Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
-
Randomized Controlled Trial Multicenter Study
Long-term use of a nasal expiratory positive airway pressure (EPAP) device as a treatment for obstructive sleep apnea (OSA).
Evaluate the long-term durability of treatment response and safety of a nasal expiratory positive airway pressure (EPAP) device used to treat obstructive sleep apnea (OSA). ⋯ NCT00849043.
-
Comparative Study
Comparison of adjustable and fixed oral appliances for the treatment of obstructive sleep apnea.
To compare the efficacy of adjustable and fixed oral appliances for the treatment of OSA. ⋯ Adjustable devices produced greater reductions in obstructive events and were more likely to provide successful therapy, especially in moderate-severe OSA. Fixed appliances were effective in mild disease, but were less successful in those with higher AHIs. Given these findings, the baseline AHI should be considered when selecting the type of oral appliance.
-
Various models and questionnaires have been developed for screening specific populations for obstructive sleep apnea (OSA) as defined by the apnea/hypopnea index (AHI); however, almost every method is based upon dichotomizing a population, and none function ideally. We evaluated the possibility of using the STOP-Bang model (SBM) to classify severity of OSA into 4 categories ranging from none to severe. ⋯ The STOP-Bang model may be useful to categorize OSA severity, triage patients for diagnostic evaluation or exclude from harm.
-
Given the pathogenesis of obstructive sleep apnea (OSA), anesthesiologists may be in a unique position to rapidly identify patients who are at risk for undiagnosed OSA in the perioperative period. Identification is the first step in prompt diagnosis and potential prevention of OSA related comorbidities. Patients who exhibit unanticipated difficult mask ventilation (DMV) during induction of general anesthesia may be at risk of having undiagnosed OSA. ⋯ In this study, difficult mask ventilation was predictive of undiagnosed OSA. Anesthesiologists may be in a unique position to identify patients at risk for OSA and prevention of related comorbidities.
-
Multicenter Study Comparative Study
Identification of patients with sleep disordered breathing: comparing the four-variable screening tool, STOP, STOP-Bang, and Epworth Sleepiness Scales.
The Epworth Sleepiness Scale (ESS) has been used to detect patients with potential sleep disordered breathing (SDB). Recently, a 4-Variable screening tool was proposed to identify patients with SDB, in addition to the STOP and STOP-Bang questionnaires. This study evaluated the abilities of the 4-Variable screening tool, STOP, STOP-Bang, and ESS questionnaires in identifying subjects at risk for SDB. ⋯ In community populations such as the SHHS, high specificities may be more useful in excluding low-risk patients, while avoiding false positives. However, sleep clinicians may prefer to use screening tools with high sensitivities, like the STOP-Bang, in order to avoid missing cases that may lead to adverse health consequences and increased healthcare costs.