 50% of participants (n=3); 33% (n=2) sustained their use, and one decreased use. Conclusion Participants consistently noted appreciation for knowledge gained and sense of community derived from the intervention. This study supports the potential utilization of social media platforms to not only provide reliable OSA/CPAP education but to also promote peer-engagement. Given the acceptability and increased CPAP use in this small sample, a larger trial is indicated. Support Lead author receives support from NIH/NHLBI Award T32 HL07953. Videos included in intervention supported by The Children’s Hospital of Philadelphia Metabolism, Nutrition and Development Research Affinity Group Pilot and Feasibility Grant.

scholarly journals Global Risk Factor Evaluation of Obstructive Sleep Apnea in Relation to Research Activity and Socioeconomic Factors

2020 ◽  
Vol 17 (18) ◽  
pp. 6785
Author(s):  
Rebekka K. Seeger-Zybok ◽  
Doris Klingelhöfer ◽  
David A. Groneberg
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Scientific Output ◽  
Global Risk ◽  
Research Activity ◽  
Prevalence Data ◽  
Obstructive Sleep ◽  
Depth Analysis ◽  
The Usa ◽  
Factor Evaluation

Obstructive Sleep Apnea is emerging as a global health epidemic, particularly due to the obesity pandemic. However, comprehensive prevalence data are still lacking and global OSA research has not yet been structurally evaluated. Using the latest comprehensive age/gender-specific BMI and obesity data, a global landscape estimating the risk/burden of OSA was created. Results were presented in relation to an in-depth analysis of OSA research and countries’ socioeconomic/scientific background. While the USA, Canada, and Japan are the highest publishing countries on OSA, Iceland, Greece, and Israel appeared at the forefront when relating the scientific output to socioeconomic parameters. Conversely, China, India, and Russia showed relatively low performances in these relations. Analysis of the estimated population at risk (EPR) of OSA showed the USA, China, India, and Brazil as the leading countries. Although the EPR and OSA research correlated strongly, major regional discrepancies between the estimated demand and actual research performances were identified, mainly in, but not limited to, developing nations. Our study highlights regional challenges/imbalances in the global activity on OSA and allows targeted measures to mitigate the burden of undiagnosed/untreated OSA. Furthermore, the inclusion of disadvantaged countries in international collaborations could stimulate local research efforts and provide valuable insights into the regional epidemiology of OSA.

scholarly journals [Management of Adult Obstructive Sleep Apnea Syndrome in General Practice: a new model of risk prevention]

2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Carla Bruschelli ◽  
Germano Bettoncelli ◽  
Giorgio Carlo Monti
Keyword(s):  
General Practice ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Treatment Protocol ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Management Of Care

Obstructive Sleep Apnea Syndrome is a condition characterized by paused breathing during sleep due to complete or partial obstruction of the upper airways. It is still underdiagnosed and underestimated, despite its respiratory, cardiovascular, and neurocognitive complications. Polysomnography is the gold standard for diagnosis. The treatment protocol, that has to be agreed with the patient, is behavioral, ventilator, and sometimes surgical.The role of general practitioners is essential for early identification of patients with high probability of OSAS. Physicians are supported by specific instruments of general practice, such as continuity of care, computerized medical records for oriented problems, medical history, and diagnostic-therapeutic methodology for an exclusive management model. Among their duties, there is also the management of care priorities for patients’ comorbidities.

scholarly journals Governmental and Private Dentists’ Knowledge, Educational Background, Opinion, and Clinical Experience toward Obstructive Sleep Apnea and Oral Appliances

2017 ◽  
Vol 7 (3) ◽  
pp. 139-143
Author(s):  
Saeed M Banabilh ◽  
Rasha Al-afaleg
Keyword(s):  
General Practice ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Clinical Experience ◽  
Statistical Significance ◽  
Signs And Symptoms ◽  
Educational Background ◽  
Oral Appliances ◽  
Cross Sectional ◽  
Obstructive Sleep

ABSTRACT Aim The aims of this study were to determine the knowledge, educational background, opinion, and clinical experience of general practice dentists toward obstructive sleep apnea (OSA) and oral appliances (OAs). Materials and methods A cross-sectional study was carried out through a questionnaire which was distributed randomly to 200 general practice dentists both in public and private dental clinics at Qassim, Kingdom of Saudi Arabia. About 175 completed questionnaires were returned. The data were statistically analyzed using Statistical Package for the Social Sciences (SPSS). Results The results showed that only 48.6% of our governmental and private dentists were familiar with the term OSA with a statistical significance among governmental dentists (37.9%) who were more familiar with OSA signs and symptoms than private (21.1%) dentists (p < 0.016). In addition, the majority of the respondents (90.9%) reported a general lack of education in both OSA and OAs during their study in the dental school. A total of 142 (81.1%) dentists never prescribed OAs for OSA patients. However, 87.4% have never consulted or referred a suspected OSA patient to physicians. Conclusion General practice dentists surveyed possess poor knowledge and low clinical experience regarding OSA and OAs, which reflects the weak level of education in this field of dental sleep medicine. How to cite this article Banabilh SM, Al-afaleg R. Governmental and Private Dentists’ Knowledge, Educational Background, Opinion, and Clinical Experience toward Obstructive Sleep Apnea and Oral Appliances. J Contemp Dent 2017;7(3):139-143.

Treating Velopharyngeal Inadequacy Using Bilateral Buccal Flap Revision Palatoplasty

2019 ◽  
Vol 4 (5) ◽  
pp. 878-892
Author(s):  
Joseph A. Napoli ◽  
Linda D. Vallino
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
A Priori ◽  
Sufficient Evidence ◽  
Obstructive Sleep ◽  
Before And After ◽  
Buccal Flap

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

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