Tailored Treatment to Enhance Risk Perception in Sleep Apnea
| Status: | Recruiting |
|---|---|
| Conditions: | Insomnia Sleep Studies, Pulmonary, Pulmonary |
| Therapuetic Areas: | Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 21 - 80 |
| Updated: | 4/2/2016 |
| Start Date: | October 2014 |
| End Date: | April 2019 |
| Contact: | Ann Depew, LPC |
| Email: | DepewA@NJHealth.org |
| Phone: | 303-398-1149 |
Tailored Treatment to Enhance Risk Perception in Sleep Apnea.
Obstructive Sleep Apnea (OSA) is seen in approximately 6% of Americans. It is a serious
medical condition with significant medical and psychological consequences, including
diabetes, hypertension, and cardiovascular disease. The treatment of choice for OSA is
Positive Airway Pressure therapy (PAP). PAP supplies positive pressure to the upper airway
creating a "pneumatic splint" to keep the airway open during sleep. Adherence to PAP is
notoriously low, with as few as 50% reaching minimal guidelines for adherence. One
comprehensive review of adherence research found that adherence to PAP was less than that
for any other medical disorder. The problem of adherence is significant not only because of
the medical consequences that can ensue, but also because third party payers have begun to
refuse to pay for PAP therapy when adherence is less than optimal, even in the face of
clinical improvement. This is a critical time to address this problem.
This research study is designed to identify methods that may help people respond to PAP, the
most common therapy for OSA. Identifying these methods may be an important way to better
care for patients with obstructive sleep apnea. With this research, the investigators hope
to find ways to help people have a better response to treatment and a better quality of
life.
medical condition with significant medical and psychological consequences, including
diabetes, hypertension, and cardiovascular disease. The treatment of choice for OSA is
Positive Airway Pressure therapy (PAP). PAP supplies positive pressure to the upper airway
creating a "pneumatic splint" to keep the airway open during sleep. Adherence to PAP is
notoriously low, with as few as 50% reaching minimal guidelines for adherence. One
comprehensive review of adherence research found that adherence to PAP was less than that
for any other medical disorder. The problem of adherence is significant not only because of
the medical consequences that can ensue, but also because third party payers have begun to
refuse to pay for PAP therapy when adherence is less than optimal, even in the face of
clinical improvement. This is a critical time to address this problem.
This research study is designed to identify methods that may help people respond to PAP, the
most common therapy for OSA. Identifying these methods may be an important way to better
care for patients with obstructive sleep apnea. With this research, the investigators hope
to find ways to help people have a better response to treatment and a better quality of
life.
Inclusion Criteria:
- PSG confirmed diagnosis of OSA
- choice of PAP as preferred treatment
- judged by sleep physicians to be responders to PAP
- participants will be considered responders to PAP if they have an AHI of less than 5,
do not snore, and have an arousal index of less than 10 when titrated to the proper
pressure of PAP
Exclusion Criteria:
- AHI < 15 on the diagnostic PSG and no daytime functional symptoms or associated
cardiovascular disease
- a sleep disorder other than OSA that causes arousals from sleep (e.g., periodic limb
movements, restless legs syndrome, insomnia)
- a current substance abuse problem
- a serious sleep-disruptive medical condition (e.g., end stage renal failure, severe
COPD, severe asthma)
- significant global cognitive impairment
- history of or current diagnosis of psychosis, bipolar disorder, or borderline,
schizotypal or antisocial personality disorder, and uncontrolled depression or
suicidal ideation
- change in antidepressant medications over the past 3 months
- women pregnant women, breast feeding, or planning on becoming pregnant
- currently enrolled in another research study
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