Effect of Two Interventional Strategies on Improving Continuous Positive Airway Pressure Adherence in Existing COPD and Obstructive Sleep Apnea Patients: The O2VERLAP Study.

Background: Obstructive sleep apnea (OSA) is a sleep disorder prevalent in >10% of individuals diagnosed with chronic obstructive pulmonary disease (COPD). Continuous positive airway pressure (CPAP) is the first-line therapy for OSA, but many do not use it enough during sleep to effectively manage OSA. The OVERLAP study compared (PC)-structured web-based peer-coaching education and support intervention versus (RC)-education and support based on limited scheduled interactions and patient-initiated contacts.

Real-world longitudinal data collected from the SleepHealth mobile app study.

Conducting biomedical research using smartphones is a novel approach to studying health and disease that is only beginning to be meaningfully explored. Gathering large-scale, real-world data to track disease manifestation and long-term trajectory in this manner is quite practical and largely untapped. Researchers can assess large study cohorts using surveys and sensor-based activities that can be interspersed with participants' daily routines.

Barriers and facilitators to the implementation of a novel web-based sleep apnea management platform.

Study Objective: Obstructive sleep apnea (OSA) is a highly prevalent yet underdiagnosed disorder affecting US military Veterans. The Remote Veterans Apnea Management Platform (REVAMP) is a web-based OSA management program created to improve access to care. REVAMP was launched within the Veterans Health Administration (VHA) in July 2017, with variable patient recruitment rates (from 0 to 573 patients per site) at the first 10 Veterans Affairs (VA) medical centers (Wave-1 sites).

Prevalence and management of sleep disorders in the Veterans Health Administration.

The prevalence of diagnosed sleep disorders among Veterans treated at Veterans Affairs (VA) medical facilities increased significantly during fiscal years (FY) 2012 through 2018. Specifically, the prevalence of sleep-related breathing disorders (SRBD) increased from 5.5% in FY2012 to 22.

Study design considerations for sleep-disordered breathing devices.

In recent years, sleep-disordered breathing (SDB) has been recognized as a prevalent but under-diagnosed condition in adults and has prompted the need for new and better diagnostic and therapeutic options. To facilitate the development and availability of innovative, safe and effective SDB medical device technologies for patients in the United States, the US Food and Drug Administration collaborated with six SDB-related professional societies and a consumer advocacy organization to convene a public workshop focused on clinical investigations of SDB devices. Sleep medicine experts discussed appropriate definitions of terms used in the diagnosis and treatment of SDB, the use of home sleep testing versus polysomnography, clinical trial design issues in studying SDB devices, and current and future trends in digital health technologies for diagnosis and monitoring SDB.

National Expansion of Sleep Telemedicine for Veterans: The TeleSleep Program.

Study Objectives: (1) Review the prevalence and comorbidity of sleep disorders among United States military personnel and veterans. (2) Describe the status of sleep care services at Veterans Health Administration (VHA) facilities. (3) Characterize the demand for sleep care among veterans and the availability of sleep care across the VHA.

Accelerating Research With Technology: Rapid Recruitment for a Large-Scale Web-Based Sleep Study.

Background: Participant recruitment can be a significant bottleneck in carrying out research studies. Connected health and mobile health platforms allow for the development of Web-based studies that can offer improvement in this domain. Sleep is of vital importance to the mental and physical health of all individuals, yet is understudied on a large scale or beyond the focus of sleep disorders.

The hepatitis C self-management program: sustainability of primary outcomes at 1 year.

Objective: Chronic hepatitis C infection afflicts millions of people worldwide. Although antiviral treatments are increasingly effective, many hepatitis C virus (HCV) patients avoid treatment, do not complete or respond to treatment, or have contraindications. Self-management interventions are one option for promoting behavioral changes leading to liver wellness and improved quality of life.

Mood Predicts Response to Placebo CPAP.

Study Objectives. Continuous positive airway pressure (CPAP) therapy is efficacious for treating obstructive sleep apnea (OSA), but recent studies with placebo CPAP (CPAP administered at subtherapeutic pressure) have revealed nonspecific (or placebo) responses to CPAP treatment. This study examined baseline psychological factors associated with beneficial effects from placebo CPAP treatment.

Fatigue in sleep apnea: the role of depressive symptoms and self-reported sleep quality.

Unlabelled: OBJECTIVES OR BACKGROUND: Obstructive Sleep Apnea (OSA) is characterized by partial or complete cessation of breath during sleep. OSA is associated with increased cardiovascular risk as well as psychosocial complications such as daytime somnolence, depression, and fatigue. The goal of the present study was to better understand fatigue in OSA by examining self-reported sleep quality, depressive symptoms, excessive daytime sleepiness, and OSA severity in a group of newly diagnosed OSA patients.

Pilot randomized trial of the effect of wireless telemonitoring on compliance and treatment efficacy in obstructive sleep apnea.

Background: Obstructive sleep apnea (OSA) is a prevalent and serious medical condition characterized by repeated complete or partial obstructions of the upper airway during sleep and is prevalent in 2% to 4% of working middle-aged adults. Nasal continuous positive airway pressure (CPAP) is the gold-standard treatment for OSA. Because compliance rates with CPAP therapy are disappointingly low, effective interventions are needed to improve CPAP compliance among patients diagnosed with OSA.

A self-management approach to improving continuous positive airway pressure adherence and outcomes.

Obstructive sleep apnea (OSA) is a condition with serious medical and psychosocial consequences. Low patient adherence to nasal continuous positive airway pressure (CPAP) limits the effectiveness of treatment. Intervention studies based on intensive support protocols have shown modest improvement in CPAP adherence; however, this approach would require significant resources and effort for integration into the existing U.

Social-cognitive correlates of CPAP adherence in experienced users.

Background And Purposes: Obstructive sleep apnea (OSA) is a condition with serious medical and psychosocial consequences. However, poor adherence with nasal continuous positive airway pressure (CPAP) treatment limits the effectiveness of treatment. Behavior change factors offer one avenue of research to better understand the correlates of CPAP adherence.

The anatomic basis for the acquisition of speech and obstructive sleep apnea: evidence from cephalometric analysis supports The Great Leap Forward hypothesis.

Background And Purpose: We previously postulated how evolutionary changes in man's upper respiratory tract to facilitate speech, a phenomenon Jared Diamond calls The Great Leap Forward, have predisposed man to obstructive sleep apnea (OSA) [Diamond J. The Third Chimpanzee: the evolution and future of the human animal. New York: HarperCollins Publishers; 1992.

Nightly variability of sleep-disordered breathing measured over 3 nights.

Objective: To examine the nightly variability of sleep-disordered breathing (SDB) as measured by the apnea-hypopnea index (AHI).

Study Design And Setting: Retrospective comparison of 3 sequential nights of testing performed in the home in 1091 patients who were referred for diagnostic testing of SDB.

Results: The Pearson and Intraclass correlation coefficients ranged between 0.

The effect of measurement unreliability on sleep and respiratory variables.

Introduction: Unreliability associated with scoring sleep variables is a potentially problematic issue in clinical and research studies. When scoring unreliability is unrecognized, it can contribute to the following: increase variability in the measures of interest, decrease a study's ability to detect important relationships, attenuate correlation coefficients, and increase clinical trial costs.

Methods: This paper first models the relationship between scoring variability and reliability in commonly studied sleep variables.

Socioeconomic status is associated with nocturnal blood pressure dipping.

Objective: With the advent of ambulatory blood pressure monitoring has come the awareness that blood pressure (BP) normally drops, or "dips," at night by roughly 10%. A number of pathological conditions have been associated with the nondipping of nocturnal BP. In general, researchers have looked at dipping in neurological and cardiovascular disorders.

Determinants of nasal CPAP compliance.

Background: Obstructive sleep apnea is a prevalent condition with potentially serious medical and psychosocial consequences. Nasal continuous positive airway pressure (CPAP) is the treatment-of-choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture and decrease daytime sleepiness. Patient compliance with CPAP is disappointingly low.

Dose-response relationship between CPAP compliance and measures of sleep apnea severity.

Background: Obstructive sleep apnea is a prevalent condition with serious medical and psychosocial consequences. Nasal continuous positive airway pressure (CPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness. However, little is known about the dose-response relationship between CPAP compliance and measures of sleep apnea severity.

Nasal CPAP treatment for obstructive sleep apnea: developing a new perspective on dosing strategies and compliance.

Nasal continuous positive airway pressure (CPAP) is presently considered as the "treatment of choice" for obstructive sleep apnea (OSA). Though some OSA patients adhere to treatment recommendations and ultimately respond quite well to CPAP therapy, there is a substantial subgroup for which compliance is a particularly difficult issue. Despite receiving recommendations to the contrary and for reasons that are incompletely understood, the majority of OSA patients settle for a partial compliance pattern.

Effect of ethnicity on sleep: complexities for epidemiologic research.

Study Objectives: The goal of this study was to examine whether there were ethnic differences in polysomnographically recorded sleep, either in the controlled laboratory environment or in the home setting.

Design: Prospective study of ethnic differences in stress physiology and sleep.

Setting: Two sleep recordings were performed on consecutive nights in a hospital-based sleep laboratory, followed 1 to 4 weeks later by a third sleep recording in the subject's home.