Journal of Clinical Sleep Medicine最新文献

{"title":"Using expanded diagnostic criteria mitigates gender disparities in diagnosis of sleep-disordered breathing.","authors":"Kenna Haile, Monica Mungarwadi, Nesrine Adly Ibrahim, Apala Vaishnav, Sean Carrol, Nishtha Pandya, Hossein Yarandi, Abdulghani Sankari, Jennifer L Martin, M Safwan Badr","doi":"10.5664/jcsm.11444","DOIUrl":"10.5664/jcsm.11444","url":null,"abstract":"<p><strong>Study objectives: </strong>Mitigating gender inequality in the diagnosis and management of sleep-disordered breathing (SDB) is of paramount importance. Historically, the diagnostic criteria for SDB were based on male physiology and did not account for variations in disease manifestation based on sex. Some payors use a definition of hypopnea that requires a 4% oxygen desaturation (AHI-4) to determine coverage for treatment, whereas the criteria recommended by the American Academy of Sleep Medicine require either a 3% oxygen desaturation or an arousal (AHI-3A). This study examined the diagnostic implications of these 2 definitions for men and women in a clinical setting.</p><p><strong>Methods: </strong>We reviewed polysomnography reports for all patients who completed a diagnostic polysomnography study at 1 sleep disorders center in 2019. Every polysomnography recording was scored using both sets of criteria to determine AHI-4 and AHI-3A.</p><p><strong>Results: </strong>Data from 279 women (64.7%) and 152 men (34.3%) were analyzed. Overall, the mean AHI-4 was 21.9 ± 27.3 and the mean AHI-3A was 34.7 ± 32.3 per hour of sleep. AHI-3A resulted in a diagnostic increase of 30.4% (<i>P</i> = .001) for women and 21.7% (<i>P</i> = .006) for men. Women saw a greater increase in diagnosis of mild and moderate SDB, and men saw a greater increase in severe SDB with the AHI-3A compared to the AHI-4 definition.</p><p><strong>Conclusions: </strong>The definition of hypopnea used in the AHI-3A criteria is more consistent with the pathophysiology of SDB in women and results in higher rates of diagnosis. Use of the AHI-4 criteria may create a sex-based disparity in diagnosis, leading to symptomatic women remaining undiagnosed and untreated.</p><p><strong>Citation: </strong>Haile K, Mungarwadi M, Ibrahim NA, et al. Using expanded diagnostic criteria mitigates gender disparities in diagnosis of sleep-disordered breathing. <i>J Clin Sleep Med.</i> 2025;21(3):543-548.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"543-548"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lehigh Valley Health Network Narcolepsy Cohort: clinical and polysomnographic analysis of 304 cases.","authors":"Rena Y Jiang, Roger Rochart, Irene Chu, Shae Duka, Martina Vendrame","doi":"10.5664/jcsm.11430","DOIUrl":"10.5664/jcsm.11430","url":null,"abstract":"<p><strong>Study objective: </strong>We aimed to characterize clinical features, comorbidities, and polysomnographic characteristics of a large cohort of patients with narcolepsy.</p><p><strong>Methods: </strong>We undertook a retrospective chart and polysomnographic review of all patients with a diagnosis of narcolepsy type 1 (NT1) or narcolepsy type 2 (NT2) seen within the Lehigh Valley Health Network between 2000 and 2022.</p><p><strong>Results: </strong>We found 304 cases with a diagnosis of narcolepsy (52 NT1, 252 NT2), based on <i>International Classification of Sleep Disorders</i>, third edition criteria. Compared to NT2, patients with NT1 had younger diagnosis age (24.5 vs 27.4 years, <i>P</i> = .03), shorter diagnostic gap (3.0 vs 4.6 years, <i>P</i> = .002), more frequent sleep paralysis (55.8% vs 19.4%, <i>P</i> < .0001) and hypnagogic hallucinations (46.2% vs 25.4%, <i>P</i> = .003), and higher Epworth Sleepiness Scale scores (17.8 vs 16.7, <i>P</i> = .02). The most common comorbid sleep disorders were breathing disorders (17.4%) and insomnia (15.5%). Migraine was the most common neurological disorder. Depression was more common in NT2 than NT1 (12 [23.1%] vs 94 [37.3%], <i>P</i> = .05). On the Multiple Sleep Latency Test, patients with NT1 had more sleep onset rapid eye movement periods than patients with NT2 (≥ 3 sleep onset rapid eye movement periods in 59.2% vs 26.9%, <i>P</i> < .0001). Only in NT2, hypnagogic hallucinations and higher Epworth Sleepiness Scale scores were associated with higher numbers of sleep onset rapid eye movement periods (<i>P</i> = .0277 and <i>P</i> = .0179, respectively).</p><p><strong>Conclusion: </strong>This is one of the largest monocentric studies to date of patients with narcolepsy and confirms the frequent comorbidities of narcolepsy. Specific clinical characteristics and comorbidities may help differentiate NT1 from NT2.</p><p><strong>Citation: </strong>Jiang RY, Rochart R, Chu I, Duka S, Vendrame M. The Lehigh Valley Health Network Narcolepsy Cohort: clinical and polysomnographic analysis of 304 cases. <i>J Clin Sleep Med</i>. 2025;21(3):479-491.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"479-491"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel assessment of CPAP adherence data reveals distinct diurnal patterns.","authors":"Matthew T Scharf, Ioannis P Androulakis","doi":"10.5664/jcsm.11446","DOIUrl":"10.5664/jcsm.11446","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea is a prevalent condition effectively treated by continuous positive airway pressure (CPAP) therapy. CPAP adherence data, routinely gathered in clinical practice, include detailed information regarding both duration and timing of use. The purpose of the present study was to develop a systematic way to measure the diurnal pattern of CPAP adherence data and to see if distinct patterns exist in a clinical cohort.</p><p><strong>Methods: </strong>Machine learning techniques were employed to analyze CPAP adherence data. A cohort of 200 unselected patients was assessed and a cluster analysis was subsequently performed. Application of this methodology to 17 patients with different visually noted patterns was carried out to further assess performance.</p><p><strong>Results: </strong>Each 30-day period of CPAP use for each patient was characterized by 4 variables describing the time of day of initiation and discontinuation of CPAP use, as well as the consistency of use during those times. Further analysis identified 6 distinct clusters, reflecting different timing and adherence patterns. Specifically, clusters with relatively normal timing vs delayed timing were identified. Finally, application of this methodology showed generally good performance with limitations in the ability to characterize shift worker and non-24 rhythms.</p><p><strong>Conclusions: </strong>This study demonstrates a methodology for analysis of diurnal patterns from CPAP adherence data. Furthermore, distinct timing and adherence patterns are demonstrated. The potential impact of these patterns on the beneficial effects of CPAP requires elucidation.</p><p><strong>Citation: </strong>Scharf MT, Androulakis IP. Novel assessment of CPAP adherence data reveals distinct diurnal patterns. <i>J Clin Sleep Med</i>. 2025;21(3):493-502.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"493-502"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of automated detection of REM sleep without atonia using in-laboratory and in-home recordings.","authors":"Daniel J Levendowski, Lana M Chahine, Simon J G Lewis, Thomas J Finstuen, Andrea Galbiati, Chris Berka, Sherri Mosovsky, Hersh Parikh, Jack Anderson, Christine M Walsh, Joyce K Lee-Iannotti, Thomas C Neylan, Luigi Ferini Strambi, Bradley F Boeve, Erik K St Louis","doi":"10.5664/jcsm.11488","DOIUrl":"10.5664/jcsm.11488","url":null,"abstract":"<p><strong>Study objectives: </strong>To evaluate the concordance between visual scoring and automated detection of rapid eye movement sleep without atonia (RSWA) and the validity and reliability of in-home automated-RSWA detection in patients with rapid eye movement sleep behavior disorder (RBD) and a control group.</p><p><strong>Methods: </strong>Sleep Profiler signals were acquired during simultaneous in-laboratory polysomnography in 24 isolated patients with RBD. Chin and arm RSWA measures visually scored by an expert sleep technologist were compared to algorithms designed to automate RSWA detection. In a second cohort, the accuracy of automated-RSWA detection for discriminating between RBD and control group (n = 21 and 42, respectively) was assessed in multinight in-home recordings.</p><p><strong>Results: </strong>For the in-laboratory studies, agreement between visual and auto-scored RSWA from the chin and arm were excellent, with intraclass correlations of 0.89 and 0.95, respectively, and substantial, based on Kappa scores of 0.68 and 0.74, respectively. For classification of patients with iRBD vs controls, specificities derived from auto-detected RSWA densities obtained from in-home recordings were 0.88 for the chin, 0.93 for the arm, and 0.90 for the chin or arm, while the sensitivities were 0.81, 0.81, and 0.86, respectively. The night-to-night consistencies of the respective auto-detected RSWA densities were good based on intraclass correlations of 0.81, 0.79, and 0.84, however some night-to-night disagreements in abnormal RSWA detection were observed.</p><p><strong>Conclusions: </strong>When compared to expert visual RSWA scoring, automated RSWA detection demonstrates promise for detection of RBD. The night-to-night reliability of chin- and arm-RSWA densities acquired in-home were equivalent.</p><p><strong>Citation: </strong>Levendowski DJ, Chahine LM, Lewis SJG, et al. Validation of automated detection of REM sleep without atonia using in-laboratory and in-home recordings. <i>J Clin Sleep Med</i>. 2025;21(3):583-592.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"583-592"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep apnea physiological burdens and markers of white matter injury: the Multi-Ethnic Study of Atherosclerosis.","authors":"Mohammadreza Hajipour, Wen-Hsin Hu, Neda Esmaeili, Scott Sands, Andrew Wellman, Younghoon Kwon, Gonzalo Labarca, Ilya M Nasrallah, R Nick Bryan, Patrick J Strollo, Susan R Heckbert, Susan Redline, Najib T Ayas, Ali Azarbarzin","doi":"10.5664/jcsm.11422","DOIUrl":"10.5664/jcsm.11422","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea is associated with cognitive impairment; however, the underlying mechanisms remain incompletely understood. Obstructive sleep apnea is characterized by periods of interrupted ventilation (ventilatory burden), leading to hypoxemia (hypoxic burden) and/or arousal (arousal burden) from sleep. Although hypoxemia is considered a key mechanism underlying white matter injury, its measurement has been limited. In our primary analysis, we assessed the association of hypoxic burden, a quantitative measure of hypoxemia, with white matter hyperintensity volume, a marker of small vessel disease, and compared it with that of ventilatory burden and arousal burden (quantitative measures of ventilatory deficit and arousals).</p><p><strong>Methods: </strong>Data from participants in the Multi-Ethnic Study of Atherosclerosis with full polysomnograms and brain magnetic resonance imaging were analyzed. Hypoxic burden was defined as the total area under the oxygen desaturation curve per hour of sleep, ventilatory burden was defined as the event-specific area under the ventilation signal, and arousal burden was defined as the normalized cumulative duration of all arousals. The primary outcome was white matter hyperintensity volume, with other magnetic resonance imaging measures considered secondary outcomes.</p><p><strong>Results: </strong>The analysis included polysomnograms from 587 participants (age: 65.5 ± 8.2 years). In the fully adjusted model, each 1 standard deviation increase in hypoxic burden was associated with a 0.09 standard deviation increase in white matter hyperintensity volume (<i>P</i> = .023), after adjusting for demographics, study site, and comorbidities. In contrast, ventilatory burden, arousal burden, and conventional obstructive sleep apnea measures were not associated with outcomes.</p><p><strong>Conclusions: </strong>Hypoxic burden was associated with white matter hyperintensity volume in a racially/ethnically diverse cohort of older individuals with a high prevalence of obstructive sleep apnea .</p><p><strong>Citation: </strong>Hajipour M, Hu W-H, Esmaeili N, et al. Sleep apnea physiological burdens and markers of white matter injury: the Multi-Ethnic Study of Atherosclerosis. <i>J Clin Sleep Med.</i> 2025;21(3):457-466.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"457-466"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enough is enough: strict hypopnea criteria exacerbate sleep-related health disparities in females.","authors":"Lindsay M McCullough, Hrayr Attarian","doi":"10.5664/jcsm.11550","DOIUrl":"10.5664/jcsm.11550","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"453-454"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agrypnia excitata: a clinical biomarker of acute relapse in anti-N-methyl-D-aspartate receptor encephalitis.","authors":"Lina Jeantin, Louis Cousyn, Vincent Navarro, Vi-Huong Nguyen-Michel","doi":"10.5664/jcsm.11402","DOIUrl":"10.5664/jcsm.11402","url":null,"abstract":"<p><p>Sleep disorders have been described in anti-N-methyl-D-aspartate receptor encephalitis including insomnia, hypersomnia, narcolepsy, and sleep-disordered breathing. A patient presented with typical features of anti-N-methyl-D-aspartate receptor encephalitis associated with a right ovarian teratoma. After 2 months of clinical improvement with immunotherapy, the patient deteriorated. A 24-hour video electroencephalography-polysomnography revealed a severe sleep quantity deficit, a total destruction of sleep architecture consisting of short clusters of N1 and rapid eye movement sleep stages, associated with motor and autonomic hyperactivity. These features were consistent with agrypnia excitata and were associated with disease reactivation due to a left ovarian teratoma. A new course of immunotherapy and surgery improved clinical symptoms and normalized sleep patterns. Agrypnia excitata, the most severe form of status dissociatus, was a sleep biomarker of disease relapse in this patient. Polysomnographic studies in the acute phase of anti-N-methyl-D-aspartate receptor encephalitis are lacking and are needed to better understand the evolution of sleep patterns.</p><p><strong>Citation: </strong>Jeantin L, Cousyn L, Navarro V, Nguyen-Michel V-H. Agrypnia excitata: a clinical biomarker of acute relapse in anti-N-methyl-D-aspartate receptor encephalitis. <i>J Clin Sleep Med</i>. 2025;21(3):599-603.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"599-603"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment-emergent central sleep apnea resolves with lower inspiratory pressure.","authors":"William H Noah, Ludovico Messineo, Bernard Hete, Evelyn Thompson, David P White, Robert J Farney, Krishna M Sundar","doi":"10.5664/jcsm.11492","DOIUrl":"10.5664/jcsm.11492","url":null,"abstract":"<p><strong>Study objectives: </strong>Treatment-emergent central sleep apnea (TECSA) is an important problem during therapy with continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea. We tested a device designed to improve CPAP comfort through reducing inspiratory positive airway pressure (IPAP; <math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math>) to determine whether such a reduction in IPAP could eliminate central apneas in patients with TECSA. Because increasing tidal volume (potentially via IPAP increments) has been suggested as a possible mechanism contributing to TECSA onset, our hypothesis was that reducing IPAP would yield a drop in the central apnea index.</p><p><strong>Methods: </strong>The addition of a known resistance (<math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math> device) that reduces IPAP was implemented into the CPAP circuit during the second half of CPAP titrations in a cohort of community-dwelling patients who developed TECSA during a split-night CPAP titration. Central apnea index was quantified from the sleep periods without and with <math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math> in place.</p><p><strong>Results: </strong>A total of 1,613 patients underwent CPAP titration, with 19 of them developing TECSA during the titration. The addition of <math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math> resulted in complete resolution of TECSA in all patients with adequate sleep data under all conditions (n = 13), yielding a significant reduction in the central apnea index (17.3 ± 11.0 vs 1.5 ± 1.7 events/h without and with <math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math>, respectively; <i>P</i> < .001).</p><p><strong>Conclusions: </strong><math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math> virtually resolved all instances of TECSA, suggesting that reducing IPAP could be an effective strategy for managing the occurrence of central respiratory events in patients with obstructive sleep apnea using CPAP.</p><p><strong>Citation: </strong>Noah WH, Messineo L, Hete B, et al. Treatment-emergent central sleep apnea resolves with lower inspiratory pressure. <i>J Clin Sleep Med.</i> 2025;21(3):559-564.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"559-564"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home sleep apnea testing auto-interpretation.","authors":"Felix W Wireko, Timothy I Morgenthaler","doi":"10.5664/jcsm.11432","DOIUrl":"10.5664/jcsm.11432","url":null,"abstract":"<p><p>Recent advances in sleep medicine have led to the development of various validated diagnostic devices for obstructive sleep apnea. Despite limitations, there has been an increase in the use of home sleep apnea tests. The accuracy of home sleep apnea tests may be limited by the inability of their automated signal analysis to differentiate between artifacts and the target physiological signal, leading to erroneous test interpretations with management implications. We present a 60-year-old male with a mechanical heart valve diagnosed with obstructive sleep apnea. At the 6-month postintervention follow-up, the home sleep apnea test report indicated loud snoring 100% of the time. After carefully reviewing the raw home sleep apnea test data and history, the source of the nonphysiological high-level sound was identified as the mechanical heart valve, and the patient was reassured. This case highlights how trusting only automated analysis can miss important information and arrive at misleading conclusions.</p><p><strong>Citation: </strong>Wireko FW, Morgenthaler TI. Home sleep apnea testing auto-interpretation. <i>J Clin Sleep Med.</i> 2025;21(3):605-607.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"605-607"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access and models of obstructive sleep apnea care: a cross-national comparison of Canadian and Australian patient survey data.","authors":"Duaa Fatima, Alexander Sweetman, Nicole Lovato, Andrew Vakulin, Nick Bansback, Marcus Povitz, Nigel Stocks, Mark Fenton, Ching Li Chai-Coetzer, Sachin R Pendharkar","doi":"10.5664/jcsm.11414","DOIUrl":"10.5664/jcsm.11414","url":null,"abstract":"<p><strong>Study objectives: </strong>We aimed to describe similarities and differences in obstructive sleep apnea (OSA) care pathways and their impact on patients in Australia and Canada, including among urban vs rural participants.</p><p><strong>Methods: </strong>In this secondary data analysis of patient surveys exploring OSA care in Australia and Canada, we recruited adults with a prior diagnosis of OSA from market research companies, social media, and patient-facing medical associations. Residential postal codes were used to classify participants as urban or rural. Survey domains included wait times and travel distances for care, providers, and treatments.</p><p><strong>Results: </strong>Data from 589 Canadians (21% rural; 42% female; mean [standard deviation] age = 57 [13] years) and 412 Australians (38% rural; 45% female; mean [standard deviation] age = 58 [14] years) with OSA were included. Participants in both countries most commonly sought initial care for suspected OSA from a primary care practitioner. Canadian participants waited longer to seek care than Australian participants (37% vs 51% within 12 months of symptom onset). Wait times for diagnostic testing were longer in Canada (59% vs 76% within 3 months of initial assessment), especially in urban settings (58% vs 78%). In both countries, > 80% of participants were offered positive airway pressure therapy. Overall, a greater variety of treatments were offered and used by Australian participants.</p><p><strong>Conclusions: </strong>Greater access to diagnostic testing and a greater variety of treatments were found in Australia compared to Canada. Further research is needed to determine whether reduced diagnostic wait times and presentation of increased therapy options found in Australia translate to better patient outcomes.</p><p><strong>Citation: </strong>Fatima D, Sweetman A, Lovato N, et al. Access and models of obstructive sleep apnea care: a cross-national comparison of Canadian and Australian patient survey data. <i>J Clin Sleep Med.</i> 2025;21(3):467-477.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"467-477"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}