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Cited by 62Obstructive Sleep Apnea ResearchSleep and related disordersChronic Obstructive Pulmonary Disease (COPD) Research

Effect of an ambulatory diagnostic and treatment programme in patients with sleep apnoea

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Andreu, A.L., Chiner, E., Sancho-Chust, J.N., Pastor, E., Llombart, M., Gomez-Merino, E., Senent, C., Barbé, F.·2012·European Respiratory Journal
DOI 10.1183/09031936.00013311
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Abstract

The aim of this study to evaluate the efficacy of a home-based programme on clinical response, continuous positive airway pressure (CPAP) compliance and cost in a population of high pre-test probability of suffering obstructive sleep apnoea syndrome (OSAS). Patients were randomised into the following three groups. Group A: home respiratory polygraphy (RP) and home follow-up; group B: hospital polysomnography and hospital follow-up; and group C: home RP and hospital follow-up. Evaluation during 6 months included Epworth Sleepiness Scale (ESS), Functional Outcomes Sleep Questionnaire (FOSQ), and daily activity and symptom questionnaires. Compliance was assessed by memory cards (group A) and using an hourly counter (groups B and C). 66 patients were included (22 per branch), 83% were males, aged mean±sd 52±10 yrs, body mass index 34±7kg·m−2, apnoea/hypopnoea index 43±20 h−1, CPAP pressure 8±2 cmH 2 O, with no between-group differences. Clinical response showed an ESS of mean±sd 15±3 to 6±4, a FOSQ of 16±3 to 18±2, symptoms of 43±7 to 25±7, and activity of 37±11 to 25±8. At the end of the study, compliance was: group A 73%, group B 68% and group C 57%. The cost per patient was: group A €590±43, group B €894±11 and group C €644±93 (p<0.001). In conclusion, patients with a high initial probability of having OSAS can be diagnosed and treated in a home setting, with a high level of CPAP compliance and lower cost than using either a hospital-based approach or home RP/hospital follow-up.

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  • A meta-analysis of seven RCTs compared changes in patient-reported sleepiness, using the ESS, in patients diagnosed by HSAT or PSG, followed by PAP titration.

    “A meta-analysis of seven RCTs compared changes in patient-reported sleepiness, using the ESS, in patients diagnosed by HSAT or PSG, followed by PAP titration”

    From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [107]

    The Study design and Results sections (pages not provided) describe one three-arm randomized trial comparing home respiratory polygraphy with hospital PSG and measuring changes in sleepiness using the ESS. They do not describe a meta-analysis of seven RCTs. The Study design also says CPAP pressure was calculated by an equation and not changed during follow-up, rather than describing PAP titration. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • When determining adherence by number of nights with greater than 4 hours of use, meta-analysis of five RCTs found a clinically insignificant trend towards increased CPAP adherence in the HSAT arm versus the PSG arm.

    “When determining adherence by number of nights with greater than 4 hours of use, meta-analysis of five RCTs found a clinically insignificant trend towards increased CPAP adherence in the HSAT arm versus the PSG arm”

    From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [107]

    The Study design defines compliance as at least 4 hours of CPAP use on 70% of days. The Results report higher compliance in the home-testing/home-follow-up group than the PSG/hospital-follow-up group, without a statistically significant difference. But this paper reports one three-arm trial, not a meta-analysis of five RCTs; it also reports proportions of compliant patients, not the number of nights exceeding 4 hours. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Six RCTs, using various validated instruments (i.e., FOSQ, SAQLI, and SF-36), compared QOL in patients diagnosed by HSAT or PSG, followed by PAP titration.

    “Six RCTs, using various validated instruments (i.e., FOSQ, SAQLI, and SF-36), compared QOL in patients diagnosed by HSAT or PSG, followed by PAP titration.”

    From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [107]

    The Study design and Study subjects sections describe a randomised comparison of home respiratory polygraphy and hospital polysomnography that measured quality of life with the validated FOSQ. However, the Study design says CPAP pressure was calculated with an equation and was not changed during follow-up; it does not describe PAP titration. This paper is one trial and cannot itself establish the citing sentence’s total of six RCTs. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Cites

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Research works printed but not linked: 43

  1. Young T, Palta M, Dempsey J, et al. The ocurrence of sleep- disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230-1235.
  2. Dura ´n J, Esnaola S, Ramo ´n R, et al. Obstructive sleep apnoea- hypopnoea and related clinical features in a population-based sample of subjects aged 30 to 70 years. Am J Respir Crit Care Med 2001; 163: 685-689.
  3. D'Ambrosio C, Bowman T, Mohsenin V. Quality of life in patients with obstructive sleep apnoea. Effect of nasal continuous positive airway pressure: a prospective study. Chest 1999; 115: 123-129.
  4. Barbe ´F, Dura ´n-Cantolla J, Capote F, et al. Long-term effect of continuous positive airway pressure in hypertensive patients with sleep apnoea. Am J Respir Crit Care Med 2010; 181: 718-726.
  5. Pack AI, Gislason T. Obstructive sleep apnoea and cardiovascular disease: a perspective and future directions. Prog Cardiovasc Dis 2009; 51: 434-451.
  6. Parra O, Arboix A, Bechich S, et al. Time course of sleep-related breathing disorders in first-ever stroke or transient ischemic attack. Am J Respir Crit Care Med 2000; 161: 375-380.
  7. Tera ´n-Santos J, Jime ´nez-Go ´mez A, Cordero-Guevara J, et al. The association between sleep apnoea and the risk of traffic accidents. N Engl J Med 1999; 340: 847-851.
  8. Rodenstein D. Sleep apnoea: traffic and occupational accidents - individual risks, socioeconomic and legal implications. Respiration 2009; 78: 241-248.
  9. Douglas NJ, Thomas S, Jan MA. Clinical value of polysomno- graphy. Lancet 1992; 339: 347-350.
  10. Masa Jimenez JF, Barbe ´Illa F, Capote Gil F, et al. Resources and delays in the diagnosis of sleep apnoea-hypopnoea syndrome. Arch Bronconeumol 2007; 43: 188-198.
  11. Chiner E, Signes-Costa J, Arriero JM, et al. Nocturnal oximetry for the diagnosis of the sleep apnoea hypopnoea syndrome: a method to reduce the number of polysomnographies? Thorax 1999; 54: 968-971.
  12. Lloberes P, Sampol G, Levy G, et al. Influence of setting on unattended respiratory monitoring in the sleep apnoea/hypop- noea syndrome. Eur Respir J 2001; 18: 530-534.
  13. Parra O, Garcı ´a-Esclasans N, Montserrat JM, et al. Should patients with sleep apnoea/hypopnoea syndrome be diagnosed and managed on the basis of home sleep studies? Eur Respir J 1997; 10: 1720-1724.
  14. Mulgrew AT, Fox N, Ayas NT, et al. Diagnosis and initial management of obstructive sleep apnoea without polysomnogra- phy. Ann Intern Med 2007; 146: 157-166.
  15. Engleman HM, Kingshott RN, Wraith PK, et al. Randomised placebo-controlled crossover trial of continuous positive airway pressure for mild sleep apnoea/hypopnoea syndrome. Am J Respir Crit Care Med 1999; 159: 461-467.
  16. Ballester E, Badia JR, Herna ´ndez L, et al. Evidence of the effectiviness of continuous positive airway pressure in the treatment of sleep apnoea/hypopnoea syndrome. Am J Respir Crit Care Med 1999; 159: 495-501.
  17. Fletcher EC, Luckett RA. The effect of positive reinforcement on hourly compliance in nasal continuous positive airway pressure users with obstructive sleep apnoea. Am Rev Respir Dis 1991; 143: 936-941.
  18. Likar LL, Panciera TM, Erickson AD, et al. Group education sessions and compliance with nasal CPAP therapy. Chest 1997; 111: 1273-1277.
  19. Richards D, Bartlett DJ, Wong K, et al. Increased adherence to CPAP with a group cognitive behavioral treatment intervention: a randomizad trial. Sleep 2007; 30: 635-640.
  20. Wiese HJ, Boethel C, Philllips B, et al. CPAP compliance: video education may help!. Sleep Medicine 2005; 6: 171-174.
  21. Martinez-Garcı ´a MA, Soler-Catalun ˜a JJ, Roma ´n-Sa ´nchez P, et al. Efficacy of a training program on sleep apnoea-hypopnoea syndrome aimed at primary care physicians. Arch Bronconeumol 2008; 44: 15-21.
  22. Flemons WW, Whitelaw WA, Brant R, et al. Likelihood ratios for a sleep apnoea clinical prediction rule. Am J Respir Crit Care Med 1994; 150: 1279-1285.
  23. Grupo Espan ˜ol de Suen ˜o (GES). Consenso Nacional sobre el sı ´ndrome de apnoeas-hipopneas del suen ˜o. [Spanish Group of Sleep (GES). National Consensus on sleep apnoea-hypopnoea syndrome]. Arch Bronconeumol 2005; 41: 51-67.
  24. Chiner E, Signes-Costa J, Arriero JM, et al. Validation of a portable sleep monitoring device (STARDUST1) for home studies. Am J Respir Crit Care Med 2003; 167: A403.
  25. Andreu AL, Chiner E, Signes-Costa J, et al. Validez diagno ´stica y reproductibilidad de la poligrafı ´a respiratoria practicada en el hospital y en el domicilio [Diagnostic validity and reproducibility of respiratory polygraphy performed in the hospital and at home]. Arch Bronconeumol 2004; 40: 60.
  26. Chiner E, Arriero JM, Signes-Costa J, et al. Validacio ´n de la versio ´n espan ˜ola del test de somnolencia Epworth en pacientes con sı ´ndrome de apnoea de suen ˜o [Validation of the Spanish version of the Epworth Sleepiness Scale in patients with a sleep apnea syndrome]. Arch Bronconeumol 1999; 35: 422-427.
  27. Ferrer M, Vilagut G, Monasterio C, et al. Medida del impacto de los trastornos del suen ˜o: las versiones espan ˜olas del cuestionario del impacto funcional del suen ˜o y de la escala de somnolencia de Epworth [Measurement of the perceived impact of sleep problems: the Spanish version of the functional outcomes sleep questionnaire and the Epworth sleepiness scale]. Med Clin (Barc) 1999; 113: 250-255.
  28. Weaver TE, Laizner AM, Evans LK, et al. An instrument to measure functional status outcomes for disorders of excessive sleepiness. Sleep 1997; 20: 835-843.
  29. Miljeteig H, Hoffstein V Determinants of continuous positive airway pressure level for treatment of obstructive sleep apnoea, Am Rev Respir Dis 1993; 147: 1526-1530.
  30. Masa JF, Jime ´nez A, Dura ´n J, et al. Alternative methods of titrating continuous positive airway pressure: a large multicenter study. Am J Respir Crit Care Med 2004; 170: 1218-1224.
  31. Pe ´pin JL, Krieger J, Rodenstein D, et al. Effective compliance during the first 3 months of continuous positive airway pressure. A European prospective study of 121 patients. Am J Respir Crit Care Med 1999; 160: 1124-1129.
  32. Collop NA, Anderson WM, Boehlecke B, et al. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnoea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2007; 3: 737-747.
  33. Whitelaw WA, Brant RF, Flemons WW. Clinical usefulness of home oximetry compared with polysomnography for assessment of sleep apnoea. Am J Respir Crit Care Med 2005; 171: 188-193.
  34. Kribbs NB, Pack AI, Kline LR, et al. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnoea. Am Rev Respir Dis 1993; 147: 887-895.
  35. Hoy CJ, Vennelle M, Kingshott RN, et al. Can intensive support improve continuous positive airway pressure use in patients with the sleep apnoea/hypopnoea syndrome? Am J Respir Crit Care Med 1999; 159: 1096-1100.
  36. Tomlinson M, Gibson GJ. Obstructive sleep apnoea syndrome: a nurse-led domiciliary service. J Adv Nurs 2006; 55: 391-397.
  37. Damjanovic D, Fluck A, Bremer H, et al. Compliance in sleep apnoea therapy: influence of home care support and pressure mode. Eur Respir J 2009; 33: 804-811.
  38. Taylor Y, Eliasson A, Andrada T, et al. The role of telemedicine in CPAP compliance for patients with obstructive sleep apnoea syndrome. Sleep Breath 2006; 10: 132-138.
  39. Stepnowsky C, Palau J, Marler MR, et al. Pilot randomized trial of the effect of wireless telemonitoring on compliance and treatment efficacy in obstructive sleep apnoea. J Med Internet Res 2007; 9: e14.
  40. Smith CE, Dauz ER, Clements F, et al. Telehealth services to improve nonadherence: a placebo controlled study. Telemed J E Health 2006; 12: 289-296.
  41. Skomro RP, Gjevre J, Reid J, et al. Outcomes of home-based diagnosis and treatment of obstructive sleep apnoea. Chest 2010; 138: 257-263.
  42. Lettieri CF, Lettieri CJ, Carter K. Does home sleep testing impair continuous positive airway pressure adherence in patients with obstructive sleep apnoea? Chest 2011; 139: 849-854.
  43. Buchan J, Aiken L. Solving nursing shortages: a common priority. J Clin Nurs 2008; 17: 3262-3268.

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Authors
Andreu, A. L., Chiner, E., Sancho-Chust, J. N., Pastor, E., Llombart, M., Gomez-Merino, E., Senent, C., & Barbé, F.
Affiliations
  • Hospital Universitari Sant Joan D'Alacant (ES)
  • Instituto de Salud Carlos III (ES)
Corresponding author
Chiner, E.
ORCID
Venue
European Respiratory Journal
Publisher
European Respiratory Society (ERS)
Published
2011-06-30
Volume
39
Issue
2
Pages
305-312
ISSN
  • 0903-1936 (ISSN-L)
  • 1399-3003
DOI
10.1183/09031936.00013311
OpenAlex
W2164704643
Cited by
62
References
8
Citations by year
2026: 2 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 3 · 2020: 6 · 2019: 4 · 2018: 2 · 2017: 5 · 2016: 3 · 2015: 5 · 2014: 6 · 2013: 9 · 2012: 2
FWCI
3.71
Type
journal article
Language
en
Open access
Locations
  • European Respiratory Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Keywords
obstructive sleep apnea, home sleep testing, CPAP adherence, ambulatory diagnosis, home-based therapy, polysomnography, Epworth Sleepiness Scale, treatment costs
MeSH terms
Adult, Ambulatory Care, Female, Follow-Up Studies, Home Care Services, Humans, Male, Middle Aged, Patient Compliance, Surveys and Questionnaires, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure

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