Obstructive sleep apnea (OSA) is a major public health problem that, if untreated, can be deadly. Despite the proven reliability of continuous positive airway pressure (CPAP) in treating OSA, resistance and intolerance to CPAP poses limitations to its use.
However, access to specialized services with a structured management protocol for OSA and close follow-up in a sleep center accredited by the American Academy of Sleep Medicine (AASM) improves CPAP compliance and is a model for development in sleep centers, according to a research abstract that will be presented Tuesday at SLEEP 2007, the 21st Annual Meeting of the Associated Professional Sleep Societies (APSS).
The study, conducted by Siva Ramachandran, MD, of the Sleep Wellness Center of Pottstown, Pennsylvania, focused on 64 patients with OSA, who were initially evaluated by a board certified sleep specialist and subsequently followed by a certified respiratory therapist. The subjects were educated about OSA and received printed AASM brochures on sleep apnea. The educational program was reinforced by technologists prior to their sleep studies. CPAP desensitization and mask fittings were conducted, followed by a specialized CPAP clinic where patients watched a video, were fitted with masks and received their CPAP with downloadable compliance cards. All patients had open access to the center and were seen on follow up at one month.
It was discovered that 51 patients (80 percent) used CPAP for more than four hours per night.
“Our study shows that a model of care based on education, intense follow up, close attention to masks and open access to an AASM accredited sleep center resulted in dramatic compliance data that was at least 10 percentage points higher than the national average of approximately 70 percent,” said Ramachandran. “Patient demographics, severity of disease or extent of daytime sleepiness did not influence CPAP usage. This study was particularly important as it was done in a community setting with resources exclusively provided from the center, and all patients had objective CPAP compliance data that was downloadable from their compliance card. Such data could also be tracked in follow up visits to initiate programs in the future to sustain and improve compliance further.”
Those who think they might be suffering from OSA, or another sleep disorder, are encouraged to consult with their primary care physician, who will refer them to a sleep specialist.
OSA affects an estimated 15 million to 20 million Americans, as well as millions more who remain undiagnosed and untreated.
Scientific evidence shows that CPAP is the best treatment for sleep apnea. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize OSA and restoring normal oxygen levels.