Obstructive Sleep Apnea (OSA)
Conditions
Keywords
sleep apnea syndromes, polysomnography, home sleep apnea testing
Brief summary
The primary objective of this project is to compare a health care delivery model, Direct Referral for Apnea Monitoring (DREAM), with initial in-person (Traditional) clinic appointments for Veterans at risk for obstructive sleep apnea (OSA). A secondary objective is to determine the negative predictive value (NPV) of home sleep apnea testing (HSAT).
Detailed description
Patients referred to one of 3 participating VA sleep medicine clinics (San Francisco VA, VA Portland or VA Pittsburgh) for OSA will be assigned either to the Traditional clinical pathway (which might include an initial encounter with a sleep care provider through in-person visits, telephone clinics, or video conferencing) or the DREAM pathway which will omit the initial encounter with a care provider. After a clinician conducts a chart review of medical records, patients in the DREAM pathway will be referred for sleep testing. All patients will be tracked from the time of referral until 90-days past the initiation of treatment. To determine the NPV of HSAT, results of sleep tests will be compared for patients who undergo both HSAT and polysomnographic (PSG) procedures. Concurrent PSG and HSAT studies will be done at Portland, Pittsburgh, and San Francisco.
Interventions
None listed
Sponsors
VA Office of Research and Development
San Francisco Veterans Affairs Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Age 18 years Agrees to be seen by a VA sleep program Reason for referral to sleep clinic: New OSA Evaluation
Exclusion criteria
Age \< 18 years Declines to be seen by a VA sleep program Reason for referral to sleep clinic: anything other than a new OSA evaluation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time from referral | 1 year | For Arms 1 \& 2: Compare time from referral to sleep testing and treatment of OSA |
| PAP adherence | 1 year | For Arms 1 \& 2: PAP treatment adherence (for example, Percentage of days with usage \>= 4 hours) between Traditional and DREAM clinical pathways |
| AHI scores | 4 years | For Arm 3: Compare apnea-hypopnea index (AHI) scores between HSAT and PSG procedures |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORKathleen Fumiko Sarmiento, MD MPH
San Francisco VA Medical Center, San Francisco, CA
Outcome results
None listed