Obstructive sleep apnoea: is it moving into primary care?

Stradling, John

doi:10.3399/bjgp16x683785

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…The delayed sleep may be linked to the fact that sleep initiation seems to involve/require a small reduction in core temperature [163], and exercise may override this circadian driven change in body temperature; feeding during the latter part of the day has been shown to predispose individuals to weight gain and increased susceptibility to metabolic abnormalities such as diabetes II [164]. Weight gain can predispose to obstructive sleep apnoea where the walls of the throat relax and narrow during sleep, interrupting normal breathing [165]. If untreated this can lead to multiple health issues.…”

Section: Scrd-induced Employee Issue Employer Responsementioning

confidence: 99%

Sleep, circadian rhythms and health

2020

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At the core of human thought, for the majority of individuals in the developed nations at least, there is the tacit assumption that as a species we are unfettered by the demands imposed by our biology and that we can do what we want, at whatever time we choose, whereas in reality every aspect of our physiology and behaviour is constrained by a 24 h beat arising from deep within our evolution. Our daily circadian rhythms and sleep/wake cycle allow us to function optimally in a dynamic world, adjusting our biology to the demands imposed by the day/night cycle. The themes developed in this review focus upon the growing realization that we ignore the circadian and sleep systems at our peril, and this paper considers the mechanisms that generate and regulate circadian and sleep systems; what happens mechanistically when these systems collapse as a result of societal pressures and disease; how sleep disruption and stress are linked; why sleep disruption and mental illness invariably occur together; and how individuals and employers can attempt to mitigate some of the problems associated with working against our internal temporal biology. While some of the health costs of sleep disruption can be reduced, in the short-term at least, there will always be significant negative consequences associated with shift work and sleep loss. With this in mind, society needs to address this issue and decide when the consequences of sleep disruption are justified in the workplace.

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Section: Scrd-induced Employee Issue Employer Responsementioning

confidence: 99%

Sleep, circadian rhythms and health

2020

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“…Apesar da magnitude, das consequências deletérias multissistêmicas e do impacto negativo na qualidade de vida dos indivíduos, é condição negligenciada 2,3,5 . Médicos da Atenção Primária à Saúde (APS) raramente fazem rastreamento e manejo da SAHOS, mesmo havendo evidências de melhor custo-efetividade, em relação àqueles realizados nos níveis secundário e terciário de atenção à saúde, 13,14 e de redução de danos quando é diagnosticada e tratada oportunamente 15 .…”

Section: Introductionunclassified

Rastreamento da síndrome da apneia e hipopneia obstrutiva do sono em hipertensos na Atenção Primária à Saúde

Carrilho¹,

Leite

Col³

et al. 2022

Revista de APS

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Introdução: a síndrome da apneia-hipopneia obstrutiva do sono (SAHOS) é o distúrbio respiratório do sono mais comum, associado a condições facilmente identificáveis, como a hipertensão arterial sistêmica. Objetivo: determinar prevalência de rastreamento positivo para SAHOS e identificar fatores associados em hipertensos em serviço de Atenção Primária à Saúde (APS). Métodos: estudo transversal com 326 hipertensos adscritos a uma unidade de APS. Foram obtidas variáveis antropométricas, clínicas e sociodemográficas e utilizados os questionários Short Assessment of Health Literacy for Portuguese-Speaking Adults, para identificar o letramento em saúde; a Morisky Medication Adherence Scale, para a adesão medicamentosa e o Snoring, Tiredness, Observed Apnea, High Blood Pressure, Bodymass index, Age, Neck Circumference, and Gender - STOP-Bang, para rastreamento da SAHOS. Resultados: o sexo feminino foi majoritário (66,3%). A média temporal de tratamento para hipertensão arterial sistêmica alcançou 12,51 ± 9,83 anos. Constatou-se prevalência de 86,5% de rastreio positivo para SAHOS e o sexo masculino e a obesidade como fatores associados a essa condição (p<0,01). Conclusão: o rastreamento sistemático da SAHOS na APS deve ser incorporado à prática dos profissionais de saúde, assim como é feito para outras doenças crônicas não transmissíveis.

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“…To date OSA has been managed primarily within a sleep specialist setting however, with increasing prevalence of OSA, the waiting times both for assessment and for care within these specialised services have increased significantly [8][9][10]. Since the early exploratory work of Kramer et al [11] there has been growing interest in the role of primary care in the management of OSA [12][13][14][15]. Several randomised controlled trials have recently demonstrated that primary care management of OSA is not inferior to specialist-led care, which leads the way for a more primary care focused approach to OSA management [16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Assessment, referral and management of obstructive sleep apnea by Australian general practitioners: a qualitative analysis

Grivell

Haycock

Redman

et al. 2021

BMC Health Serv Res

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Background The high and increasing demand for obstructive sleep apnea (OSA) care has exceeded the capacity of specialist sleep services prompting consideration of whether general practitioners could have an enhanced role in service delivery. However, little is known about the current involvement, experiences and attitudes of Australian general practitioners towards OSA. The purpose of this study was to provide an in-depth analysis of Australian general practitioners’ experiences and opinions regarding their care of patients with OSA to inform the design and implementation of new general practice models of care. Methods Purposive sampling was used to recruit participants with maximum variation in age, experience and location. Semi-structured interviews were conducted and were analysed using Thematic Analysis. Results Three major themes were identified: (1) General practitioners are important in recognising symptoms of OSA and facilitating a diagnosis by others; (2) Inequities in access to the assessment and management of OSA; and (3) General practitioners currently have a limited role in the management of OSA. Conclusions When consulting with patients with symptoms of OSA, general practitioners see their primary responsibility as providing a referral for diagnosis by others. General practitioners working with patients in areas of greater need, such as rural/remote areas and those of socio-economic disadvantage, demonstrated interest in being more involved in OSA management. Inequities in access to assessment and management are potential drivers for change in future models of care for OSA in general practice.

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Obstructive sleep apnoea: is it moving into primary care?

Cited by 7 publications

References 13 publications

Sleep, circadian rhythms and health

Sleep, circadian rhythms and health

Rastreamento da síndrome da apneia e hipopneia obstrutiva do sono em hipertensos na Atenção Primária à Saúde

Assessment, referral and management of obstructive sleep apnea by Australian general practitioners: a qualitative analysis

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