Diagnostic criteria for obstructive sleep apnea: time for reappraisal

McNicholas, Walter T.

doi:10.21037/jtd.2017.12.91

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…There is also little evidence that treating patients with mild OSA (based on AHI) or patients with low sleepiness is useful in preventing cardiovascular disease or incidents 24–27. In the past few years there has therefore been international discussion regarding new approaches to diagnose ‘clinically relevant’ OSA 28 29. This discussion has also made its way into recent Dutch guidelines for OSA, in which it is recommended that there should be a greater focus on the presence of potentially related comorbidities, as well as the experienced burden of disease for individual patients.…”

Section: Introductionmentioning

confidence: 99%

Does the Patient-Reported Apnea Questionnaire (PRAQ) increase patient-centredness in the daily practice of sleep centres? a mixed-methods study

Abma

Rovers

IJff³

et al. 2019

BMJ Open

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ObjectivesThe objective of this exploratory study was to see how the Patient-Reported Apnea Questionnaire (PRAQ) may impact the daily clinical practice of sleep centres, and why it may or may not work as expected. The hypotheses were tested that this patient-reported outcome measure makes patients more aware of which of their health complaints may be related to obstructive sleep apnoea (OSA), and that it improves patient-centredness of care by shifting the focus of care away from (only) medical problems towards the individual burden of disease and quality of life.DesignMixed methods. The quantitative study (surveys, patient records) was a before-and-after study.SettingThree sleep centres in The Netherlands (secondary care).Participants27 patients and 14 healthcare professionals were interviewed. 487 patients completed surveys pre-implementation, and 377 patients completed surveys post-implementation of the PRAQ. For the health records, 125 patients were included in the pre-implementation group, and 124 other patients in the post-implementation group.InterventionsThe PRAQ was used in clinical practice for six successive months.Outcome measuresScores on individual survey items, number of patients receiving non-medical treatment, adjustment of treatment at first follow-up, compliance with treatment.ResultsPatients were generally positive about the usefulness of the PRAQ before and during the consultation, as they felt more informed. Healthcare providers did not consider the PRAQ very useful, and they reported minor impact on their consultations. The surveys and health record study did not show an impact of the PRAQ on clinical practice.ConclusionsImplementing the PRAQ may be beneficial to patients, but this study does not show much impact with regard to patient-centredness of care. New Dutch guidelines for OSA care may lead to a greater emphasis on quality of life and value of care for patients, making its integration in clinical care potentially more useful.

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Section: Introductionmentioning

confidence: 99%

Does the Patient-Reported Apnea Questionnaire (PRAQ) increase patient-centredness in the daily practice of sleep centres? a mixed-methods study

Abma

Rovers

IJff³

et al. 2019

BMJ Open

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“…A patient with a severe case of OSA may experience 30 to 60 episodes of breathing pauses per hour. Severe sleep apnea may be associated with significant oxygen desaturation, approaching levels as low as 50% (5). Thus, there is a major reduction in sleep quality.…”

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confidence: 99%

An Oral Myofunctional Exercise Prescription For Obstructive Sleep Apnea

Sechser

Overhue

Guilder

2021

ACSM's Health and Fitness Journal

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Apply It! After having read this article, the health and fitness professional will be able to ▪ Describe the signs/symptoms, risk factors, and causes of obstructive sleep apnea ▪ Identify the anatomical location and functions of the primary oropharyngeal skeletal muscles ▪ Instruct how to perform oropharyngeal exercises to a client/patient ▪ Integrate evidence-based oropharyngeal exercise training into a physical activity plan for persons suffering from obstructive sleep apnea

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Determinants of Survival in Older Adults With Congenital Heart Disease Newly Hospitalized for Heart Failure

Wang

Liu²,

Brophy

et al. 2020

Circ: Heart Failure

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Background: Nearly 90% of patients with adult congenital heart disease (ACHD) die after the age of 40 years, and heart failure (HF) is the most common cause of death. We aimed to characterize the association between an incident HF hospitalization (HFH) and mortality and to identify the predictors of 1-year postdischarge mortality after incident and repeated HFHs, respectively. Methods: Patients with ACHD aged ≥40 years between 2000 and 2010 were identified from the Québec CHD database. We conducted a propensity score–matched study to explore the association between an incident HFH and mortality. We performed Bayesian model averaging to identify the predictors of 1-year postdischarge mortality with a posterior probability ≥50% considered to be evidence of a significant association. Results: The mortality hazard ratio was high at 6.01 (95% CI, 4.02–10.72) within 1-year postdischarge, decreasing significantly but entering an elevated equilibrium until year 4 with a continued 3-fold increase in death. Kidney dysfunction (hazard ratio, 2.28 [95% credible interval, 1.59–3.28], posterior probability, 100.0%) and a history of ≥2 HFHs in the past 12 months (hazard ratio, 1.77 [95% credible interval, 1.18–2.66], posterior probability: 82.2%) were the most robust predictors of 1-year mortality after incident and repeated HFHs, respectively. Conclusions: In patients with ACHD aged ≥40 years, incident HFH was associated with high mortality risk at 1 year, declining but remaining elevated for 4 years. Kidney dysfunction was a potent predictor of 1-year mortality risk after incident HFHs. Repeated HFHs further increased mortality risk. These observations should inform early risk-tailored health services interventions for monitoring and prevention of HF and its associated complications in older patients with ACHD.

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Diagnostic criteria for obstructive sleep apnea: time for reappraisal

Cited by 4 publications

References 18 publications

Does the Patient-Reported Apnea Questionnaire (PRAQ) increase patient-centredness in the daily practice of sleep centres? a mixed-methods study

Does the Patient-Reported Apnea Questionnaire (PRAQ) increase patient-centredness in the daily practice of sleep centres? a mixed-methods study

An Oral Myofunctional Exercise Prescription For Obstructive Sleep Apnea

Determinants of Survival in Older Adults With Congenital Heart Disease Newly Hospitalized for Heart Failure

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