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primary health care sleep apnea

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https://www.readbyqxmd.com/read/29664672/primary-care-physicians-can-comprehensively-manage-sleep-apnea-patients-a-non-inferiority-randomized-controlled-trial
#1
M Ángeles Sánchez-Quiroga, Jaime Corral, Francisco J Gómez-de-Terreros, Carmen Carmona-Bernal, M Isabel Asensio-Cruz, Marta Cabello, M Ángeles Martínez-Martínez, Carlos J Egea, Estrella Ordax, Ferran Barbe, Javier Barca, Juan F Masa
RATIONALE: General practitioners play a passive role in obstructive sleep apnea (OSA) management. Simplification of the diagnosis and use of a semi-automatic algorithm for treatment can facilitate the integration of general practitioners, which has cost advantages. OBJECTIVE: To determine differences in effectiveness between primary healthcare area (PHA) and in-hospital specialized management protocols during six months of follow-up. METHOD: A multicenter, non-inferiority, randomized, controlled trial with two open parallel arms and a cost-effectiveness analysis was performed in six tertiary hospitals in Spain...
April 17, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29391284/unexplained-practice-variation-in-primary-care-providers-concern-for-pediatric-obstructive-sleep-apnea
#2
Sarah Honaker, Tamara Dugan, Ameet Daftary, Stephanie Davis, Chandan Saha, Fitsum Baye, Emily Freeman, Stephen Downs
OBJECTIVE: To examine primary care provider (PCP) screening practice for obstructive sleep apnea (OSA) and predictive factors for screening habits. A secondary objective was to describe the polysomnography (PSG) completion proportion and outcome. We hypothesized that both provider and child health factors would predict PCP suspicion of OSA. METHODS: A computer decision support system that automated screening for snoring was implemented in five urban primary care clinics in Indianapolis, Indiana...
January 29, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29379962/provider-types-and-outcomes-in-obstructive-sleep-apnea-case-finding-and-treatment-a-systematic-review
#3
Ken M Kunisaki, Nancy Greer, Wajahat Khalil, Erin Koffel, Eva Koeller, Roderick MacDonald, Timothy J Wilt
Background: Obstructive sleep apnea (OSA) diagnosis and care models rely on sleep specialist physicians (SSPs) and can be expensive and inefficient. Purpose: To assess OSA case-finding accuracy and comparative effectiveness of care by non-sleep specialists (NSSs) and SSPs. Data Sources: MEDLINE and CINAHL from January 2000 through July 2017. Study Selection: English-language trials or observational studies comparing case finding or care by SSPs versus providers not specifically trained as SSPs (NSSs) for adults with suspected or diagnosed OSA...
January 30, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29332673/prevalence-and-comorbidity-of-sleep-conditions-in-australian-adults-2016-sleep-health-foundation-national-survey
#4
Sarah L Appleton, Tiffany K Gill, Carol J Lang, Anne W Taylor, R Douglas McEvoy, Nigel P Stocks, David A González-Chica, Robert J Adams
OBJECTIVE: To determine the prevalence of sleep conditions (obstructive sleep apnea [OSA], insomnia symptoms, simple snoring, and restless legs) and their associated burden of chronic conditions in a community sample. DESIGN: Cross-sectional national adult online survey. SETTING: Community-based sample. PARTICIPANTS: Australian adults ≥18 years, N = 1011. MEASUREMENTS: A cross-sectional national online survey assessed diagnosed OSA, OSA symptoms, insomnia symptoms, sleep problems, excessive daytime sleepiness (Epworth Sleepiness Scale ≥11), and physician-diagnosed health conditions (heart disease, diabetes, hypertension, reflux disease, lung disease, depression, anxiety/panic disorder, arthritis)...
February 2018: Sleep Health
https://www.readbyqxmd.com/read/28942762/clinical-use-of-a-home-sleep-apnea-test-an-american-academy-of-sleep-medicine-position-statement
#5
Ilene M Rosen, Douglas B Kirsch, Ronald D Chervin, Kelly A Carden, Kannan Ramar, R Nisha Aurora, David A Kristo, Raman K Malhotra, Jennifer L Martin, Eric J Olson, Carol L Rosen, James A Rowley
The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. It is the position of the American Academy of Sleep Medicine (AASM) that only a physician can diagnose medical conditions such as OSA and primary snoring. Throughout this statement, the term "physician" refers to a medical provider who is licensed to practice medicine. A home sleep apnea test (HSAT) is an alternative to polysomnography for the diagnosis of OSA in uncomplicated adults presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA...
October 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28869721/the-utility-and-feasibility-of-assessing-sleep-disruption-in-a-men-s-health-clinic-using-a-mobile-health-platform-device-a-pilot-study
#6
Hai H Le, Rachel Marie E Salas, Alyssa Gamaldo, Kevin L Billups, Peter Dziedzic, Seulah Choi, Neftali Bermudez, Roland J Thorpe, Charlene E Gamaldo
INTRODUCTION: Evidence linking sleep disruption and sexual dysfunction in men is mounting; yet the characterisation of sleep patterns and complaints utilising a clinically feasible method within this patient population remain largely under-reported. AIM: A pilot study aiming to demonstrate a clinically feasible method to characterise the sleep patterns and complaints in a representative sample of patients treated in a men's health clinic. METHODS: Male patients (n = 48) completed a battery of validated sleep questionnaires using an mHealth mobile platform, MySleepScript, at the Johns Hopkins Men's Health and Vitality Center...
September 4, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28810998/delayed-diagnosis-of-acromegaly-in-the-context-of-post-traumatic-stress-disorder-due-to-symptoms-mimicking-known-psychotropic-medication-side-effects
#7
Ray-Bernard Portier, Afshin Afarin, Sara Pope
BACKGROUND: Acromegaly is caused by elevated secretion of human growth hormone, which is frequently because of intracranial tumors. This diagnosis is fairly uncommon with an incidence of 3 to 4 cases per million patients per year. We are presenting a case of acromegaly diagnosed in an active duty Chief Petty Officer. MATERIALS AND METHODS: A 38-year-old male Chief Petty Officer with no previous mental health diagnosis experienced post-traumatic stress disorder (PTSD)-like symptoms in early 2012 after deploying to Iraq and Afghanistan from 2010 to 2011...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28708880/pediatric-sleep-apnea-and-depressive-disorders-risk-a-population-based-15-year-retrospective-cohort-study
#8
Chun-Hung Chang, Shaw-Ji Chen, Chieh-Yu Liu
BACKGROUND: Studies have shown a higher risk of depressive disorders in children with sleep apnea than in those without sleep apnea. However, the association between sleep apnea and subsequent depressive disorders in the pediatric population remains undetermined. Thus, this study investigated the risk of depressive disorders among pediatric patients with sleep apnea. METHODS: In this study, the population-based National Health Insurance Research Database of Taiwan was used to identify patients who had first been diagnosed with sleep apnea between 1999 and 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#9
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28527475/the-oximapa-study-hypertension-control-by-abpm-and-association-with-sleep-apnea-syndrome-by-pulse-oximetry
#10
Tiago Maricoto, Eurico Alves Rodrigues Silva, Pedro Damião, José Mesquita Bastos
INTRODUCTION: Ambulatory blood pressure monitoring by automatic device is the best blood pressure evaluation method and sleep apnea syndrome is the leading cause of poor control. Oximetry allows screening these individuals but its usefulness has been poorly explored in Primary Health Care. The aim was to evaluate the blood pressure control at the office and with ambulatory blood pressure monitoring by automatic device and to relate it to sleep apnea syndrome. MATERIAL AND METHODS: We selected a sample of 50 participants, representative of 3036 hypertensive patients...
February 27, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28474653/raising-awareness-about-sleep-disorders
#11
REVIEW
Stuti J Jaiswal, Robert L Owens, Atul Malhotra
Sleep disorders affect a substantial number of people worldwide and may be increasing in prevalence. Unfortunately, many of these disorders can go unrecognized and untreated in clinical practice. Although physicians understand that good sleep is essential to patient health, approaching the issue is often glossed over in the primary care setting. Importantly, recent data also suggest that sleep disorders are becoming increasingly recognized in developing nations. Here, we review the pertinent features and treatment of some of the major sleep disorders, including obstructive sleep apnea, central sleep apnea, insomnia, and others, that affect patient health...
May 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28398157/effects-of-continuous-positive-airway-pressure-on-fatigue-in-two-patients-with-obstructive-sleep-apnea-presenting-with-chronic-fatigue-case-report-and-lessons-learned-from-a-failed-trial
#12
Els Tobback, Liesbeth Delesie, Ignace Hanoulle, Dirk Vogelaers, Dirk Pevernagie, An Mariman
INTRODUCTION: Patients referred to tertiary care for multidisciplinary investigation of unexplained chronic fatigue are not seldom diagnosed with obstructive sleep apnoea (OSA). As standard treatment for OSA, continuous positive airway pressure (CPAP) has been shown to decrease daytime sleepiness in OSA patients. However, the effect on fatigue as major complaint in chronic fatigue patients without excessive daytime sleepiness, is not fully understood nor explored. CASE REPORT: A prospective cross-over trial using effective and sham CPAP treatment periods in patients with unexplained chronic fatigue and OSA was interrupted because of poor recruitment and retainment due to complex design issues...
April 11, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28352476/cpap-treatment-adherence-in-women-with-obstructive-sleep-apnea
#13
E Libman, S Bailes, C S Fichten, D Rizzo, L Creti, M Baltzan, R Grad, A Pavilanis, D-L Tran, K Conrod, R Amsel
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...
2017: Sleep Disorders
https://www.readbyqxmd.com/read/28145848/clinical-practice-guideline-improving-nasal-form-and-function-after-rhinoplasty-executive-summary
#14
Lisa E Ishii, Travis T Tollefson, Gregory J Basura, Richard M Rosenfeld, Peter J Abramson, Scott R Chaiet, Kara S Davis, Karl Doghramji, Edward H Farrior, Sandra A Finestone, Stacey L Ishman, Robert X Murphy, John G Park, Michael Setzen, Deborah J Strike, Sandra A Walsh, Jeremy P Warner, Lorraine C Nnacheta
Objective Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work...
February 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28145823/clinical-practice-guideline-improving-nasal-form-and-function-after-rhinoplasty
#15
Lisa E Ishii, Travis T Tollefson, Gregory J Basura, Richard M Rosenfeld, Peter J Abramson, Scott R Chaiet, Kara S Davis, Karl Doghramji, Edward H Farrior, Sandra A Finestone, Stacey L Ishman, Robert X Murphy, John G Park, Michael Setzen, Deborah J Strike, Sandra A Walsh, Jeremy P Warner, Lorraine C Nnacheta
Objective Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work...
February 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28132683/probability-of-accurate-heart-failure-diagnosis-and-the-implications-for-hospital-readmissions
#16
MULTICENTER STUDY
Sandra A Carey, Kyle Bass, Giovanna Saracino, Cara A East, Joost Felius, Paul A Grayburn, Ravi C Vallabhan, Shelley A Hall
Heart failure (HF) is a complex syndrome with inherent diagnostic challenges. We studied the scope of possibly inaccurately documented HF in a large health care system among patients assigned a primary diagnosis of HF at discharge. Through a retrospective record review and a classification schema developed from published guidelines, we assessed the probability of the documented HF diagnosis being accurate and determined factors associated with HF-related and non-HF-related hospital readmissions. An arbitration committee of 3 experts reviewed a subset of records to corroborate the results...
April 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28118461/screening-for-obstructive-sleep-apnea-in-adults-us-preventive-services-task-force-recommendation-statement
#17
Kirsten Bibbins-Domingo, David C Grossman, Susan J Curry, Karina W Davidson, John W Epling, Francisco A R García, Jessica Herzstein, Alex R Kemper, Alex H Krist, Ann E Kurth, C Seth Landefeld, Carol M Mangione, William R Phillips, Maureen G Phipps, Michael P Pignone, Michael Silverstein, Chien-Wen Tseng
Importance: Based on data from the 1990s, estimated prevalence of obstructive sleep apnea (OSA) in the United States is 10% for mild OSA and 3.8% to 6.5% for moderate to severe OSA; current prevalence may be higher, given the increasing prevalence of obesity. Severe OSA is associated with increased all-cause mortality, cardiovascular disease and cerebrovascular events, diabetes, cognitive impairment, decreased quality of life, and motor vehicle crashes. Objective: To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for OSA in asymptomatic adults...
January 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28118460/screening-for-obstructive-sleep-apnea-in-adults-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#18
REVIEW
Daniel E Jonas, Halle R Amick, Cynthia Feltner, Rachel Palmieri Weber, Marina Arvanitis, Alexander Stine, Linda Lux, Russell P Harris
Importance: Many adverse health outcomes are associated with obstructive sleep apnea (OSA). Objective: To review primary care-relevant evidence on screening adults for OSA, test accuracy, and treatment of OSA, to inform the US Preventive Services Task Force. Data Sources: MEDLINE, Cochrane Library, EMBASE, and trial registries through October 2015, references, and experts, with surveillance of the literature through October 5, 2016. Study Selection: English-language randomized clinical trials (RCTs); studies evaluating accuracy of screening questionnaires or prediction tools, diagnostic accuracy of portable monitors, or association between apnea-hypopnea index (AHI) and health outcomes among community-based participants...
January 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28055233/assessment-of-patients-medical-fitness-to-drive-by-primary-care-physicians-a-cross-sectional-study
#19
Ghassan A Alkharboush, Faisal A Al Rashed, Ahmed H Saleem, Ibrahim S Alnajashi, Aljohara S Almeneessier, Awad H Olaish, Junaid A Bhatti, Ahmed S BaHammam
OBJECTIVES: Motor vehicle collisions (MVCs) are a significant health burden in Saudi Arabia. The literature has consistently indicated that chronic medical conditions, such as diabetes, heart disease, stroke, obstructive sleep apnea, and neurodevelopmental disorders, increase the risk of MVCs. Therefore, assessment of driver fitness by primary care physicians (PCPs) remains a major health intervention that might reduce MVCs. We studied the practices of PCPs in assessing medical fitness to drive in at-risk patients...
July 4, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/27930509/current-challenges-in-providing-bariatric-surgery-in-france-a-nationwide-study
#20
COMPARATIVE STUDY
Sébastien Czernichow, Michel Paita, David Nocca, Simon Msika, Arnaud Basdevant, Bertrand Millat, Anne Fagot-Campagna
Bariatric surgery is a well-accepted procedure for severe and massive obesity management. We aimed to determine trends, geographical variations, and factors influencing bariatric surgery and the choice of procedure in France in a large observational study.The Health Insurance Fund for Salaried Workers (Caisse National Assurance Maladie Travailleurs Salariés) covers about 86% of the French population. The Système National d'Information Inter-régimes de l'Assurance Maladie database contains individualized and anonymized patient data on all reimbursements for healthcare expenditure...
December 2016: Medicine (Baltimore)
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