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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 16 of 16 Research Studies DisplayedFeltnerl. C, Wallace IF, Aymes S
Screening for obstructive sleep apnea in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to examine the evidence on screening for obstructive sleep apnea (OSA) in asymptomatic adults or those with unrecognized OSA symptoms to inform the U.S. Preventive Services Task Force. The researchers utilized data from PubMed/MEDLINE, Cochrane Library, Embase, and trial registries through August 23, 2021 and surveillance data through September 23, 2022. The main outcomes were accuracy, excessive daytime sleepiness, sleep-related and general health-related quality of life (QOL), and harms. Eighty-six studies were included (N = 11,051), researchers finding that no study directly compared screening with no screening. Five studies evaluating the accuracy of other screening tools provided inconsistent results. When compared with inactive control, positive airway pressure was associated with a significant improvement in ESS score from baseline, sleep-related QOL, and general health-related QOL measured by the 36-Item Short Form Health Survey (SF-36) mental health component summary score change, and SF-36 physical health component summary score change. When compared with controls, utilization of mandibular advancement devices was also related with a significantly larger ESS score change. Reporting of other health outcomes was scarce; no trial included in the study found significant benefit related with treatment on mortality, cardiovascular events, or motor vehicle crashes. In 3 systematic reviews, positive airway pressure was significantly associated with reduced blood pressure; but the difference was relatively small. The researchers concluded that the accuracy and clinical usefulness of OSA screening tools was unclear.
Citation: Feltnerl. C, Wallace IF, Aymes S .
Screening for obstructive sleep apnea in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Nov 15;328(19):1951-71. doi: 10.1001/jama.2022.18357..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sleep Problems, Screening, Evidence-Based Practice, Prevention
Manjunath J, Silverberg JI
Association of sleep disturbances with geriatric age in atopic dermatitis patients.
The purpose of this cross-sectional study was to investigate the association of geriatric age with atopic dermatitis (AD) severity and sleep disturbances (SD). Patients over the age of 18 seen at an eczema clinic were recruited and completed a self-administered questionnaire for encounters between 2014 and 2019. AD severity was assessed using the patient-oriented eczema measure (POEM), eczema area and severity index, Scoring AD (SCORAD), SCORAD-itch, investigator global assessment, and patient global assessment. The frequency of SD due to eczema was assessed using POEM. The impact of itching on the activity of falling asleep was assessed using 5 dimensions (5D) of itch. Fatigue was assessed using the patient-reported outcome measurement information system (PROMIS)-global health. Difficulty sleeping, falling asleep, and staying asleep was assessed using PROMIS-SD. The study found that geriatric AD patients had more profound SD, particularly staying asleep and fatigue, despite having AD severity similar to younger adult AD patients. The researchers concluded that future research is needed to understand why there is a difference between geriatric and non-geriatric patients as related to increased itching from atopic dermatitis and sleep disorders.
AHRQ-funded; HS023011.
Citation: Manjunath J, Silverberg JI .
Association of sleep disturbances with geriatric age in atopic dermatitis patients.
J Am Acad Dermatol 2022 Jul;87(1):206-08. doi: 10.1016/j.jaad.2021.07.039..
Keywords: Elderly, Sleep Problems, Skin Conditions
Wickwire EM, Bailey MD, Somers VK
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
The purpose of this study was to examine the impact of adherence to continuous positive airway pressure (CPAP) therapy on health care utilization among a nationally representative and sample of older adults with multiple morbidities and pre-existing cardiovascular disease and subsequently diagnosed with obstructive sleep apnea in the United States. The investigators concluded that in this nationally representative sample of older Medicare beneficiaries with multiple morbidities and relative to low adherers, high adherers demonstrated reduced inpatient utilization.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Bailey MD, Somers VK .
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
J Clin Sleep Med 2022 Jan;18(1):39-45. doi: 10.5664/jcsm.9478..
Keywords: Elderly, Medicare, Sleep Problems, Cardiovascular Conditions, Patient Adherence/Compliance, Hospitalization, Healthcare Utilization, Respiratory Conditions
Zhou NY, Nili A, Blackwell CK
Parent report of sleep health and attention regulation in a cross-sectional study of infants and preschool-aged children with atopic dermatitis.
Older children with atopic dermatitis (AD) suffer from poor sleep and attention problems. However, until recently, the dearth of developmentally sensitive assessment tools impeded characterization in younger children. In this study the investigators aimed to characterize sleep and attention problems in young children with AD and identify modifiable factors. The investigators concluded that more severe AD correlates with poor sleep health and attention dysregulation.
AHRQ-funded; HS023011.
Citation: Zhou NY, Nili A, Blackwell CK .
Parent report of sleep health and attention regulation in a cross-sectional study of infants and preschool-aged children with atopic dermatitis.
Pediatr Dermatol 2022 Jan;39(1):61-68. doi: 10.1111/pde.14889..
Keywords: Children/Adolescents, Newborns/Infants, Sleep Problems, Skin Conditions
Wickwire EM, Schnyer DM, Germain A
Sleep, sleep disorders, and circadian health following mild traumatic brain injury in adults: review and research agenda.
A rapidly expanding scientific literature supports the frequent co-occurrence of sleep and circadian disturbances following mild traumatic brain injury (mTBI). In this paper, the authors review relevant literature and present a research agenda to 1) advance understanding of the reciprocal relationships between sleep and circadian factors and mTBI sequelae and 2) advance rapidly the development of sleep-related treatments in this population.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Schnyer DM, Germain A .
Sleep, sleep disorders, and circadian health following mild traumatic brain injury in adults: review and research agenda.
J Neurotrauma 2018 Nov 15;35(22):2615-31. doi: 10.1089/neu.2017.5243..
Keywords: Sleep Problems, Brain Injury, Evidence-Based Practice
Hirayama A, Goto T, Faridi MK
Association of obstructive sleep apnoea with acute severity of chronic obstructive pulmonary disease exacerbation: a population-based study.
This retrospective cohort study investigated the association of coexistent obstructive sleep apnoea with acute severity markers (i.e. invasive positive pressure ventilation use and hospital length of stay) among adults hospitalised for acute exacerbation of chronic obstructive pulmonary disease.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Faridi MK .
Association of obstructive sleep apnoea with acute severity of chronic obstructive pulmonary disease exacerbation: a population-based study.
Intern Med J 2018 Sep;48(9):1150-53. doi: 10.1111/imj.14016..
Keywords: Respiratory Conditions, Hospitalization, Sleep Problems, Chronic Conditions
Kline CE, Burke LE, Sereika SM
Bidirectional relationships between weight change and sleep apnea in a behavioral weight loss intervention.
This study examined the relationship between weight change and obstructive sleep apnea (OSA) in the context of behavioral weight loss intervention. A total of 114 adults who were overweight or obese participated in a 12-month behavioral weight loss intervention program from April 2012 to February 2015. Over half (58%) had OSA at the baseline. Those with OSA were found to lose less weight and were less adherent to daily calorie and activity goals. The results suggest that OSA screening should be used before attempting weight loss and also may indicate additional behavioral counseling.
AHRQ-funded; HS022989.
Citation: Kline CE, Burke LE, Sereika SM .
Bidirectional relationships between weight change and sleep apnea in a behavioral weight loss intervention.
Mayo Clin Proc 2018 Sep;93(9):1290-98. doi: 10.1016/j.mayocp.2018.04.026..
Keywords: Sleep Problems, Obesity: Weight Management, Obesity, Lifestyle Changes, Respiratory Conditions
Li JC, Fishbein A, Singam V
Sleep disturbance and sleep-related impairment in adults with atopic dermatitis: a cross-sectional study.
The aim of this prospective online questionnaire-based study was to determine the relationship between atopic dermatitis (AD) severity, sleep disturbance (SD), and sleep-related impairment (SRI). The investigators concluded that their study suggests that SD and SRI are common in adults with AD, particularly those with severe diseases. They suggest that sleep disturbances and SRI should be considered when assessing burden of AD and therapeutic decisions.
AHRQ-funded; HS023011.
Citation: Li JC, Fishbein A, Singam V .
Sleep disturbance and sleep-related impairment in adults with atopic dermatitis: a cross-sectional study.
Dermatitis 2018 Sep/Oct;29(5):270-77. doi: 10.1097/der.0000000000000401..
Keywords: Skin Conditions, Sleep Problems
Barone Gibbs B, Kline CE
When does sedentary behavior become sleep? A proposed framework for classifying activity during sleep-wake transitions.
The Sedentary Behavior Research Network recently published a consensus definition for sedentary. The authors of this paper indicated that further clarity around issues of classifying sedentary behavior while in bed is needed, specifically during sleep-wake transitions. In this paper they propose a framework for classifying activity during sleep-wake transitions.
AHRQ-funded; HS021162.
Citation: Barone Gibbs B, Kline CE .
When does sedentary behavior become sleep? A proposed framework for classifying activity during sleep-wake transitions.
Int J Behav Nutr Phys Act 2018 Aug 22;15(1):81. doi: 10.1186/s12966-018-0712-2..
Keywords: Lifestyle Changes, Sleep Problems
Harris VC, Links AR, Kim JM
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
The purpose of this study was to evaluate follow-up and timing of sleep-disordered breathing diagnosis and treatment in urban children referred from primary care. Researchers found that half of the children referred for sleep-disordered breathing evaluation are lost to follow-up from primary care. Obstructive sleep apnea severity did not predict follow-up or timeliness of treatment. They conclude that these findings suggest social determinants may pose barriers to care in addition to the clinical burden of sleep-disordered breathing.
AHRQ-funded; HS022932.
Citation: Harris VC, Links AR, Kim JM .
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
Otolaryngol Head Neck Surg 2018 Aug;159(2):371-78. doi: 10.1177/0194599818772035..
Keywords: Access to Care, Children/Adolescents, Disparities, Healthcare Delivery, Patient-Centered Healthcare, Quality of Care, Respiratory Conditions, Sleep Problems, Urban Health
Ye L, Richards KC
Sleep and long-term care.
This review describes the nature and consequences of sleep disturbances in long-term care (LTC), clinical assessment and management of sleep disturbances in LTC, and implications for future research and clinical practice.
AHRQ-funded; HS024330.
Citation: Ye L, Richards KC .
Sleep and long-term care.
Sleep Med Clin 2018 Mar;13(1):117-25. doi: 10.1016/j.jsmc.2017.09.011..
Keywords: Quality of Care, Long-Term Care, Nursing Homes, Sleep Problems
Fishbein AB, Mueller K, Kruse L
Sleep disturbance in children with moderate/severe atopic dermatitis: a case-control study.
The researchers sought to characterize sleep in a cohort of children with moderate-to-severe atopic dermatitis (AD) and to determine methods for assessment of sleep disturbance. In nineteen patients and nineteen controls, they found that patients with AD experienced wake after sleep onset (WASO) for 103 plus or minus 55 minutes as compared with 50 plus or minus 27 minutes in the controls. They had a higher frequency of restless sleep, daytime sleepiness, difficulty falling back to sleep at night, and teacher-reported daytime sleepiness. They concluded that children with moderate-to-severe AD experience more WASO and lower sleep efficiency than healthy controls but similar bedtime and wake time, sleep duration, and sleep onset latency.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Mueller K, Kruse L .
Sleep disturbance in children with moderate/severe atopic dermatitis: a case-control study.
J Am Acad Dermatol 2018 Feb;78(2):336-41. doi: 10.1016/j.jaad.2017.08.043.
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Keywords: Children/Adolescents, Children/Adolescents, Skin Conditions, Sleep Problems
Sylvia LG, Chang WC, Kamali M
Sleep disturbance may impact treatment outcome in bipolar disorder: a preliminary investigation in the context of a large comparative effectiveness trial.
The purpose of this paper is to explore the potential impact of poor sleep at baseline on outcomes in a randomized effectiveness trial of quetiapine and lithium. Sixty-three percent of patients had baseline sleep disturbance. Individuals with sleep disturbance had worse bipolar illness severity, greater severity of depression, mania, anxiety, irritability, and psychosis, were less likely to have sustained response, and had more necessary clinical adjustments.
AHRQ-funded; HS019371.
Citation: Sylvia LG, Chang WC, Kamali M .
Sleep disturbance may impact treatment outcome in bipolar disorder: a preliminary investigation in the context of a large comparative effectiveness trial.
J Affect Disord 2018 Jan 1;225:563-68. doi: 10.1016/j.jad.2017.08.056.
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Keywords: Medication, Comparative Effectiveness, Behavioral Health, Patient-Centered Outcomes Research, Sleep Problems
Shear TC, Balachandran JS, Mokhlesi B
Risk of sleep apnea in hospitalized older patients.
This study assessed the prevalence of undiagnosed obstructive sleep apnea (OSA) among general medical inpatients and to investigate whether OSA risk is associated with in-hospital sleep quantity and quality. It found that two of every 5 inpatients older than 50 years screened at high risk for OSA. Those screening at high risk have worse in-hospital sleep quantity and quality.
AHRQ-funded; HS016967.
Citation: Shear TC, Balachandran JS, Mokhlesi B .
Risk of sleep apnea in hospitalized older patients.
J Clin Sleep Med 2014 Oct 15;10(10):1061-6. doi: 10.5664/jcsm.4098..
Keywords: Elderly, Sleep Problems, Risk, Respiratory Conditions
Petrov ME, Kim Y, Lauderdale DS
Objective sleep, a novel risk factor for alterations in kidney function: the CARDIA study.
The investigators determined the association between objectively measured sleep and 10-year changes in estimated glomerular filtration rate. They found that, in this community-based sample, shorter sleep and poorer sleep quality were related to higher kidney filtration rates over 10 years.
AHRQ-funded; HS013852.
Citation: Petrov ME, Kim Y, Lauderdale DS .
Objective sleep, a novel risk factor for alterations in kidney function: the CARDIA study.
Sleep Med 2014 Sep;15(9):1140-6. doi: 10.1016/j.sleep.2014.05.021.
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Keywords: Risk, Sleep Problems, Kidney Disease and Health
Petrov ME, Howard VJ, Kleindorfer D
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
The authors investigated the relation between sleep medication use and incident stroke. At the sleep assessment, 9.6% of the participants used prescription sleep medication and 11.1% used over-the-counter sleep aids. Over an average follow-up of 3.3 ± 1.0 years, 297 stroke events occurred. The authors found that over-the-counter sleep medication use was associated with increased risk of incident stroke; however, there was no significant association with prescription sleep medications. They concluded that over-the-counter sleep medication use may independently increase the risk of stroke beyond other risk factors in middle-aged to older individuals with no history of stroke.
AHRQ-funded; HS013852.
Citation: Petrov ME, Howard VJ, Kleindorfer D .
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
J Stroke Cerebrovasc Dis 2014 Sep;23(8):2110-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.03.025.
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Keywords: Medication: Safety, Medication, Risk, Sleep Problems, Stroke, Cardiovascular Conditions, Racial and Ethnic Minorities