April 2012
Register for AARC Congress 2012 Now and Save
Earlybird registration is underway now for AARC
CONGRESS 2012, Nov. 10–13 in New Orleans,
LA through April 30. Don’t miss this great
opportunity to learn the latest in respiratory care
in a city that’s proud to show off its remarkable
recovery from Hurricane Katrina in 2005. The sleep
offerings at the meeting promise to deliver the
state of the art information you need to stay on
the cutting edge of your practice.
Initial Poor Response to CPAP not Improved by Switch to Auto Bilevel
Early intervention with an auto bilevel device in OSA patients with an initial poor response to CPAP does not improve outcomes, report researchers publishing in the February issue of the Journal of Clinical Sleep Medicine. In a parallel group, randomized, double-blind, controlled pilot study conducted among 47 patients who were matched for OSA severity, gender, age, and education, compliance with the two interventions at 90 days was similar, 62% for auto bilevel vs. 54% for CPAP, and functional outcomes improved significantly and similarly in both groups. “Patients with a poor initial CPAP exposure may still achieve an acceptable long-term clinical outcome,” write the authors. READ ABSTRACT
In-Hospital Screening for OSA Leads to Improved Outcomes for CPAP Compliant Patients
Canadian investigators conducted a two-year follow up study of patients who were given the STOP questionnaire for OSA screening upon admission to the hospital to find out how those who screened positive for OSA and underwent sleep testing fared over the long term. Surveys were sent out to all 211 patients, with a response rate of 156, or 67%. Among that group, 128 were diagnosed with OSA by polysomnography and 88 were prescribed treatment with CPAP. The remaining patients received another form of treatment. Forty of the CPAP patients, or 45%, were currently compliant with CPAP treatment and the remaining 48, or 55%, were not. When comparing the compliant CPAP patients with the non-compliant CPAP patients and patients who received other treatment, researchers found CPAP compliant patients had a greater reduction in the need for medications for comorbidities, along with significant improvements in snoring, sleep quality, and daytime sleepiness. The study was published ahead of print in the Canadian Journal of Anaesthesia on Mar. 30. READ ABSTRACT
Telemedicine System Improves CPAP Compliance
A web-based telemedicine system can help improve CPAP compliance, report Canadian researchers who tested such a system among 75 OSA patients, 36 of whom were randomized to an autotitrating PAP machine alone and 39 of whom were randomized to an autotitrating PAP machine that transmitted physiologic information such as adherence, air leak, and residual AHI to a website on a daily basis. The website was then reviewed by a technician, who made follow up calls to the patient when problems with compliance were noted. Over the three month study, researchers found significantly higher CPAP adherence in the telemedicine group than the usual care group, 191 minutes per day vs. 105 minutes per day. Mean adherence to CPAP on days when the device was used was also higher, 321 minutes vs. 207 minutes. On average, technicians spent an additional 67 minutes of time on their telemedicine patients over the course of the study. The study appeared in the April 1 edition of Sleep. READ ABSTRACT
Sleep Breathing Problems Common in Patients Seeking Treatment for Insomnia
A new study out of New Mexico suggests sleep breathing problems may be common in patients who seek treatment for insomnia. Researchers reached that conclusion after conducting a retrospective chart review on 1035 consecutive treatment-seeking chronic insomnia patients. Among the findings:
- The average insomnia severity was in the range of a clinically relevant problem: total sleep time 5.50 hours; sleep efficiency 71.05%; wake time after sleep onset 120.70 minutes; and an insomnia severity index of 18.81.
- 42% ranked a sleep breathing disorder among their list of reasons for seeking treatment; 13% revealed a concern about a sleep breathing problem; and 26% reported awareness of sleep breathing symptoms.
- Only 19% reported no awareness or concerns about sleep breathing disorders, problems, or symptoms.
- A greater proportion of men than women reported significantly more sleep breathing disorders, problems, or symptoms.
The study was published ahead of print by Sleep & Breathing on April 1. READ ABSTRACT
