The Past Is Prologue: The Future of Sleep Medicine

Watson, Nathaniel F.; Rosen, Ilene M.; Chervin, Ronald D.

doi:10.5664/jcsm.6406

Cited by 80 publications

(36 citation statements)

References 41 publications

(40 reference statements)

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“…In-person models of treatment delivery may not be feasible or sustainable for individuals who need to travel great distances or who lack convenient access to transportation. Further, while the vast majority of sleep specialists reside in densely populated regions, there is an overflow of demand for their services (Flemons et al, 2004; Thomas et al, 2016; Watson et al, 2017). Thus, an online insomnia intervention may also be a viable option for those who live in relatively densely populated areas but are unable to see a sleep specialist.…”

Section: Discussionmentioning

confidence: 99%

A secondary analysis of the role of geography in engagement and outcomes in a clinical trial of an efficacious Internet intervention for insomnia

Chow

Gonzalez

Ingersoll

et al. 2019

Internet Interventions

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BackgroundOnline interventions for insomnia can increase access to treatments for those with limited access to services. What remains unknown is whether individuals from more isolated (vs. more densely populated) regions engage with, and benefit as much from, an online intervention. This secondary analysis examined the relationship of geographical indices with engagement and outcomes of an efficacious, fully automated online cognitive behavioral therapy for insomnia (CBT—I) program (Sleep Healthy Using the Internet-SHUTi).Method303 participants (Mage = 43.3; SD = 11.6) were randomly assigned to SHUTi or an online patient education condition and assessed at baseline and post intervention. Rural code of participants was determined using participant zip codes. Distance to the nearest sleep medicine provider was calculated as the distance between the center of the nearest provider's city (from a publicly available list of CBT-I providers) and the center of the participants' zip code. Adherence outcomes were number of intervention core completions, sleep diaries, and logins. Sleep outcomes were insomnia severity as well as sleep onset latency and wake after sleep onset derived from online sleep diaries.ResultsIndividuals were from a range of geographic locations. Most lived in fairly densely populated areas; however, there was a large variation in distance to the nearest sleep medicine provider. Findings indicate that the efficacy, adherence, and engagement with SHUTi were not impacted by where people lived. Controlling for age and gender did not impact any of the relationships among geography variables (i.e., distance, ruralness) and adherence or sleep related outcomes.ConclusionsInternet interventions must demonstrate that they can overcome obstacles posed by geography. This is the first study to examine the geographic location of participants and its association with engagement with, and outcomes of, online CBT-I.

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Section: Discussionmentioning

confidence: 99%

A secondary analysis of the role of geography in engagement and outcomes in a clinical trial of an efficacious Internet intervention for insomnia

Chow

Gonzalez

Ingersoll

et al. 2019

Internet Interventions

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“…Même si la médecine du sommeil ou somnologie appartient de prime abord aux neurosciences cliniques, il s'agit d'une sous-spécialisation médicale de nature transdisciplinaire (figure 4), nécessitant des compétences bien définies tant au niveau européen qu'au niveau international [12][13][14][15] . En Belgique, la médecine du Hypnogramme résumant les stades et phases de sommeil (en ordonnée) à travers le temps en heures (en abscisse), chez un sujet adulte normal avec 5 cycles " NREM (sommeil lent) -REM (sommeil paradoxal) ".…”

Section: La Somnologie Ou Medecine Du Sommeilunclassified

Medical indications of polysommnography in clinical practice

et al. 2020

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While combining specific brain activities, sleep actively interacts with many central and peripheral systems and body functions. Hence, sleep disorders often present as chronic and comorbid conditions. Given the ubiquity of sleep-related complaints in clinical practice, it appears that sleep disorders can be suspected by a wide range of medical practitioners. This is particularly true for specialists treating patients with chronic and/or comorbid clinical conditions (i.e. internistic disciplines, neurology, psychiatry, physical medicine, ENT and general practitioners). In addition, given that our patients are sometimes unnecessarily conveyed between care providers, it seems appropriate to remind the practical interests and clinical indications of polysomnography.

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“…Within-trial sleep-related costs were lower in the primary care group, but the study did not assess indirect costs or potential long-term costs. In a recent special article, the AASM Board of Directors outlined a five-point comprehensive plan to confront workforce challenges including “growing sleep fellowship programs, exploring novel sleep medicine training opportunities, creating and fostering the sleep team (with special emphasis on engagement of primary care providers), embracing the role of consumer sleep technologies, and expanding the reach of sleep specialists through telemedicine” [95].…”

Section: Applying a Patient-centered Care Approach In Osa (See Table 1)mentioning

confidence: 99%

Patient-centered care in obstructive sleep apnea: A vision for the future

Hilbert

Yaggi

2018

Sleep Medicine Reviews

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Obstructive sleep apnea is a common condition, with multiple potential neurocognitive, cardiovascular, and metabolic consequences. Efficacious treatment is available, but patient engagement is typically required for treatment to be effective. Patients with sleep apnea are phenotypically diverse and have individual needs, preferences, and values that impact treatment decisions. There has been a shift in obstructive sleep apnea management from diagnosis to chronic care management. Making treatment decisions that incorporate an individual patient's values and preferences and are personalized for that patient's biology has the potential to improve patient outcomes. A patient-centered care approach in obstructive sleep apnea is reviewed including 1) determining patient-specific needs to guide treatment decisions, 2) understanding patient values, preferences, and other factors impacting treatment decisions and using shared decision-making, 3) enhancing patient education and support to improve treatment adherence, 4) promoting patient engagement, 5) optimizing care coordination, continuity of care, and access to care, and 6) determining and assessing patient-centered outcomes.

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The Past Is Prologue: The Future of Sleep Medicine

Cited by 80 publications

References 41 publications

A secondary analysis of the role of geography in engagement and outcomes in a clinical trial of an efficacious Internet intervention for insomnia

A secondary analysis of the role of geography in engagement and outcomes in a clinical trial of an efficacious Internet intervention for insomnia

Medical indications of polysommnography in clinical practice

Patient-centered care in obstructive sleep apnea: A vision for the future

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