Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
-
To assess positive airway pressure (PAP) therapy adherence in commercial motor vehicle (CMV) drivers presenting to a sleep center. ⋯ Early PAP utilization patterns predicted one year adherence for our CMV driver population within a sleep clinic setting. OSA testing of these CMV drivers after occupational health referral identifies high proportions of undiagnosed OSA, with approximately half requiring PAP therapy based on current published treatment recommendations.
-
CPAP applied by a nasal mask is the gold standard treatment of obstructive sleep apnea. Oronasal masks are an alternative interface that can be used, especially in subjects with predominant oral breathing. However, oronasal masks have higher costs, are associated with larger leaks and higher residual apnea-hypopnea index, and in some cases may be ineffective.
-
Randomized Controlled Trial Multicenter Study
Impact of Randomization, Clinic Visits, and Medical and Psychiatric Cormorbidities on Continuous Positive Airway Pressure Adherence in Obstructive Sleep Apnea.
To evaluate factors associated with continuous positive airway pressure (CPAP) adherence in patients with obstructive sleep apnea (OSA) in the Apnea Positive Pressure Long-term Efficacy Study (APPLES) cohort. ⋯ Randomization to active therapy, belief that one is in the active treatment group, older age, and possibly presence of cardiovascular disorders are positively linked to CPAP adherence. Nasal congestion and anxiety are negatively associated with CPAP adherence. CPAP nightly usage increases as clinic visits approach.
-
Sleep disturbances are frequently reported following traumatic brain injury (TBI); however, the exact disturbances remain unclear. This meta-analysis aimed to characterize sleep disturbance in community dwelling patients with TBI as compared to controls. ⋯ The evidence suggests that TBI is associated with widespread objective and subjective sleep deficits. The present results highlight the need for physicians to monitor and address sleep deficits following TBI.
-
Obstructive sleep apnea (OSA) is associated with increased morbidity and mortality, and treatment with positive airway pressure (PAP) is cost-effective. However, the optimal diagnostic strategy remains a subject of debate. Prior modeling studies have not consistently supported the widely held assumption that home sleep testing (HST) is cost-effective. ⋯ Using a model framework that captures a broad range of clinical possibilities, the optimal diagnostic approach to uncomplicated OSA depends on pretest probability, cost of untreated OSA, and time horizon. Estimating each of these critical factors remains a challenge warranting further investigation.