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primary health care sleep apnea

Andrew M Namen, Arjun Chatterjee, Karen E Huang, Steven R Feldman, Edward F Haponik
RATIONALE: Little is known regarding recent trends in physician reporting of sleep apnea during outpatient practice visits. OBJECTIVES: To assess trends in the frequency of adult outpatient visits in the United States for sleep apnea, the clinicians who provided those visits, and the characteristics of patients reported to have sleep apnea. We also assessed whether the reporting of a diagnosis of sleep apnea varies across regions of the country as a function of body weight and insurance status...
September 1, 2016: Annals of the American Thoracic Society
R Doug McEvoy, Nick A Antic, Emma Heeley, Yuanming Luo, Qiong Ou, Xilong Zhang, Olga Mediano, Rui Chen, Luciano F Drager, Zhihong Liu, Guofang Chen, Baoliang Du, Nigel McArdle, Sutapa Mukherjee, Manjari Tripathi, Laurent Billot, Qiang Li, Geraldo Lorenzi-Filho, Ferran Barbe, Susan Redline, Jiguang Wang, Hisatomi Arima, Bruce Neal, David P White, Ron R Grunstein, Nanshan Zhong, Craig S Anderson
Background Obstructive sleep apnea is associated with an increased risk of cardiovascular events; whether treatment with continuous positive airway pressure (CPAP) prevents major cardiovascular events is uncertain. Methods After a 1-week run-in period during which the participants used sham CPAP, we randomly assigned 2717 eligible adults between 45 and 75 years of age who had moderate-to-severe obstructive sleep apnea and coronary or cerebrovascular disease to receive CPAP treatment plus usual care (CPAP group) or usual care alone (usual-care group)...
September 8, 2016: New England Journal of Medicine
Anna J Esbensen, Dean W Beebe, Kelly C Byars, Emily K Hoffman
OBJECTIVE: To characterize practice patterns regarding sleep evaluation and intervention among children with Down syndrome (DS). METHOD: Data were obtained from electronic health records from 2009 to 2013 for a retrospective cohort of 954 children with DS, aged 5 to 21 years during the time sampled. International Classification of Diseases, Ninth Revision, diagnoses were used to identify children with obstructive sleep apnea and/or behavioral sleep disturbances...
October 2016: Journal of Developmental and Behavioral Pediatrics: JDBP
Nathan E Cross, Christopher M Harrison, Brendon J Yee, Ronald R Grunstein, Keith K H Wong, Helena C Britt, Nathaniel S Marshall
STUDY OBJECTIVES: To characterize the changes in management of snoring and obstructive sleep apnea (OSA) in general practice in Australia. METHODS: The Bettering the Evaluation And Care of Health (BEACH) study is a nationally representative rolling cross-sectional survey of general practice activity in Australia. We analyzed all adult (age 18+ y) encounters for OSA or snoring, annually from 2000 to 2014 (approximately 1,000 general practitioners (GPs) per year recording approximately 100,000 patient encounters per year)...
2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Rashmi N Aurora, Stuart F Quan
Obstructive sleep apnea (OSA) is a highly prevalent condition which remains under-diagnosed and under-treated. Untreated OSA is associated with several chronic medical conditions, a reduction in quality of life and increases in health care costs. Therefore, early identification of undiagnosed cases is important. Implementation of a screening measure in a primary care environment for populations at high-risk for OSA could improve patient outcomes and reduce the health care burden of untreated OSA.
2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Galit Almoznino, Rafael Benoliel, Yair Sharav, Yaron Haviv
Chronic craniofacial pain involves the head, face and oral cavity and is associated with significant morbidity and high levels of health care utilization. A bidirectional relationship is suggested in the literature for poor sleep and pain, and craniofacial pain and sleep are reciprocally related. We review this relationship and discuss management options. Part I reviews the relationship between pain and sleep disorders in the context of four diagnostic categories of chronic craniofacial pain: 1) primary headaches: migraines, tension-type headache (TTH), trigeminal autonomic cephalalgias (TACs) and hypnic headache, 2) secondary headaches: sleep apnea headache, 3) temporomandibular joint disorders (TMD) and 4) painful cranial neuropathies: trigeminal neuralgia, post-herpetic trigeminal neuropathy, painful post-traumatic trigeminal neuropathy (PTTN) and burning mouth syndrome (BMS)...
May 11, 2016: Sleep Medicine Reviews
Elizabeth K Seng, Cynthia Cervoni, Jessica L Lawson, Tanya Oken, Sloane Sheldon, M Diane McKee, Karen A Bonuck
INTRODUCTION: Sleep disorders affect up to 1 in 4 adults and can adversely affect a variety of health conditions. However, little is known about detection of sleep disorders in ethnically diverse urban primary care settings. METHODS: Patients in urban primary care settings completed surveys to screen for sleep problems and identify comorbid conditions. Providers were given screening results, and provided feedback regarding their clinical utility. RESULTS: Participants (n = 95) were predominantly women (76...
October 2016: Journal of Primary Care & Community Health
Nicole Thompson, Bobbe Mansfield, Meredith Stringer, Brandy Stewart, Jami Potter, Karen Fernengel
PURPOSE: Overweight and obesity in children and adolescents is often accompanied by obesity-related comorbidities. An integrative review of the literature was performed to create a comprehensive algorithm to help primary care providers manage the common comorbidities associated with childhood overweight and obesity. DATA SOURCES: The Cumulative Index to Nursing and Allied Health Literature, ProQuest Nursing and Allied Health Source, and PubMed databases were searched...
October 2016: Journal of the American Association of Nurse Practitioners
J-N Cornu, G Amarenco, F Bruyere, E Chartier-Kastler, B Fatton, P Grise, F Haab, R Bourouina
AIMS: To determine the prevalence of overactive bladder (OAB) syndrome in France and gather data about initial patient trajectories in the healthcare system. METHODS: A dedicated questionnaire (41 questions) has been sent to a 12,000 sample of people representative of the global population. The following data were investigated: social and demographic features, medical history, Urinary Symptom Profile questionnaire, bother, history of symptoms, care seeking and treatments received...
June 2016: Progrès en Urologie
Helen K Delichatsios, Michelle E Hauser, Jonathan D Burgess, David M Eisenberg
INTRODUCTION: Diseases linked to obesity such as cardiovascular disease, diabetes, degenerative joint disease, gastroesophageal reflux, and sleep apnea constitute a large portion of primary care visits. Patients with these conditions often lack knowledge, skills, and support needed to maintain health. Shared medical appointments (SMAs) that include culinary skills and nutrition education offer a novel, cost-effective way to address these diseases in primary care. METHODS: Adult patients in a primary care practice at a large academic hospital in Boston, Massachusetts, who had at least 1 cardiovascular risk factor were invited to participate in SMAs that included cooking demonstrations and teaching about nutrition in addition to medical management of their conditions...
November 2015: Global Advances in Health and Medicine: Improving Healthcare Outcomes Worldwide
Jennifer N Miller, Ann M Berger
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and contributes to increased morbidity and compromised cardiovascular outcomes. Sleep disorders are common but rarely reported and addressed by primary health providers. An American Academy of Sleep Medicine task force (2015) released quality measures for the care of adult patients with OSA; the first outcome is improved detection and categorization of OSA symptoms and severity to promote assessment and diagnosis of the disorder...
October 2016: Sleep Medicine Reviews
Luu V Pham, Alan R Schwartz
Obstructive sleep apnea (OSA) is a major source of cardiovascular morbidity and mortality, and represents an increasing burden on health care resources. Understanding underlying pathogenic mechanisms of OSA will ultimately allow for the development of rational therapeutic strategies. In this article, we review current concepts about the pathogenesis of OSA. Specifically, we consider the evidence that the upper airway plays a primary role in OSA pathogenesis and provide a framework for modelling its biomechanical properties and propensity to collapse during sleep...
August 2015: Journal of Thoracic Disease
Jeffrey C Posnick, Elbert Choi, Anish Chavda
PURPOSE: The purpose of this study was to assess operative time, perioperative airway management, early postoperative cardiopulmonary health, need for blood transfusion, and in-hospital stay associated with simultaneous bimaxillary, intranasal, and osseous genioplasty surgery. MATERIALS AND METHODS: The authors executed a retrospective cohort study derived from patients treated by 1 surgeon at a single institution from 2009 through 2014. The sample consisted of a consecutive series of patients with symptomatic chronic obstructed nasal breathing and a dentofacial deformity (DFD)...
March 2016: Journal of Oral and Maxillofacial Surgery
Amanda Hu, Thomas Sibert, Wei Zhao, Vincent Zarro
OBJECTIVES/HYPOTHESIS: To determine the otolaryngology needs in a free clinic providing care to medically indigent patients, as perceived by the patients and health care providers. STUDY DESIGN: Cross-sectional survey. METHODS: A survey was administered to patients and health care providers of a free clinic from September 2014 through January 2015 in an urban, inner-city location. RESULTS: One hundred and thirty-seven patients (35...
June 2016: Laryngoscope
Surendra K Sharma, Vishwa Mohan Katoch, Alladi Mohan, T Kadhiravan, A Elavarasi, R Ragesh, Neeraj Nischal, Prayas Sethi, D Behera, Manvir Bhatia, A G Ghoshal, Dipti Gothi, Jyotsna Joshi, M S Kanwar, O P Kharbanda, Suresh Kumar, P R Mohapatra, B N Mallick, Ravindra Mehta, Rajendra Prasad, S C Sharma, Kapil Sikka, Sandeep Aggarwal, Garima Shukla, J C Suri, B Vengamma, Ashoo Grover, V K Vijayan, N Ramakrishnan, Rasik Gupta
Obstructive sleep apnea (OSA) and obstructive sleep apnea syndrome (OSAS) are subsets of sleep-disordered breathing. Awareness about OSA and its consequences among the general public as well as the majority of primary care physicians across India is poor. This necessitated the development of the Indian initiative on obstructive sleep apnea (INOSA) guidelines under the auspices of Department of Health Research, Ministry of Health and Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep-related symptoms or co-morbidities or ≥15 such episodes without any sleep-related symptoms or co-morbidities...
July 2015: Lung India: Official Organ of Indian Chest Society
J Bayó Llibre, R Riel Cabrera, E Mellado Breña, J Filomena Paci, M Priego Artero, F J García Alfaro, J M Grau Granero, D Vázquez González, J López Solana, M I Fernández San Martín
INTRODUCTION AND OBJECTIVES: Sleep apnea hypopnea syndrome (SAHS) is frequent in hypertensive patients and plays a role in a greater incidence of cardiovascular morbidity-mortality. This study aims to know the clinical profile of hypertensive patients with SAHS compared to hypertensive patients without SAHS to know which variables should be used to orient their screening from primary care. METHODOLOGY: An observational, descriptive, retrospective study of cases (hypertensive patients with SAHS) and controls (hypertensive patients without) was performed in an urban health care center...
April 2015: Hipertensión y Riesgo Vascular
Robert E Post, Megha Mendiratta, Treah Haggerty, Alexia Bozek, Gregory Doyle, Jun Xiang, Dana E King
BACKGROUND: The concept of body mass index (BMI) may not be well understood by patients. The purpose of this study was to evaluate patients' knowledge of BMI in the primary care setting. METHODS: Adult patients seen in 18 practices in West Virginia and New Jersey were invited to complete a voluntary survey. The survey assessed the patient's baseline knowledge of BMI as well as demographic information and whether the patient had known chronic conditions associated with increased BMI, including hypertension, hyperlipidemia, diabetes mellitus, and sleep apnea...
July 2015: Journal of the American Board of Family Medicine: JABFM
Kannan Ramar, Leslie C Dort, Sheri G Katz, Christopher J Lettieri, Christopher G Harrod, Sherene M Thomas, Ronald D Chervin
INTRODUCTION: Since the previous parameter and review paper publication on oral appliances (OAs) in 2006, the relevant scientific literature has grown considerably, particularly in relation to clinical outcomes. The purpose of this new guideline is to replace the previous and update recommendations for the use of OAs in the treatment of obstructive sleep apnea (OSA) and snoring. METHODS: The American Academy of Sleep Medicine (AASM) and American Academy of Dental Sleep Medicine (AADSM) commissioned a seven-member task force...
July 15, 2015: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Saeed Abbasi, Shadi Farsaei, Kamran Fazel, Samad Ej Golzari, Ata Mahmoodpoor
BACKGROUND: Management of difficult to wean patients is a dilemma for health care system. Recently published studies demonstrated efficacy of donepezil to counteract respiratory depression in sleep apnea. However, to the best of our knowledge, pharmaceutical interventions with donepezil to facilitate weaning have not been tested so far. Therefore in the present study, we evaluated the efficacy of using donepezil on weaning course in difficult to wean patients. METHODS: In this non-randomized interventional clinical study, difficult to wean patients with prior inappropriately depressed respiratory responses were included from two referral intensive care units (ICU) in Iran...
2015: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
Susanna S S Ng, Ruth S M Chan, Jean Woo, Tat-On Chan, Bernice H K Cheung, Mandy M M Sea, Kin-Wang To, Ken K P Chan, Jenny Ngai, Wing-Ho Yip, Fanny W S Ko, David S C Hui
BACKGROUND: Obesity is an important risk factor for OSA. This study aimed to assess the effect of weight reduction through a lifestyle modification program (LMP) on patients with moderate to severe OSA. METHODS: This was a parallel group, randomized controlled trial. Altogether, 104 patients with moderate to severe OSA diagnosed on portable home sleep monitoring were randomized to receive a dietician-led LMP or usual care for 12 months. The primary outcome was reduction of apnea-hypopnea index (AHI) at 12 months as assessed by portable home sleep monitoring...
November 2015: Chest
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