An evaluation of heart failure clinicians' knowledge, attitudes and clinical practice in the diagnosis and treatment of obstructive sleep apnoea

2020 ◽  
Vol 15 (7) ◽  
pp. 1-16
Author(s):  
Lizelle Bernhardt ◽  
Emer M Brady ◽  
Noelle Robertson ◽  
Iain B Squire
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Obstructive Sleep Apnoea ◽  
Public Health Problem ◽  
Sleep Apnoea ◽  
Interquartile Range ◽  
Diagnosis And Treatment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Obstructive Sleep

Background/aims Obstructive sleep apnoea is a public health problem that remains under recognised. Despite obstructive sleep apnoea being associated with the incidence and progression of heart failure, clinician awareness is lacking within and across clinical specialities. This study aimed to evaluate heart failure clinicians' knowledge, attitudes and clinical practice in the diagnosis and treatment of obstructive sleep apnoea. Methods This study used a web-based, cross-sectional survey, using the modified Obstructive Sleep Apnoea Knowledge and Attitudes questionnaire among heart failure clinicians in the UK. Results The survey was completed by 102 heart failure clinicians. Out of a possible score of 37, the median knowledge scores were 29 (78%; interquartile range 26–31), 26 (70%; interquartile range 22–28) and 18 (49%; interquartile range 16.5–23.5) for doctors, nurses and pharmacists, respectively. The majority of doctors and nurses felt that obstructive sleep apnoea was important; however, confidence in the identification and management of obstructive sleep apnoea was low across all three groups of clinicians. Conclusions There is a knowledge deficit regarding the diagnosis and treatment of obstructive sleep apnoea among heart failure clinicians.

scholarly journals Prevalence of glaucoma in patients with obstructive sleep apnoea—a cross-sectional case-series

Eye ◽  
2007 ◽  
Vol 22 (9) ◽  
pp. 1105-1109 ◽  
Author(s):  
R E Bendel ◽  
J Kaplan ◽  
M Heckman ◽  
P A Fredrickson ◽  
S-C Lin
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Case Series ◽  
Sleep Apnoea ◽  
Cross Sectional ◽  
Obstructive Sleep

scholarly journals Self-reported sleepiness and not the apnoea hypopnoea index is the best predictor of sleepiness-related accidents in obstructive sleep apnoea

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
P. Philip ◽  
S. Bailly ◽  
M. Benmerad ◽  
J. A. Micoulaud-Franchi ◽  
Y. Grillet ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Traffic Accidents ◽  
Sleep Apnoea ◽  
Near Miss ◽  
Cross Sectional ◽  
Periodic Leg Movements ◽  
Obstructive Sleep ◽  
History Of ◽  
Respiratory Polygraphy ◽  
Sectional Analysis

Abstract To evaluate the value of apnoea + hypopnoea index versus self-reported sleepiness at the wheel in anticipating the risk of sleepiness-related accidents in patients referred for obstructive sleep apnoea. A cross-sectional analysis of the French national obstructive sleep apnoea registry. 58,815 subjects referred for a suspicion of obstructive sleep apnoea were investigated by specific items addressing sleepiness at the wheel and sleepiness-related accidents. Apnoea + hypopnoea index was evaluated with a respiratory polygraphy or full polysomnography. Subjects had a median age of 55.6 years [45.3; 64.6], 65% were men, with a median apnoea + hypopnoea index of 22 [8; 39] events/h. Median Epworth sleepiness scale score was 9 [6; 13], 35% of the patients reported sleepiness at the wheel (n = 20,310), 8% (n = 4,588) reported a near-miss accident and 2% (n = 1,313) reported a sleepiness-related accident. Patients reporting sleepiness at the wheel whatever their obstructive sleep apnoea status and severity exhibited a tenfold higher risk of sleepiness-related accidents. In multivariate analysis, other predictors for sleepiness-related accidents were: male gender, ESS, history of previous near-miss accidents, restless leg syndrome/periodic leg movements, complaints of memory dysfunction and nocturnal sweating. Sleep apnoea per se was not an independent contributor. Self-reported sleepiness at the wheel is a better predictor of sleepiness-related traffic accidents than apnoea + hypopnoea index.

Obstructive sleep apnoea and schizophrenia: a primer for psychiatrists

2011 ◽  
Vol 23 (5) ◽  
pp. 201-209 ◽  
Author(s):  
Abdulkader Alam ◽  
Kadiamada Nanaiah Roy Chengappa
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Daytime Sleepiness ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Sleep Apnoea ◽  
Diagnosis And Treatment ◽  
Adverse Health Outcomes ◽  
Ovid Medline ◽  
Obstructive Sleep ◽  
Osa Treatment

Alam A, Chengappa KNR. Obstructive sleep apnoea and schizophrenia: a primer for psychiatristsObjective:The main objective of this review is to improve psychiatric clinician awareness of obstructive sleep apnoea (OSA) and its potential consequences in patients with schizophrenia. This article will also discuss the diagnosis and treatment options for OSA while considering the significant role psychiatrists can play in facilitating the diagnosis and treatment of OSA.Data sources:Ovid, Medline and PsychInfo databases were searched for articles between 1960 and 2010. Search terms used wereSleep apnoeaorapnoeaandschizophreniaorpsychosis. The number of articles retrieved was 38. Articles were carefully reviewed for any data pertinent to OSA in patients with schizophrenia.Conclusions:OSA is a common disorder that is frequently unrecognised. As a chronic breathing condition, OSA is associated with adverse health outcomes and high mortality. OSA may co-occur with schizophrenia or evolve over time, especially with weight gain. The diagnosis should be considered whenever a patient presents with risk factors or clinical manifestations that are highly suggestive of OSA. Those who report snoring, daytime sleepiness and are obese or have a large neck circumference should be considered for an OSA diagnosis. Appropriate diagnosis and treatment of OSA can reduce daytime sleepiness, improve cardiovascular and other medical conditions, as well as reduce mortality. Psychiatrists can play very important role in suspecting OSA in their patients and making the initial referral. Furthermore, behavioural management, especially promoting weight loss and smoking cessation, are effective components of OSA treatment that psychiatrists are positioned to facilitate with their patients.

P4404Prognostic value of novel nocturnal oxygen saturation metrics in patients with obstructive sleep apnoea and high cardiovascular event risk

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Linz ◽  
K Loffler ◽  
P Sanders ◽  
P Catcheside ◽  
C Anderson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Oxygen Saturation ◽  
Obstructive Sleep Apnoea ◽  
Controlled Trial ◽  
Characteristic Curve ◽  
Sleep Apnoea ◽  
Time Ratio ◽  
Event Risk ◽  
Obstructive Sleep

Abstract Aim To determine prognostic value of novel oximetry-derived metrics in patients with obstructive sleep apnoea (OSA) and high cardiovascular (CV) event risk. Methods and results Ancillary study of the Sleep Apnoea CV Endpoints (SAVE) randomised controlled trial, which investigated the effects of CPAP treatment on secondary CV event outcomes in 2687 participants with moderate-severe OSA and established CV disease. Associations between baseline characteristics, standard sleep and pulse oximetry-derived metrics, and CV outcomes were determined in Cox proportional hazards regression models stratified for treatment allocation. Metrics evaluated included: oxygen desaturation index, time below 90% oxygen saturation (SpO2), average SpO2across recordings (mean SpO2), across episodic desaturation events (desaturation SpO2), and baseline interpolated through episodic desaturation events (baseline SpO2); duration and desaturation/resaturation time ratio of episodic desaturation events; and mean and standard deviation of pulse rate. No SpO2 metric was associated with the composite outcome. Mean and baseline SpO2 were negatively associated with heart failure (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.69–0.95; P=0.009 and 0.78, 0.67–0.90; P=0.001, respectively) and myocardial infarction risk (0.86, 0.77–0.95; P=0.003 and 0.81, 0.73–0.90; P<0.001, respectively) and marginally positively associated with stroke risk (1.09, 1.00–1.20; P=0.065 and 1.13, 1.02–1.26; P=0.020, respectively). Desaturation duration and desaturation/resaturation time ratio, with established risk factors, predicted heart failure (area under the receiver-operating-characteristic curve 0.86, 95% CI 0.79–0.93). Conclusions Higher mean and baseline SpO2 were associated with reduced risk of heart failure and myocardial infarction, and small increases in stroke rate. Desaturation shape may have predictive utility for future CV events. Clinical trial registration: clinicaltrials (NCT00738179).

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