Can primary care providers manage obstructive sleep apnea?

Chai-Coetzer, Ching Li; Redman, Sally; McEvoy, R. Doug

doi:10.5664/jcsm.8990

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…As a result, assessment, referral and management of OSA in many countries is now shared between sleep specialists, respiratory physicians, cardiologists and GPs [ 31 ]. Thus, although primary care models of OSA care and service delivery will differ between countries (and maybe even within the same country), successful initiation and efficacy of CPAP therapy is likely to require strong support and established networks with existing specialist sleep services [ 30 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another factor significantly related to continuation of CPAP after therapy resumption in the current analysis was device prescription by a pulmonologist versus a general practitioner, and continuation of CPAP also tended to be better when CPAP was prescribed by a cardiologist versus general practitioner. Again, these findings are clinically relevant because the high and increasing demand for OSA care has exceeded the capacity of specialist sleep services [30,31]. There are several factors that might impact on the management of OSA in primary care, including limited access to specialist support and lack of clarity around roles for different healthcare providers [32].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, although primary care models of OSA care and service delivery will differ between countries (and maybe even within the same country), successful initiation and efficacy of CPAP therapy is likely to require strong support and established networks with existing specialist sleep services [30,34].…”

Section: Discussionmentioning

confidence: 99%

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CPAP resumption after a first termination and impact on all-cause mortality in France

Pépin,

Tamisier,

Benjafield

et al. 2023

Eur Respir J

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Continuation of continuous positive airway pressure (CPAP) therapy after initial prescription has been shown to reduce all-cause mortalityversustherapy termination. However, there is a lack of data on the rates and impact of resuming CPAP in patients with obstructive sleep apnea (OSA). This analysis determined the prevalence of CPAP resumption in the year after termination, characterized determinants of CPAP resumption, and examined the impact of CPAP resumption on all-cause mortality.French national health insurance reimbursement system data for adults aged ≥18 years were used. CPAP prescription was identified by specific treatment codes. Patients who resumed CPAP after first therapy termination and continued to use CPAP for 1 year were matched with those who resumed CPAP then terminated therapy for a second time.Of 103 091 individuals with a first CPAP termination, 26% resumed CPAP over the next 12 months, and 65% of these were still using CPAP 1 year later. Significant predictors of CPAP continuation after resumption included male sex, hypertension and CPAP prescription by a pulmonologist. In the matched population, the risk of all-cause death was 38% lower in individuals who continued using CPAP after therapy resumptionversusthose who had a second therapy discontinuation (hazard ratio 0.62, 95% confidence interval 0.48–0.79; p=0.0001).These data suggest that individuals with OSA who fail initial therapy with CPAP should be offered a second trial with the device to ensure that effective therapy is not withheld from those who might benefit.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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CPAP resumption after a first termination and impact on all-cause mortality in France

Pépin,

Tamisier,

Benjafield

et al. 2023

Eur Respir J

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Examining changes in knowledge and practice in nurse practitioners after an online educational module on obstructive sleep apnea

Pietras

Richards

Ding

et al. 2023

Applied Nursing Research

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COVID-19 Vaccine Could Trigger the Relapse of Secondary Hypersomnia

Wu¹,

Li²,

Xue³

et al. 2021

NSS

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The coronavirus disease (COVID-19) has brought significant social and economic disruptions and devastating impacts on public health, and vaccines are being developed to combat the disease. Timely vaccination may prevent complications and morbidity but may also potentially result in unforeseen outcomes in some special clinical populations. We report on a case of hypersomnia relapse after the COVID-19 vaccination, with the aim of informing the development of the guideline on vaccination in specific groups. A 19-year old female presented with persistent daytime sleepiness after receiving the COVID-19 vaccine. She had a known history of hypersomnia secondary to infectious mononucleosis but has fully recovered for 8 months. A series of examinations were performed on this patient. Neurologic and psychiatric examinations were unremarkable. Despite normal nocturnal subjective sleep quality (Pittsburgh Sleep Quality Index score = 5, Insomnia Severity Index score = 7), her Epworth sleepiness scale score (15) suggested an abnormal level of subjective sleepiness. Consistent with the subjective report, the objective assessment by Multiple Sleep Latency Test found mean sleep latency was 1.3 min with no sleep onset rapid-eye-movement (REM) period. We speculate that COVID-19 vaccine may potentially trigger the relapse of hypersomnia. The immune memory could be an explanation for the increased response to vaccine in patients with secondary hypersomnia. Caution should be warranted when administering COVID-19 vaccine in patients with hypersomnia secondary to infections.

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Can primary care providers manage obstructive sleep apnea?

Cited by 6 publications

References 14 publications

CPAP resumption after a first termination and impact on all-cause mortality in France

CPAP resumption after a first termination and impact on all-cause mortality in France

Examining changes in knowledge and practice in nurse practitioners after an online educational module on obstructive sleep apnea

COVID-19 Vaccine Could Trigger the Relapse of Secondary Hypersomnia

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