Awareness Level of Obstructive Sleep Apnea Syndrome During Routine Unstructured Interviews of a Standardized Patient by Primary Care Physicians

Reuveni, Haim; Tarasiuk, Ariel; Wainstock, Tamar; Ziv, Amitai; Elhayany, Asher; Tal, Asher

doi:10.1093/sleep/27.8.1518

Cited by 90 publications

(71 citation statements)

References 36 publications

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“…Some previous studies have cited a lack of understanding of OSA among primary care physicians, 27 but we do not believe that this is true in our practice. According to OSAKA data, our physicians were highly knowledgeable about OSA, and most expressed confidence in their ability to identify and manage patients.…”

Section: Discussionmentioning

confidence: 67%

Identifying Patients at Risk for Obstructive Sleep Apnea in a Primary Care Practice

Grover¹,

Mookadam²,

Armas³

et al. 2011

The Journal of the American Board of Family Medicine

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Purpose: The purpose of this study was to determine (1) whether our review of systems (ROS) form facilitates identification of sleep complaints; (2) how frequently department physicians investigate these sleep complaints; (3) the prevalence of our family practice patients at increased risk for obstructive sleep apnea (OSA); and (4) how well ROS responses function as diagnostic tests to identify OSA risk.Methods: We used a prospectively collected sample of consecutive adult patients undergoing preventive examinations at 2 family medicine clinics. Patients completed ROS forms and the Berlin Questionnaire to determine OSA risk level. Physicians at only one site used ROS forms during care.Results: Two hundred forty-nine of 382 eligible patients (65%) completed forms and underwent examinations. Thirty-seven percent responded positively to sleep-related ROS questions. Physicians documented 24% of those complaints. ROS form use affected documentation (31% with use vs 5% without; P ‫؍‬ .03). Thirty-three percent of all patients had increased OSA risk. Fifty-seven percent of high-risk patients responded affirmatively to an ROS question as opposed to 27% for those at lower risk (P < .001). ROS responses were 57% sensitive and 73% specific for increased OSA risk.Conclusions: Sleep symptoms were common and were recognized significantly more often when our physicians used a ROS form. However, few complaints were investigated.

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Section: Discussionmentioning

confidence: 67%

Identifying Patients at Risk for Obstructive Sleep Apnea in a Primary Care Practice

Grover¹,

Mookadam²,

Armas³

et al. 2011

The Journal of the American Board of Family Medicine

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“…48 Reliable snoring reporting cannot be made based solely on a patient's (or partner's) history of noisy respiration during sleep, 12,14,16 or sleep laboratory technician reports 14 ; a large portion of the subjects respond that they "do not know" if they snore. 49 The need for an agreed-upon approach to extract and analyze whole-night snoring sounds is of major importance to the field of sleep disordered breathing.…”

Section: Discussionmentioning

confidence: 99%

Breathing and Snoring Sound Characteristics during Sleep in Adults

Levartovsky

Dafna

Zigel

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Sound level meter is the gold standard approach for snoring evaluation. Using this approach, it was established that snoring intensity (in dB) is higher for men and is associated with increased apnea-hypopnea index (AHI). In this study, we performed a systematic analysis of breathing and snoring sound characteristics using an algorithm designed to detect and analyze breathing and snoring sounds. The effect of sex, sleep stages, and AHI on snoring characteristics was explored. Methods: We consecutively recruited 121 subjects referred for diagnosis of obstructive sleep apnea. A whole night audio signal was recorded using noncontact ambient microphone during polysomnography. A large number (> 290,000) of breathing and snoring (> 50 dB) events were analyzed. Breathing sound events were detected using a signal-processing algorithm that discriminates between breathing and nonbreathing (noise events) sounds. Results: Snoring index (events/h, SI) was 23% higher for men (p = 0.04), and in both sexes SI gradually declined by 50% across sleep time (p < 0.01) independent of AHI. SI was higher in slow wave sleep (p < 0.03) compared to S2 and rapid eye movement sleep; men have higher SI in all sleep stages than women (p < 0.05). Snoring intensity was similar in both genders in all sleep stages and independent of AHI. For both sexes, no correlation was found between AHI and snoring intensity (r = 0.1, p = 0.291).Conclusions: This audio analysis approach enables systematic detection and analysis of breathing and snoring sounds from a full night recording. Snoring intensity is similar in both sexes and was not affected by AHI.

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“…Reuveni and colleagues discussed the need for educational programs to increase awareness among family physicians of the signs of obstructive sleep apnea. 111 Such programs will likely increase testing, optimize the use of diagnostic resources and expedite treatment. [112][113][114] Our findings confirm those of previous reviews, health technology assessments and clinical practice guidelines based on earlier evidence of portable monitor use in the diagnosis of sleepdisordered breathing.…”

Section: E48mentioning

confidence: 99%

Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis

Shayeb

Topfer

Stafinski

et al. 2013

CMAJ

187

104

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Awareness Level of Obstructive Sleep Apnea Syndrome During Routine Unstructured Interviews of a Standardized Patient by Primary Care Physicians

Abstract: Increased awareness level of obstructive sleep apnea syndrome among primary care physicians, through publications and educational programs, monitored by standardized patients.

Cited by 90 publications

References 36 publications

Identifying Patients at Risk for Obstructive Sleep Apnea in a Primary Care Practice

Identifying Patients at Risk for Obstructive Sleep Apnea in a Primary Care Practice

Breathing and Snoring Sound Characteristics during Sleep in Adults

Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis

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