The National Veteran Sleep Disorder Study: Descriptive Epidemiology and Secular Trends, 2000–2010

Alexander, Melannie; Ray, Meredith; Hébert, James R.; Youngstedt, Shawn D.; Zhang, Hongmei; Steck, Susan E.; Bogan, Richard; Burch, James B.

doi:10.5665/sleep.5972

Cited by 159 publications

(138 citation statements)

References 89 publications

(114 reference statements)

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“…In April 2015, the Veterans Health Administration (VA) approved the use of HGNS for the nine million veterans receiving health care in the VA system . This decision was based on research indicating a steadily increasing incidence of OSA in US veterans; most recent estimates show that the prevalence of OSA among veterans treated in the VA system ranges from 3% to 8% .…”

Section: Introductionmentioning

confidence: 99%

Hypoglossal Nerve Stimulator Outcomes for Patients Outside the U.S. FDA Recommendations

et al. 2019

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Objectives The hypoglossal nerve stimulator (HGNS) is currently approved for the treatment of obstructive sleep apnea (OSA) in patients with an apnea‐hypopnea index (AHI) of >15 to ≤65 events/hour, and a central apnea index (CAI) <25% of the AHI, no complete concentric collapse on drug‐induced sleep endoscopy, and a recommended body mass index (BMI) <32 kg/m2. We present 18 patients implanted as a salvage procedure despite being outside these guidelines. Methods We included all patients who underwent HGNS but who did not meet all FDA guidelines. Demographic data, previous OSA treatments, polysomnographic (PSG) parameters from baseline and HGNS titration PSG, Epworth sleepiness score (ESS), and BMI were compared before and after surgery. Results Eighteen patients were identified: 94.4% male, median age 63 years. Seven underwent previous sleep surgery. Four had an AHI <15 (mean 10.5 events/hour), four had an AHI >65 (mean 86.9 events/hour), two had an elevated CAI (mean 31.3% of AHI), and 12 had a BMI >32 kg/m2 (range 32.1–39.1). Median AHI decreased from 25.3 to 3.75 events/hour on titration polysomnography (P = .0006), oxyhemoglobin saturation nadir increased from 82% to 88.5% (P = .0001) and median ESS dropped from 11 to 7.5 (P = .0016). Fifteen (83.3%) patients achieved surgical success (decrease in AHI >50% and AHI <20 events/hour) and 12 (66.7%) had an AHI <5 events/hour. Neither patient with CAI >25% was successfully treated. Median adherence = 33.5 hours/week. Conclusion Our success rate for patients outside the Food and Drug Administration guidelines for HGNS (67%) was similar to the 1‐year STAR trial results (66%). Future studies are necessary to consider expansion of these guidelines. Level of Evidence 4 Laryngoscope, 130:866–872, 2020

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Section: Introductionmentioning

confidence: 99%

Hypoglossal Nerve Stimulator Outcomes for Patients Outside the U.S. FDA Recommendations

et al. 2019

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“…Since 2011, Hughes, Jouldjian, Washington, Alessi, and Martin (2013) have reported that women veterans with insomnia have higher rates of posttraumatic stress disorder, and a recent publication based on the Women’s Health Initiative reported that women veterans had similar overall rates of insomnia compared with nonveteran women (30.5% vs. 30.8%, respectively), but women veterans had higher risk for insomnia co-occurring with sleep apnea risk factors (Rissling et al, 2016). Recently, changes in rates of diagnosed sleep disorders among more than 9,000,000 VA users was described by Alexander et al (2016). Rates of diagnosed insomnia differed between men and women who receive VA care; however, these differences were not consistent across fiscal years.…”

mentioning

confidence: 99%

Estimated Prevalence of Insomnia among Women Veterans: Results of a Postal Survey

Martin

Schweizer

Hughes

et al. 2017

Women's Health Issues

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Objectives Insomnia is a significant public health concern known to particularly impact women and the veteran population; however, rates of insomnia disorder among women veterans are not known. Method Women veterans who had received health care at VA Greater Los Angeles Healthcare System between 2008 and 2010 and resided within 25 miles of the facility were sent a postal survey assessing sleep, demographics, and other related patient characteristics. Results A total of 660 women (43.1% of potential responders) returned the postal survey and provided sufficient information for insomnia diagnosis. On average, women reported 6.2 hours of sleep per night. The prevalence of insomnia, determined according to diagnostic criteria from the International Classification of Sleep Disorders-2, was 52.3%. Women with insomnia reported more severely disturbed sleep, and more pain, menopausal symptoms, stress/worries, and nightmares compared with women without insomnia. There was a quadratic relationship between age and insomnia with women in their mid-40s, most likely to have insomnia. Conclusions This survey study found that insomnia symptoms were endorsed by more than one-half of the women veterans in this sample of VA users, highlighting the critical need for enhanced clinical identification and intervention. Further research is needed to establish national rates of insomnia among women veterans and to improve access to evidence-based treatment of insomnia disorder.

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“…At-home sleep monitoring may useful in detecting previously undetected sleep apnea and thereby facilitate its treatment. Assessing insomnia and apnea in Veterans is particularly crucial given recent documentation that over the decade from 2000-2010, sleep disorder prevalence rose 6-fold in those seeking care in Veteran's Administration (VA) facilities 3 .…”

Section: Sleep Disorders In Veteransmentioning

confidence: 99%

Detecting the Undiagnosed: Findings on Sleep Apnea Identification in Veterans With Insomnia Using at-Home Sleep Monitor Technology

Reilly¹,

Petrakis²,

Pigeon³

et al. 2017

iproc

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The National Veteran Sleep Disorder Study: Descriptive Epidemiology and Secular Trends, 2000–2010

Abstract: A commentary on this article appears in this issue on page 1331.

Cited by 159 publications

References 89 publications

Hypoglossal Nerve Stimulator Outcomes for Patients Outside the U.S. FDA Recommendations

Hypoglossal Nerve Stimulator Outcomes for Patients Outside the U.S. FDA Recommendations

Estimated Prevalence of Insomnia among Women Veterans: Results of a Postal Survey

Detecting the Undiagnosed: Findings on Sleep Apnea Identification in Veterans With Insomnia Using at-Home Sleep Monitor Technology

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