Sleep Apnea - ACP

65 Pages·2014·2.08 MB·English

Sleep Apnea
ACP Oct 26, 2014
Bashir Chaudhary, MD
Sleep Institute of Augusta, Augusta GA

Emeritus Professor of Medicine and
Assistant Dean of Clinical Affairs, CAHS
Medical College of Georgia, Georgia Health Sciences
University
Future of Sleep Medicine?
• Main sleep problem will continue to be OSA
• In-lab studies are going to decrease
• Home studies are going to increase
• Shift of studies to PCPs
• Shift to studies to commercial companies
• Type of patients are going to be different
• New therapeutic modalities
Outcome Studies
Equivalence between HST and in-lab PSG
• – Patient satisfaction

• – Quality of Life

• – Epworth and other sleep measurement tools

• – CPAP adherence (one study ↑ home)
Multi-Center Studies of HST

Rosen CL, et al, Sleep 35:757, 2012

• CPAP compliance (3months)
• 219 mins 281 mins p=0.001
• Change in Epworth score -7.4 -7.0 p=0.65
• Change in FOSQ +3.6 3.1 p=0.38

Improved CPAP compliance but no difference in
changes in other outcomes between two
pathways
Sleep Apnea

• Snoring

• Sleepiness / tiredness

• Disturbed sleep

Clinical Features of OSA
• Awakenings / gasping or choking
• Awakenings for uncertain reasons
• Restless sleep
• Non-refreshing sleep
• Poor memory / intellectual function
• Irritability / personality change
• Morning headache / confusion