ORIGINAL ARTICLE. Validation of the Snore Outcomes Survey for Patients With Sleep-Disordered Breathing
|
|
- Camilla Bradley
- 5 years ago
- Views:
Transcription
1 Validation of the Snore Outcomes Survey for Patients With Sleep-Disordered Breathing Richard E. Gliklich, MD; Pa-Chun Wang, MD, MSc ORIGINAL ARTICLE Objective: To develop and validate a self-reported outcomes measure for patients with sleep-disordered breathing the Snore Outcomes Survey. Design: Item areas of the SOS were developed by an expert panel. Consecutive patients were enrolled into the study in a prospective manner. Patients received the SOS, the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the Medical Outcomes Study 36-Item Short- Form Health Survey, and standard overnight polysomnography at baseline and after 4 months of continuous positive airway pressure therapy. Setting: A tertiary care, academic otolaryngology and sleep disorders referral center. Patients: One hundred fifty-six adult patients presenting with a chief complaint of snoring or sleep-disordered breathing to the Massachusetts Eye and Ear Infirmary, Boston. Main Outcome Measures: Test-retest reliability, intrasurvey reliability, internal consistency, validity, and standardized response means of the SOS. Results: Overall, reliability of the SOS was excellent (testretest reliability r=0.86; P.001; Cronbach coefficient, 0.85). The SOS index significantly correlated with the Epworth Sleepiness Scale (r= 0.42; P.001) and the global Pittsburgh Sleep Quality Index score (r= 0.38; P.001), as well as with the number of recorded arterial oxygen saturation levels below 85% (r= 0.46; P=.02). The SOS index was sensitive to clinical changes after intervention (standardized response mean, 0.57). Conclusion: The SOS is a reliable and valid instrument for assessing sleep-related health status for patients with snoring and sleep-disordered breathing and for measuring change in health status following therapy. Arch Otolaryngol Head Neck Surg. 2002;128: From the Department of Otolaryngology and the Clinical Outcomes Research Unit, Massachusetts Eye and Ear Infirmary, and the Department of Otology and Laryngology, Harvard Medical School, Boston, Mass. Dr Wang is now with the Department of Otolaryngology, Cathay General Hospital, and the Department of Public Health, China Medical College, Taiwan. SLEEP-DISORDERED breathing (SDB) represents a continuum of sleep disorders from simple snoring to severe obstructive sleep apnea syndrome. While 2% to 4% of the middleaged workforce are reportedly affected by obstructive sleep apnea syndrome, SDB affects 3 to 6 times this number. 1-5 Recent advances in treatment of SDB in patients with and without obstructive sleep apnea syndrome have raised questions regarding treatment efficacy and how to determine the best practice While the polysomnogram (PSG) provides reliable data on respiratory behavior during sleep, it does not fully address the problem of SDB from either a patient s or a spouse s perspective and is prohibitively expensive and burdensome to be used for long-term, multiple follow-ups in these patients. 12,13 In view of this, we developed the Snore Outcomes Survey (SOS) to be a patient-based measure for the full range of SDB patients in whom snoring is a primary symptom, where the goal is to measure the snoring component of SDB. Approaches to develop and validate qualityof-life measures as performed in this study have been previously well described. 17 RESULTS STUDY POPULATION There were 130 men and 26 women (mean±sd age, 46.2±11.6 years). The mean Respiratory Distress Index was 32.66± The mean awake oxygen saturation was 94.97%±2.4%, and the minimum oxygen saturation during sleep was 77.85%±16.04%. RELIABILITY OF SOS 1. Test-Retest Reliability: mean test and retest total scores varied from 27.54±
2 PARTICIPANTS AND METHODS CONSTRUCTION OF SOS The item areas for the SOS were developed by an expert panel. The initial questionnaires were piloted with open-ended responses. Actual survey items were constructed according to a Likert scaling model. The SOS (Figure) contains 8 items that evaluate the duration, severity, frequency, and consequences of problems associated with SDB, snoring in particular. Because of the impact of SDB on others, a separate Spouse/Bed Partner Survey (SBPS) containing 3 Likert-type items was also developed. Scores on the SOS and SBPS are normalized on a scale ranging from 0 (worst) to 100 (best), similar to other measures such as the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). STUDY POPULATION One hundred fifty-six consecutive patients with chief complaints of snoring and SDB who were evaluated by otolaryngologists at the Sleep and Snoring Center of Massachusetts Eye and Ear Infirmary, Boston, were enrolled. All patients underwent overnight PSG. SLEEP STUDY Measurements of height and weight were obtained to calculate the body mass index as weight in kilograms divided by the square of height in meters. All patients underwent standard overnight PSG to record the pulse oxygen saturation, chest and abdominal wall movement, electroencephalogram, oronasal airflow, electrocardiogram, electrooculogram, and submental electromyogram. Respiratory Distress Index was defined as the sum of total apnea and hypopnea episodes per hour of sleep. An apnea episode is defined as cessation of airflow lasting longer than 10 seconds, whereas a hypopnea episode is defined as a 33% or greater reduction in combined oral and nasal flow lasting longer than 10 seconds. SURVEY FORMS At entry, patients were administered the SOS, the Epworth Sleepiness Scale 15,18 (ESS), the Pittsburgh Sleep Quality Index 19 (PSQI), and the SF ,21 Permission to use these forms were obtained in each case. The 8-item ESS evaluates daytime somnolence and generates a total score ranging from 0 (best) to 24 (worst). The PSQI is a 19-item, selfreported, global sleep questionnaire that evaluates 7 dimensions of sleep quality. Each domain is scored on a scale from 0 (best) to 3 (worst), and these subscores are summed to yield a total score ranging from 0 (best) to 21 (worst). The SF-36 is a widely used generic quality-of-life measure that divides general health into 8 domains. The subscales and definition of SF-36 and PSQI are listed in Table 1. RELIABILITY AND VALIDITY OF SOS Fifty-nine patients who were deemed clinically stable were retested after a 2- to 4-week interval. This cohort received no medical or surgical intervention during this interval. Testretest, intersurvey, and intrasurvey reliability were calculated using Spearman rank order correlation coefficients for individual items and for total survey score. Internal consistency of the SOS was calculated using Cronbach correlation coefficients. In addition to its face validity, the SOS was assessed for convergent validity through correlations to concurrent PSG data. In addition, scores on the SOS were compared with 3 previously validated measures that were completed by the patients at the same time as the SOS. These measures were the ESS, PSQI, and SF-36. One hundred fortynine patients completed all 3 surveys. REPONSIVENESS OF SOS Instrument responsiveness or sensitivity to clinical change was assessed in the following manner. Of the 149 patients used in the validity analysis, 21 were retested with the SOS after being treated for 4 months with continuous positive airway pressure. These patients were evaluated on an intention-to-treat basis. Actual in-home monitoring of continuous positive airway pressure compliance was not performed. However, all patients reported that continuous positive airway pressure resolved their snoring when it was used. Longitudinal sensitivity to clinical change was calculated as the standardized response mean, according to method described by Liang et al. 22 STATISTICAL ANALYSIS All data were stored in an Access 7.0 database (Microsoft, Redmond, Wash). Analyses were conducted using the SAS software package (SAS Institute, Cary, NC). on the first administration to 27.59±17.44 on the second administration. The test-retest correlation coefficients for individual items (r= ; P.001) and total score (r=0.86; P<.001) were statistically significant (Table 2). 2. Intersurvey Reliability: the correlation between SOS and SBPS was not significant (r=0.18; P=.07). 3. Intrasurvey Reliability: the item-item, item-total correlations for SOS are presented in Table 3. The itemitem correlations for SBPS were very high. 4. Internal Consistency: Cronbach correlation coefficients were calculated as 0.85 for the SOS and 0.96 for the SBPS. VALIDITY OF SOS 1. Correlation With PSG Data: the correlations between the SOS and the PSG parameters are shown in Table 4. Four Respiratory Distress Index elements, awake oxygen saturation, number of arterial oxygen saturation values less than 85%, and minimum arterial oxygen saturation were collected from a computerized PSG database. The number of desaturation values to less than 85% was most strongly correlated with the SOS (r= 0.46; P=.02). 2. Correlation With ESS: a significant correlation was observed between the SOS and the ESS (r = 0.42; 820
3 The Snore Outcomes Survey. (Printed with permission of Outcome Sciences Inc, Boston, Mass.) P.001). The correlation between the SBPS and ESS was not significant (Table 5). 3. Correlation With SF-36: the 8 subscale scores of the SF-36 were compared with the SOS total score, and the correlation coefficient was derived. The SOS demonstrated significant correlations with all SF-36 subscales except for the mental health subscale. The SBPS did not correlate well with any SF-36 subscale (Table 5). 4. Correlation With PSQI: component and total scores were calculated according to published guidelines. 19 The PSQI evaluates 7 dimensions of sleep quality: subjective quality, latency, duration, efficiency, disturbance, use of sleep medication, and daytime dysfunction (Table 1). The SOS was found to be significantly (P.01) correlated with the total PSQI score, subjective sleep quality, habitual sleep efficiency, sleep disturbance, and daytime dysfunction (Table 5). RESPONSIVENESS OF SOS The standardized response mean for the total SOS score was 0.57, indicating that the SOS is responsive to clinical change. The SBPS, on the other hand, was not sensitive to change. COMMENT Sleep-disordered breathing 1 is a condition characterized by repeated pauses in breathing during sleep, which lead to the fragmentation of sleep and a decrease in arterial oxygenation. The spectrum of SDB includes simple snoring, obstructive sleep apnea, and upper airway resistance syndrome. Several studies have shown that patients with SDB carry higher risks of daytime somnolence and cardiovascular morbidities. 2,3 The objective evaluation of SDB has relied on standard PSG, which requires a patient to sleep in a laboratory overnight. From a cost and burden perspective, overnight PSG is not an efficient means to track patients over time. Although snoring is only one component of SDB, a valid and reliable patient-based measure for snoring could contribute to the tracking of patients with SDB and certainly those whose SDB is limited to snoring alone. Use of patient-based questionnaires to assess patients with SDB has become a widely accepted ap- 821
4 Table 1. SF-36 and PSQI Subscales* SF-36 Subscales and Definition Physical functioning: limitation on physical activities such as walking, bathing, and strenuous sports Role-physical: problems with work or other daily activities as a result of physical health Bodily pain: intensity of bodily pain or limitation due to pain General health: perception of current health and health outlook Vitality: level of energy Social functioning: extent health interferes with normal social activities Role-emotional: problems with daily activities as result of emotional issues Mental health: mental health screening PSQI Components Subjective sleep quality Sleep latency Sleep duration Habitual sleep efficiency Sleep disturbances Use of sleeping medication Daytime dysfunction Total score *SF-36 indicates Medical Outcomes Study 36-Item Short-Form Health Survey; PSQI, Pittsburgh Sleep Quality Index. Table 2. Spearman Correlations for Test-Retest Reliability of SOS* Individual Items Spearman r Total score 0.86 *SOS indicates Snore Outcomes Survey. P.001 for all items. proach ,18,19 In this study, we introduce the SOS as a reliable, valid, and sensitive disease-specific outcomes measure that adds another dimension to our understanding of the impact of SDB to patients quality of life. While other measures focus on sleep quality and somnolence, the SOS focuses on snoring with the idea that it is the presenting complaint for many patients. In terms of reliability, the SOS demonstrated good test-retest reliability for individual test questions and for total score. Improvement in wording may further enhance the reliability of items 1, 4, and 8. The measured item and total score test-retest reliabilities ranging from 0.54 to 0.88 were comparable with those of wellstudied SF-36, which had correlations ranging from 0.6 to 0.81 for its subscales. 23 The poor correlation between the SOS and SBPS show a significant discrepancy between patient and bed-partner evaluations in terms of the patient s snoring. This result was not expected. The Cronbach correlation coefficients of 0.85 and 0.96 for SOS and SBPS, respectively, exceed the commonly accepted threshold (0.7) for a reliable measure. 17 The overall comparison between the SOS and the PSG data suggests that snoring may be more strongly related to oxygen desaturation than previously assumed. Previous studies have also shown oxygen desaturation to be more closely related to quality of life than the Respiratory Distress Index. 24 Although the SOS and PSG were Table 4. Spearman Correlations Between SOS and Polysomnogram Data* r (P Value) Polysomnogram Data SOS SBPS Respiratory Distress Index 0.21 (.26) 0.22 (.31) Awake oxygen saturation 0.04 (.83) 0.52 (.01) No arterial oxygen saturation 0.46 (.02) 0.1 (.46) values 85% Minimum oxygen saturation 0.35 (.07) 0.16 (.48) *SOS indicates Snore Outcomes Survey; SBPS, Spouse/Bed Partner Survey. Table 3. Spearman Correlations for Intrasurvey Reliability of SOS and SBPS* Items, r (P Value) SOS Intrasurvey Reliability SOS items (.001) 0.52 (.001) 0.6 (.001) 0.38 (.001) 0.47 (.001) 0.51 (.001) 0.65 (.001) (.001) 0.47 (.001) 0.29 (.004) 0.37 (.001) 0.57 (.001) 0.51 (.001) (.001) 0.11 (.27) 0.27 (.006) 0.31 (.002) 0.35 (.001) (.23) 0.43 (.001) 0.33 (.001) 0.46 (.001) (.01) 0.52 (.001) 0.35 (.001) (.001) 0.79 (.001) (.001) SBPS Intrasurvey Reliability SBPS items (.001) 0.88 (.001) (.001) *SOS indicates Snore Outcomes Survey; SBPS, Spouse/Bed Partner Survey. 822
5 Table 5. Spearman Correlations Between SOS With ESS, SF-36, and PSQI* r (P Value) Data SOS SBPS Correlations Between SOS and ESS ESS data ESS total score 0.42 (.001) 0.11 (.23) Correlations Between SOS and SF-36 SF-36 data Physical functioning 0.23 (.006) 0.04 (.68) Role-physical 0.33 (.001) 0.14 (.16) Bodily pain 0.18 (.03) 0.14 (.30) Vitality 0.37 (.001) 0.11 (.29) Role-emotional 0.23 (.006) 0.14 (.71) Social functioning 0.34 (.001) 0.01 (.91) General health 0.18 (.04) 0.04 (.67) Mental health 0.15 (.08) (.96) Correlations Between SOS and PSQI PSQI data Global PSQI total score 0.38 (.001) 0.09 (.35) Subjective sleep quality 0.34 (.001) 0.03 (.76) Sleep latency (.56) 0.1 (.30) Sleep duration (.68) 0.21 (.04) Habitual sleep efficiency 0.22 (.007) 0.07 (.45) Sleep disturbances 0.31 (.001) 0.08 (.40) Use of sleep medication (.11) 0.08 (.40) Daytime dysfunction 0.47 (.001) 0.12 (.21) *SOS indicates Snores Outcomes Survey; ESS, Epworth Sleepiness Scale; SF-36, Medical Outcomes Study 36-Item Short-Form Health Survey; PSQI, Pittsburgh Sleep Quality Index; and SBPS, Spouse/Bed Partner Survey. correlated, the correlations were moderate, again suggesting that they are measuring different aspects of sleep disturbance. The SOS was rigorously compared with other sleep-specific questionnaires such as the ESS and PSQI. The correlation coefficient of 0.42 between the SOS and ESS was similar to that between the SOS and PSQI daytime dysfunction component (r= 0.47) and confirms the predicted convergent validity. The weak but statistically significant correlation between the SOS and several SF-36 subscales again supports convergence and suggests that SDB may have an impact on general health. 24 Responsiveness, or sensitivity to longitudinal change, is the ability of a health measure to detect clinical change over time. The standardized response mean measures this sensitivity. The SOS (standardized response mean, 0.57) demonstrates moderate responsivenesss. 22,25 Hence, the SOS can be used as an evaluative instrument in clinical studies of interventions for snoring and other forms of SDB when the principal complaint is snoring. The SOS is short, easy to understand, and easy to administer in a busy clinical setting without sacrificing its evaluative power. In addition to providing a qualityof-life dimension to the overall assessment of SDB, the SOS can be used to follow-up patients with SDB over time, with and without intervention. To summarize, the SOS is a patient-based, diseasespecific outcomes measure for SDB. It is valid, reliable, and sensitive to clinical change. The SOS also provides an inexpensive and accurate measure to follow up patients with SDB, especially when snoring is the primary symptom. Accepted for publication November 21, Corresponding author and reprints: Richard E. Gliklich, MD, Department of Otolaryngology and Clinical Outcomes Research Unit, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA REFERENCES 1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328: Briones B, Adams N, Strauss M, et al. Relationship between sleepiness and general health status. Sleep. 1996;19: Lavie P. Incidence of sleep apnea in a presumably healthy working population: a significant relationship with excessive daytime sleepiness. Sleep. 1983;6: Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1990; 20: Young T, Blustein J, Finn L, Palta M. Sleep-disordered breathing and motor vehicle accidents in a population-based sample of employed adults. Sleep. 1997; 20: Fujita A, Conway W, Zorick F, et al. Surgical correction of anatomic abnormalities of obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg. 1981;89: Mickelson SA. Laser-assisted uvulopalatoplasty for obstructive sleep apnea. Laryngoscope. 1996;106: Powell NB, Riley RW, Guilleminault C. Radiofrequency tongue base reduction in sleep-disordered breathing: a pilot study. Otolaryngol Head Neck Surg. 1999; 120:
6 9. Li KK, Powell NB, Riley RW, et al. Radiofrequency volumetric reduction of the palate. Otolaryngol Head Neck Surg. 2000;122: Woodson BT, Derowe A, Hawe M, et al. Pharyngeal suspension suture with repose bone screw for obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000; 122: Conradt R, Hochban W, Heitmann J, et al. Sleep fragmentation and daytime vigilance in patients with OSA treated by surgical maxillomandibular advancement compared to CPAP therapy. J Sleep Res. 1998;7: Li KK, Riley RW, Powell NB, Gervacio L, Troell RJ, Guilleminault C. Obstructive sleep apnea surgery: patient perspective and polysomnographic results. Otolaryngol Head Neck Surg. 2000;123: Pradhan PS, Gliklich RE, Winkelman J. Screening for obstructive sleep apnea in patients presenting for snoring surgery. Laryngoscope. 1996;106: Piccirillo JF, Gates GA, White DL, Schectman KB. Obstructive sleep apnea treatment outcomes pilot study. Otolaryngol Head Neck Surg. 1998;118: Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep. 1991;14: Flemons WW, Reimer MA. Development of a disease-specific health related quality of life questionnaire for sleep apnea. Am J Respir Crit Care Med. 1998;158: Nunnally JC. Psychometric Theory. 2nd ed. New York, NY: McGraw-Hill; Johns MW. Daytime sleepiness, snoring, and obstructive sleep apnea. Chest. 1993;103: Buysse DJ, Reynolds CF III, Monk TH, Bermen SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28: Mchorney CA, Ware JE, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36), II: psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993;31: Ware JE. Validity: norm-based interpretation. In: Ware JE, ed. SF-36 Health Survey Manual and Interpretation Guide. Boston, Mass: Nimrod Press; 1993:10:1-10: Liang MH, Fossel AH, Larson MG. Comparisons of five health status instruments for orthopedic evaluation. Med Care. 1990;28: Brazier JE, Harper R, Jones NMB, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992;305: Gliklich RE, Taghizadeh F, Winkelman JW. Health status in patients with disturbed sleep and obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000; 122: Cohen J. Statistical Power Analyses for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; CME Announcement CME Hiatus: July Through December 2002 CME from JAMA/Archives will be suspended between July and December Beginning in early 2003, we will offer a new online CME program that will provide many enhancements: Article-specific questions Hypertext links from questions to the relevant content Online CME questionnaire Printable CME certificates and ability to access total CME credits We apologize for the interruption in CME and hope that you will enjoy the improved online features that will be available in early
ORIGINAL ARTICLE. Hsueh-Yu Li, MD; Ning-Hung Chen, MD; Yu-Hsiang Shu, MSc; Pa-Chun Wang, MD, MSc
ORIGINAL ARTICLE Changes in Quality of Life and Respiratory Disturbance After Extended Uvulopalatal Flap Surgery in Patients With Obstructive Sleep Apnea Hsueh-Yu Li, MD; Ning-Hung Chen, MD; Yu-Hsiang
More informationDiagnostic Accuracy of the Multivariable Apnea Prediction (MAP) Index as a Screening Tool for Obstructive Sleep Apnea
Original Article Diagnostic Accuracy of the Multivariable Apnea Prediction (MAP) Index as a Screening Tool for Obstructive Sleep Apnea Ahmad Khajeh-Mehrizi 1,2 and Omid Aminian 1 1. Occupational Sleep
More informationSurgical Options for the Successful Treatment of Obstructive Sleep Apnea
Surgical Options for the Successful Treatment of Obstructive Sleep Apnea Benjamin J. Teitelbaum, MD, FACS Otolaryngology Head and Neck Surgery Saint Agnes Medical Center Fresno, California Terms Apnea
More informationORIGINAL ARTICLE. Improvement in Quality of Life After Nasal Surgery Alone for Patients With Obstructive Sleep Apnea and Nasal Obstruction
ORIGINAL ARTICLE Improvement in Quality of Life After Nasal Surgery Alone for Patients With Obstructive Sleep Apnea and Nasal Obstruction Hsueh-Yu Li, MD; Ying Lin, BS; Ning-Hung Chen, MD; Li-Ang Lee,
More informationTranslation and Validation Assessment of the Chinese Version of the Chronic Sinusitis Survey
Original Article 9 Translation and Validation Assessment of the Chinese Version of the Chronic Sinusitis Survey Pa-Chun Wang, MD, MSc; Chih-Jaan Tai 1, MD, MSc; Chia-Chen Chu 2, MSc; Shu-Cheng Liang 2,
More informationComparing Upper Airway Stimulation to Expansion Sphincter Pharyngoplasty: A Single University Experience
771395AORXXX10.1177/0003489418771395Annals of Otology, Rhinology & LaryngologyHuntley et al research-article2018 Original Article Comparing Upper Airway Stimulation to Expansion Sphincter Pharyngoplasty:
More informationObstructive sleep apnea (OSA) is characterized by. Quality of Life in Patients with Obstructive Sleep Apnea*
Quality of Life in Patients with Obstructive Sleep Apnea* Effect of Nasal Continuous Positive Airway Pressure A Prospective Study Carolyn D Ambrosio, MD; Teri Bowman, MD; and Vahid Mohsenin, MD Background:
More informationObstructive sleep apnoea How to identify?
Obstructive sleep apnoea How to identify? Walter McNicholas MD Newman Professor in Medicine, St. Vincent s University Hospital, University College Dublin, Ireland. Potential conflict of interest None Obstructive
More informationSLEEP DISORDERED BREATHING The Clinical Conditions
SLEEP DISORDERED BREATHING The Clinical Conditions Robert G. Hooper, M.D. In the previous portion of this paper, the definitions of the respiratory events that are the hallmarks of problems with breathing
More informationTongue Base Reduction with Radiofrequency Tissue Ablation: Preliminary Results after Two Treatment Sessions
SLEEP AND BREATHING VOL. 4, NO. 4, 2000 Tongue Base Reduction with Radiofrequency Tissue Ablation: Preliminary Results after Two Treatment Sessions BORIS A. STUCK, M.D., JOACHIM T. MAURER, M.D., and KARL
More informationTemperature controlled radiofrequency ablation for OSA
Temperature controlled radiofrequency ablation for OSA Ridhwan Y. Baba, M.B.B.S. *1, V.V.S. Ramesh Metta, M.B.B.S. 1, Arjun Mohan, M.B.B.S. 2, M. Jeffery Mador, M.D. 2 1 Department of Internal Medicine,
More informationOBSTRUCTIVE SLEEP APNEA and WORK Treatment Update
OBSTRUCTIVE SLEEP APNEA and WORK Treatment Update David Claman, MD Professor of Medicine Director, UCSF Sleep Disorders Center 415-885-7886 Disclosures: None Chronic Sleep Deprivation (0 v 4 v 6 v 8 hrs)
More informationDECLARATION OF CONFLICT OF INTEREST
DECLARATION OF CONFLICT OF INTEREST Obstructive sleep apnoea How to identify? Walter McNicholas MD Newman Professor in Medicine, St. Vincent s University Hospital, University College Dublin, Ireland. Potential
More informationORIGINAL ARTICLE. The Nasal Obstruction Symptom Evaluation. as a Screening Tool for Obstructive Sleep Apnea
ORIGINAL ARTICLE The Nasal Obstruction Symptom Evaluation Survey as a Screening Tool for Obstructive Sleep Apnea Lisa Ishii, MD, MHS; Andres Godoy, MD; Stacey L. Ishman, MD, MPH; Christine G. Gourin, MD;
More informationUpper Airway Stimulation for Obstructive Sleep Apnea
Upper Airway Stimulation for Obstructive Sleep Apnea Background, Mechanism and Clinical Data Overview Seth Hollen RPSGT 21 May 2016 1 Conflicts of Interest Therapy Support Specialist, Inspire Medical Systems
More informationTolerance of Positive Airway Pressure following Site-Specific Surgery of Upper Airway
34 The Open Sleep Journal, 2008, 1, 34-39 Open Access Tolerance of Positive Airway Pressure following Site-Specific Surgery of Upper Airway Ho-Sheng Lin *,#,1,2, Roger Toma #,2, Cara Glavin 2, Mark Toma
More informationRESEARCH PACKET DENTAL SLEEP MEDICINE
RESEARCH PACKET DENTAL SLEEP MEDICINE American Academy of Dental Sleep Medicine Dental Sleep Medicine Research Packet Page 1 Table of Contents Research: Oral Appliance Therapy vs. Continuous Positive Airway
More informationPrediction of sleep-disordered breathing by unattended overnight oximetry
J. Sleep Res. (1999) 8, 51 55 Prediction of sleep-disordered breathing by unattended overnight oximetry L. G. OLSON, A. AMBROGETTI ands. G. GYULAY Discipline of Medicine, University of Newcastle and Sleep
More informationAppendix 1. Practice Guidelines for Standards of Adult Sleep Medicine Services
Appendix 1 Practice Guidelines for Standards of Adult Sleep Medicine Services 1 Premises and Procedures Out-patient/Clinic Rooms Sleep bedroom for PSG/PG Monitoring/Analysis/ Scoring room PSG equipment
More informationEFFICACY OF MODAFINIL IN 10 TAIWANESE PATIENTS WITH NARCOLEPSY: FINDINGS USING THE MULTIPLE SLEEP LATENCY TEST AND EPWORTH SLEEPINESS SCALE
EFFICACY OF MODAFINIL IN 10 TAIWANESE PATIENTS WITH NARCOLEPSY: FINDINGS USING THE MULTIPLE SLEEP LATENCY TEST AND EPWORTH SLEEPINESS SCALE Shih-Bin Yeh 1 and Carlos Hugh Schenck 2,3 1 Department of Neurology
More informationOnline Supplement. Relationship Between OSA Clinical Phenotypes and CPAP Treatment Outcomes
Relationship Between OSA Clinical Phenotypes and CPAP Treatment Outcomes Frédéric Gagnadoux, MD, PhD; Marc Le Vaillant, PhD; Audrey Paris, MD, PhD; Thierry Pigeanne, MD; Laurence Leclair-Visonneau, MD;
More informationObstructive Sleep Apnea in Truck Drivers
Rocky Mountain Academy of Occupational and Environmental Medicine Denver, Colorado February 6, 2010 Obstructive Sleep Apnea in Truck Drivers Philip D. Parks, MD, MPH, MOccH Medical Director, Lifespan Health
More informationOutcomes of Upper Airway Surgery in Obstructive Sleep Apnea
Original Research Outcomes of Upper Airway Surgery in Obstructive Sleep Apnea Hadiseh Hosseiny 1, Nafiseh Naeimabadi 1, Arezu Najafi 1 *, Reihaneh Heidari 1, Khosro Sadeghniiat-Haghighi 1 1. Occupational
More informationPolysomnography (PSG) (Sleep Studies), Sleep Center
Policy Number: 1036 Policy History Approve Date: 07/09/2015 Effective Date: 07/09/2015 Preauthorization All Plans Benefit plans vary in coverage and some plans may not provide coverage for certain service(s)
More informationWhat is the Role of Soft Palate Surgery in OSA?
What is the Role of Soft Palate Surgery in OSA? Edward M. Weaver, MD, MPH Seattle VA Medical Center University of Washington Harborview Medical Center Acknowledgments This material is the result of work
More informationEffect of two types of mandibular advancement splints on snoring and obstructive sleep apnoea
European Journal of Orthodontics 20 (1998) 293 297 1998 European Orthodontic Society Effect of two types of mandibular advancement splints on snoring and obstructive sleep apnoea J. Lamont*, D. R. Baldwin**,
More informationBrian Palmer, D.D.S, Kansas City, Missouri, USA. April, 2001
Brian Palmer, D.D.S, Kansas City, Missouri, USA A1 April, 2001 Disclaimer The information in this presentation is for basic information only and is not to be construed as a diagnosis or treatment for any
More informationTHE RISE AND FALL(?) OF UPPP FOR SLEEP APNEA COPYRIGHT NOTICE
THE RISE AND FALL(?) OF UPPP FOR SLEEP APNEA COPYRIGHT NOTICE Washington University grants permission to use and reproduce the The Rise and Fall(?) of UPPP for Sleep Apnea as it appears in the PDF available
More informationRoles of Surgery in OSA MASM Annual Fall Conference 2017 October 14, 2017 Kathleen Yaremchuk, MD, MSA Chair, Department of Otolaryngology/Head and
Roles of Surgery in OSA MASM Annual Fall Conference 2017 October 14, 2017 Kathleen Yaremchuk, MD, MSA Chair, Department of Otolaryngology/Head and Neck Surgery Senior Staff Sleep Medicine Henry Ford Hospital
More informationInspire Therapy for Sleep Apnea
Inspire Therapy for Sleep Apnea Patient Guide Giving You the FREEDOM TO SLEEP Like Everyone Else Take Comfort. Inspire therapy can help. Inspire therapy is a breakthrough implantable treatment option for
More informationSleep Apnea: Diagnosis & Treatment
Disclosure Sleep Apnea: Diagnosis & Treatment Lawrence J. Epstein, MD Sleep HealthCenters Harvard Medical School Chief Medical Officer for Sleep HealthCenters Sleep medicine specialty practice group Consultant
More informationEffects of Radiofrequency Versus Sham Surgery of the Soft Palate on Daytime Sleepiness
The Laryngoscope VC 2014 The American Laryngological, Rhinological and Otological Society, Inc. Effects of Radiofrequency Versus Sham Surgery of the Soft Palate on Daytime Sleepiness Thorbjorn Holmlund,
More informationTranssubmental tongue-base suspension in treating patients with severe obstructive sleep apnoea after failed uvulopalatopharyngoplasty:
CORRESPONDENCE: OUR EXPERIENCE Transsubmental tongue-base suspension in treating patients with severe obstructive sleep apnoea after failed uvulopalatopharyngoplasty: Our Experience Huang, T.-W.,* Su,
More informationEdward M. Weaver, MD, MPH. University of Washington VA Puget Sound
What is the Role of Soft Palate Surgery in OSA? Edward M. Weaver, MD, MPH University of Washington Harborview Medical Center VA Puget Sound Question: Should we do UPPP? Answer: Yes Role of Palate Surgery
More informationSleep Dentistry and Otolaryngology Head and Neck Surgery
MANAGEMENT OF SLEEP-DISORDERED BREATHING June 29 th 2013 Sleep Dentistry and Otolaryngology Head and Neck Surgery General Introduction: Sleep-disordered breathing (SDB) is a collective term which includes
More informationInspire Therapy for Obstructive Sleep Apnea. Clinical Data Update
Inspire Therapy for Obstructive Sleep Apnea For OSA patients unable to tolerate or get consistent benefit from CPAP Clinical Data Update Summary of published long-term 3-year outcomes data Treatment Goals
More informationNational Sleep Disorders Research Plan
Research Plan Home Foreword Preface Introduction Executive Summary Contents Contact Us National Sleep Disorders Research Plan Return to Table of Contents SECTION 5 - SLEEP DISORDERS SLEEP-DISORDERED BREATHING
More informationSLEEP APNOEA DR TAN KAH LEONG ALVIN CO-DIRECTOR SLEEP LABORATORY SITE CHIEF SDDC (SLEEP) DEPARTMENT OF OTORHINOLARYNGOLOGY, HEAD & NECK SURGERY
SLEEP APNOEA DR TAN KAH LEONG ALVIN CO-DIRECTOR SLEEP LABORATORY SITE CHIEF SDDC (SLEEP) DEPARTMENT OF OTORHINOLARYNGOLOGY, HEAD & NECK SURGERY
More informationDoes the dimple point represent the margin of soft palate musculature?
Asian Biomedicine Vol. 2 No. 5 October 2008;397-401 Brief Communication Does the dimple point represent the margin of soft palate musculature? Department of Otolaryngology, Faculty of Medicine, Chulalongkorn
More informationMaxillomandibular Advancement for Treatment of Obstructive Sleep Apnea: A Meta-analysis.
JAMA Otolaryngol Head Neck Surg. 06 Jan ;():8-66. doi: 0.00/jamaoto.0.678. Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea: A Meta-analysis. Zaghi S, Holty JE, Certal V, Abdullatif
More informationSleep Bruxism and Sleep-Disordered Breathing
Sleep Bruxism and Sleep-Disordered Breathing Author STEVEN D BENDER, DDS*, Associate Editor EDWARD J. SWIFT JR., DMD, MS Sleep bruxism (SB) is a repetitive jaw muscle activity with clenching or grinding
More informationReceived: 29 March 2015 /Revised: 22 May 2015 /Accepted: 29 June 2015 /Published online: 21 July 2015 # Springer-Verlag Berlin Heidelberg 2015
Sleep Breath (2016) 20:523 528 DOI 10.1007/s11325-015-1228-5 ORIGINAL ARTICLE Translation, cultural adaptation, and validation of the Sleep Apnea Quality of Life Index (SAQLI) in Persian-speaking patients
More informationInternet Journal of Medical Update
Internet Journal of Medical Update 2009 July;4(2):24-28 Internet Journal of Medical Update Journal home page: http://www.akspublication.com/ijmu Original Work EEG arousal prediction via hypoxemia indicator
More informationInspire. therapy for sleep apnea. Giving you the freedom to sleep like everyone else
Inspire therapy for sleep apnea Giving you the freedom to sleep like everyone else Take Comfort. Take Action. Inspire therapy can help. Here are some reasons people like you have chosen Inspire therapy
More informationPEDIATRIC SLEEP GUIDELINES Version 1.0; Effective
MedSolutions, Inc. Clinical Decision Support Tool Diagnostic Strategies This tool addresses common symptoms and symptom complexes. Requests for patients with atypical symptoms or clinical presentations
More informationJosé Haba-Rubio, MD; Jean-Paul Janssens, MD; Thierry Rochat, MD, PhD; and Emilia Sforza, MD, PhD
Rapid Eye Movement-Related Disordered Breathing* Clinical and Polysomnographic Features José Haba-Rubio, MD; Jean-Paul Janssens, MD; Thierry Rochat, MD, PhD; and Emilia Sforza, MD, PhD Objective: The existence
More informationSoft tissue hypopharyngeal surgery for obstructive sleep apnea syndrome
Oral Maxillofacial Surg Clin N Am 14 (2002) 371 376 Soft tissue hypopharyngeal surgery for obstructive sleep apnea syndrome B. Tucker Woodson, MD, FACS, ABSM Department of Otolaryngology and Human Communication,
More informationOvernight fluid shifts in subjects with and without obstructive sleep apnea
Original Article Overnight fluid shifts in subjects with and without obstructive sleep apnea Ning Ding 1 *, Wei Lin 2 *, Xi-Long Zhang 1, Wen-Xiao Ding 1, Bing Gu 3, Bu-Qing Ni 4, Wei Zhang 4, Shi-Jiang
More informationA New, Clinically Proven Sleep Apnea Therapy for people unable to use CPAP.
A New, Clinically Proven Sleep Apnea Therapy for people unable to use CPAP. Take Heart. If You Have OSA, You re Not Alone. Like you, more than 18 million Americans are estimated to have Obstructive Sleep
More informationThe Familial Occurrence of Obstructive Sleep Apnoea Syndrome (OSAS)
Global Journal of Respiratory Care, 2014, 1, 17-21 17 The Familial Occurrence of Obstructive Sleep Apnoea Syndrome (OSAS) Piotr Bielicki, Tadeusz Przybylowski, Ryszarda Chazan * Department of Internal
More informationObstructive sleep apnea (OSA) is the periodic reduction
Obstructive Sleep Apnea and Oxygen Therapy: A Systematic Review of the Literature and Meta-Analysis 1 Department of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto,
More informationIEHP considers the treatment of obstructive sleep apnea (OSA) medically necessary according to the criteria outlined below:
: Positive Airway Pressure, Oral Appliances, and Surgical Interventions Policy: Obstructive sleep apnea (OSA) is characterized by an interruption of breathing during sleep most commonly due to extra or
More informationInspire Therapy for Sleep Apnea
Inspire Therapy for Sleep Apnea Patient Guide Giving You the FREEDOM TO SLEEP Like Everyone Else Take Comfort. Inspire therapy can help. Inspire therapy is a breakthrough implantable treatment option for
More informationCorporate Medical Policy
Corporate Medical Policy PALATOPHARYNGOPLASTY/UVULOPALATOPHARYGOPLASTY Description of Procedure or Service Palatopharyngoplasty refers to several surgical approaches for management of the upper airway,
More informationEmerging Nursing Roles in Collaborative Management of Sleep Disordered Breathing and Obstructive Sleep Apnoea
Emerging Nursing Roles in Collaborative Management of Sleep Disordered Breathing and Obstructive Sleep Apnoea Sigma Theta Tau International 28th International Nursing Research Congress 27-31 July 2017
More information(To be filled by the treating physician)
CERTIFICATE OF MEDICAL NECESSITY TO BE ISSUED TO CGHS BENEFICIAREIS BEING PRESCRIBED BILEVEL CONTINUOUS POSITIVE AIRWAY PRESSURE (BI-LEVEL CPAP) / BI-LEVEL VENTILATORY SUPPORT SYSTEM Certification Type
More informationThe Mandibular Advancement Device and Patient Selection in the Treatment of Obstructive Sleep Apnea
ORIGINAL ARTICLE The Mandibular Advancement Device and Patient Selection in the Treatment of Obstructive Sleep Apnea Chul Hee Lee, MD; Ji-Hun Mo, MD; Ik-Joon Choi, MD; Hyun Jong Lee, MD; Beom Seok Seo,
More informationAssessment of a wrist-worn device in the detection of obstructive sleep apnea
Sleep Medicine 4 (2003) 435 442 Original article Assessment of a wrist-worn device in the detection of obstructive sleep apnea Najib T. Ayas a,b,c, Stephen Pittman a,c, Mary MacDonald c, David P. White
More informationSleep Studies: Attended Polysomnography and Portable Polysomnography Tests, Multiple Sleep Latency Testing and Maintenance of Wakefulness Testing
Portable Polysomnography Tests, Multiple Sleep Latency Testing and Maintenance of Wakefulness Testing MP9132 Covered Service: Yes when meets criteria below Prior Authorization Required: Yes as indicated
More informationSleep-disordered breathing (SDB) is a relatively common
The effect of tonsillectomy and adenoidectomy on inattention and impulsivity as measured by the Test of Variables of Attention (TOVA) in children with obstructive sleep apnea syndrome GALIT AVIOR, MD,
More informationTypes of Sleep Studies 8/28/2018. Ronald S. Prehn, ThM, DDS. Type 1 Attended in-lab polysomnography (PSG) 18 leads
Ronald S. Prehn, ThM, DDS rprehn@tmjtexas.com Board Certified in Dental Sleep Medicine Board Certified in Orofacial Pain Types of Sleep Studies Type 1 Attended in-lab polysomnography (PSG) 18 leads Type
More informationMethods of Diagnosing Sleep Apnea. The Diagnosis of Sleep Apnea: Questionnaires and Home Studies
Sleep, 19(10):S243-S247 1996 American Sleep Disorders Association and Sleep Research Society Methods of Diagnosing Sleep Apnea J The Diagnosis of Sleep Apnea: Questionnaires and Home Studies W. Ward Flemons
More informationFrequency-domain Index of Oxyhemoglobin Saturation from Pulse Oximetry for Obstructive Sleep Apnea Syndrome
Journal of Medical and Biological Engineering, 32(5): 343-348 343 Frequency-domain Index of Oxyhemoglobin Saturation from Pulse Oximetry for Obstructive Sleep Apnea Syndrome Liang-Wen Hang 1,2 Chen-Wen
More informationP revalence surveys have estimated that 4% of middle aged
483 ORIGINAL ARTICLE Independent validation of the Sleep Apnoea Quality of Life Index Y Lacasse, C Godbout, F Sériès... See end of article for authors affiliations... Correspondence to: Dr Y Lacasse, Centre
More informationUnderdiagnosis of Sleep Apnea Syndrome in U.S. Communities
ORIGINAL ARTICLE Underdiagnosis of Sleep Apnea Syndrome in U.S. Communities Vishesh Kapur, M.D., 1 Kingman P. Strohl, M.D., 2 Susan Redline, M.D., M.P.H., 3 Conrad Iber, M.D., 4 George O Connor, M.D.,
More informationTongue Coblation via the Ventral Approach for Obstructive Sleep Apnea Hypopnea Syndrome Surgery
The Laryngoscope VC 2012 The American Laryngological, Rhinological and Otological Society, Inc. Tongue Coblation via the Ventral Approach for Obstructive Sleep Apnea Hypopnea Syndrome Surgery Tiening Hou,
More information11/19/2012 ก! " Varies 5-86% in men 2-57% in women. Thailand 26.4% (Neruntarut et al, Sleep Breath (2011) 15: )
Snoring ก Respiratory sound generated in the upper airway during sleep that typically occurs during inspiration but may occur during expiration ICSD-2, 2005..... ก ก! Prevalence of snoring Varies 5-86%
More informationOutline. Major variables contributing to airway patency/collapse. OSA- Definition
Outline Alicia Gruber Kalamas, MD Associate Clinical Professor of Anesthesia & Perioperative Care University of California, San Francisco September 2011 Definition Pathophysiology Patient Risk Factors
More informationPORTABLE OR HOME SLEEP STUDIES FOR ADULT PATIENTS:
Sleep Studies: Attended Polysomnography and Portable Polysomnography Tests, Multiple Sleep Latency Testing and Maintenance of Wakefulness Testing MP9132 Covered Service: Prior Authorization Required: Additional
More informationMedicare C/D Medical Coverage Policy
Medicare C/D Medical Coverage Policy Surgical Treatment of Obstructive Sleep Apnea Origination: June 26, 2000 Review Date: January 18, 2017 Next Review January, 2019 DESCRIPTION OF PROCEDURE OR SERVICE
More informationTreatment of Obstructive Sleep Apnea (OSA)
MP9239 Covered Service: Prior Authorization Required: Additional Information: Yes when meets criteria below Yes as shown below None Prevea360 Health Plan Medical Policy: 1.0 A continuous positive airway
More informationKaniethapriya A.S, Ganesh Prasad S.
Original Article A Comparative Study of Effects of Oropharyngeal Exercises and Continuous Positive Airway Pressure (CPAP) on Parameters of Sleep on Moderate Obstructive Sleep Apnea Syndrome (OSAS) Patients
More informationQUESTIONS FOR DELIBERATION
New England Comparative Effectiveness Public Advisory Council Public Meeting Hartford, Connecticut Diagnosis and Treatment of Obstructive Sleep Apnea in Adults December 6, 2012 UPDATED: November 28, 2012
More informationObstructive Sleep Apnea
Obstructive Sleep Apnea by Barbara Phillips MD MSPH and Matthew T Naughton MD FRACP Epidemiology and risk factors 7 Clinical presentation 13 Medical complications 22 Diagnosis 40 Medical management 50
More informationLong-term outcomes of laser-assisted uvulopalatoplasty in 168 patients with snoring
The Journal of Laryngology & Otology (2006), 120, 932 938. # 2006 JLO (1984) Limited doi:10.1017/s002221510600209x Printed in the United Kingdom First published online 3 July 2006 Main Article Long-term
More informationA Reversible Uvulopalatal Flap for Snoring and Sleep Apnea Syndrome
Sleep, 19(7):593-599 1996 American Sleep Disorders Association and Sleep Research Society Short Report: Surgical Technique A Reversible Uvulopalatal Flap for Snoring and Sleep Apnea Syndrome Nelson Powell,
More informationInternational Journal of Scientific & Engineering Research Volume 9, Issue 1, January ISSN
International Journal of Scientific & Engineering Research Volume 9, Issue 1, January-2018 342 The difference of sleep quality between 2-channel ambulatory monitor and diagnostic polysomnography Tengchin
More informationWeb-Based Home Sleep Testing
Editorial Web-Based Home Sleep Testing Authors: Matthew Tarler, Ph.D., Sarah Weimer, Craig Frederick, Michael Papsidero M.D., Hani Kayyali Abstract: Study Objective: To assess the feasibility and accuracy
More informationSKUP 3 : 6 and 24 Months Follow-up of Changes in Respiration and Sleepiness After Modified UPPP
The Laryngoscope VC 2017 The American Laryngological, Rhinological and Otological Society, Inc. SKUP 3 : 6 and 24 Months Follow-up of Changes in Respiration and Sleepiness After Modified UPPP Nanna Browaldh,
More informationBipolar radiofrequency induced thermotherapy of the tongue base: its complications, acceptance and evectiveness under local anesthesia
Eur Arch Otorhinolaryngol (006) 63:03 040 DOI 0.007/s00405-006-05-x MISCELLANEOUS Bipolar radiofrequency induced thermotherapy of the tongue base: its complications, acceptance and evectiveness under local
More informationThe Epworth Sleepiness Scale (ESS) was developed by Johns
Clinical Reproducibility of the Epworth Sleepiness Scale Anh Tu Duy Nguyen, M.D. 1 ; Marc A. Baltzan, M.D., M.Sc. 1,2 ; David Small, M.D. 1 ; Norman Wolkove, M.D. 1 ; Simone Guillon, M.D. 3 ; Mark Palayew,
More informationObstructive Sleep Apnoea. Dr William Man Thoracic and Sleep Medicine, Harefield Hospital
Obstructive Sleep Apnoea Dr William Man Thoracic and Sleep Medicine, Harefield Hospital Obstructive Sleep Apnoea Common Condition (Syndrome) 3 7% of adult males, 2 5% females Prevalence expected to rise
More informationReview of self-reported instruments that measure sleep dysfunction in patients suffering from temporomandibular disorders and/or orofacial pain
Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2015 Review of self-reported instruments that measure sleep dysfunction in
More informationOutcome Measures in OSA Defining Our Treatment Goal. Defining common outcome metrics in OSA Al-Shawwa Sleep Med Rev 2008
Outcome Measures in OSA Defining Our Treatment Goal Disclosures Apnicure Minor stock holder sleep apnea device Siesta Medical Minor stock holder sleep apnea device Patent Pending 61/624,105 Sinus diagnostics
More informationSnoring and Its Outcomes
Disclosures None Snoring and Its Outcomes Jolie Chang, MD Otolaryngology, Head and Neck Surgery University of California, San Francisco February 14, 2014 Otolaryngology Head Outline Snoring and OSA Acoustics
More informationDiabetes & Obstructive Sleep Apnoea risk. Jaynie Pateraki MSc RGN
Diabetes & Obstructive Sleep Apnoea risk Jaynie Pateraki MSc RGN Non-REM - REM - Both - Unrelated - Common disorders of Sleep Sleep Walking Night terrors Periodic leg movements Sleep automatism Nightmares
More informationObesity, Weight Loss and Obstructive Sleep Apnea
Obesity, Weight Loss and Obstructive Sleep Apnea Gary D. Foster, Ph.D. Center for Obesity Research and Education Temple University School of Medicine Overview Sociocultural context Obesity: Prevalence
More informationSleep Disorders and the Metabolic Syndrome
Sleep Disorders and the Metabolic Syndrome Tom V. Cloward, M.D. Intermountain Sleep Disorders Center LDS Hospital Objectives Describe how sleep disorders impact your daily medical practice Don Don t do
More informationSleep Disordered Breathing
Sleep Disordered Breathing SDB SDB Is an Umbrella Term for Many Disorders characterized by a lack of drive to breathe Results n repetitive pauses in breathing with no effort Occurs for a minimum of 10
More informationA Deadly Combination: Central Sleep Apnea & Heart Failure
A Deadly Combination: Central Sleep Apnea & Heart Failure Sanjaya Gupta, MD FACC FHRS Ohio State University Symposium May 10 th, 2018 Disclosures Boston Scientific: fellowship support, speaking honoraria
More informationDevelopment of a self-reported Chronic Respiratory Questionnaire (CRQ-SR)
954 Department of Respiratory Medicine, University Hospitals of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK J E A Williams S J Singh L Sewell M D L Morgan Department of Clinical Epidemiology and
More informationIn-Patient Sleep Testing/Management Boaz Markewitz, MD
In-Patient Sleep Testing/Management Boaz Markewitz, MD Objectives: Discuss inpatient sleep programs and if they provide a benefit to patients and sleep centers Identify things needed to be considered when
More informationAssociation between Depression and Severity of Obstructive Sleep Apnea Syndrome
Original Article Association between Depression and Severity of Obstructive Sleep Apnea Syndrome Mojahede Salmani Nodoushan 1,2 and Farzaneh Chavoshi 3 1. Department of Occupational Medicine, Medical School,
More informationORIGINAL ARTICLE. Impact of Tonsillectomy and Adenoidectomy on Child Behavior
ORIGINAL ARTICLE Impact of Tonsillectomy and Adenoidectomy on Child Behavior Nira A. Goldstein, MD; J. Christopher Post, MD; Richard M. Rosenfeld, MD, MPH; Thomas F. Campbell, PhD Objective: To measure
More informationEfremidis George, Varela Katerina, Spyropoulou Maria, Beroukas Lambros, Nikoloutsou Konstantina, and Georgopoulos Dimitrios
Sleep Disorders Volume 2012, Article ID 324635, 5 pages doi:10.1155/2012/324635 Clinical Study Clinical Features and Polysomnographic Findings in Greek Male Patients with Obstructive Sleep Apnea Syndrome:
More informationMedicare CPAP/BIPAP Coverage Criteria
Medicare CPAP/BIPAP Coverage Criteria For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment
More informationInfluence of upper airways section area on oxygen blood saturation level in patients with obesity and sleep apnea syndrome
Influence of upper airways section area on oxygen blood saturation level in patients with obesity and sleep apnea syndrome Poster No.: P-0028 Congress: ESCR 2015 Type: Scientific Poster Authors: E. Butorova,
More informationRespiratory/Sleep Disordered Breathing. William Walker, MD, Chair Iris Perez, MD
Respiratory/Sleep Disordered Breathing William Walker, MD, Chair Iris Perez, MD Definitions SDB is highly prevalent, under recognized, under reported and under treated Central Central sleep apnea (CSA)
More information