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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 10 of 10 Research Studies Displayed
Sterling MR, Echeverria SE, Commodore-Mensah Y
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
This article discusses the key themes from a 2-day workshop that was held at the National Institutes of Health in May 2018 to promote health equity and implementation science in heart, lung, and sleep-related research. This inaugural workshop was named the Saunders-Watkins Leadership Workshop. Recommendations are offered for the future direction of this research.
Citation: Sterling MR, Echeverria SE, Commodore-Mensah Y . Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop. Circ Cardiovasc Qual Outcomes 2019 Oct;12(10):e005586. doi: 10.1161/circoutcomes.119.005586..
Keywords: Implementation, Evidence-Based Practice, Disparities, Patient-Centered Outcomes Research, Cardiovascular Conditions, Heart Disease and Health, Respiratory Conditions, Sleep Problems
Treister AD, Stefek H, Grimaldi D
Sleep and limb movement characteristics of children with atopic dermatitis coincidentally undergoing clinical polysomnography.
Atopic dermatitis (AD) is a prevalent, chronic, itchy skin condition. Children undergoing polysomnography (PSG) may coincidentally have AD. Many children with AD have sleep disturbances. This study aimed to characterize limb movements in children with AD and their effect on sleep. The investigators found altered PSG parameters in children with AD, suggesting that clinicians should consider the diagnosis when affected children undergo PSG.
Citation: Treister AD, Stefek H, Grimaldi D . Sleep and limb movement characteristics of children with atopic dermatitis coincidentally undergoing clinical polysomnography. J Clin Sleep Med 2019 Aug 15;15(8):1107-13. doi: 10.5664/jcsm.7800..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions
Ye L, Owens RL, Dykes P
Individualized sleep promotion in acute care hospitals: Identifying factors that affect patient sleep.
The aim of this study was develop a tool that can be used to measure factors that affect patient sleep in acute care hospitals. A tool called Factors Affected Inpatient Sleep (FAIS) was developed using literature review and was validated by content validity testing. The scale was tested on 105 hospitalized patients and the most significant sleep disruptors were identified. The final FAIS scale included 14 items in three subscales. The biggest factors for sleep disruption included 1) emotional or physical impairment due to illness or hospitalization; 2) sleep disturbance due to discomfort of their care plan schedule; and 3) sleep interruption due to the hospital environment or medical care. The reliability of the scale was measured at 0.87 with Cronbach’s alpha coefficient and reliability of the subscales ranged from 0.72 to 0.81.
Citation: Ye L, Owens RL, Dykes P . Individualized sleep promotion in acute care hospitals: Identifying factors that affect patient sleep. Appl Nurs Res 2019 Aug;48:63-67. doi: 10.1016/j.apnr.2019.05.006..
Keywords: Health Promotion, Hospitalization, Hospitals, Inpatient Care, Sleep Problems
St Hilaire MA, Anderson C, Anwar J
Brief (<4 hour) sleep episodes are insufficient for restoring performance in first-year resident physicians working overnight extended-duration work shifts.
This study examines the impact of reinstating extended duration (24-28) work shifts (EDWS) for postgraduate year 1 resident physicians. The performance of residents was studied for 23 male residents between 2002-2004 during a three-week on-call rotation schedule at the Medical and Intensive Care Units at Brigham and Women’s Hospital in Boston. If the sleep episodes were four hours or less then the odds of >1 attentional failure was 2.72 times higher during post-call compared to matched sessions during non-EDWS.
Citation: St Hilaire MA, Anderson C, Anwar J . Brief (<4 hour) sleep episodes are insufficient for restoring performance in first-year resident physicians working overnight extended-duration work shifts. Sleep 2019 May;42(5):pii: zsz041. doi: 10.1093/sleep/zsz041..
Keywords: Adverse Events, Education: Continuing Medical Education, Medical Errors, Patient Safety, Provider, Provider: Physician, Quality of Care, Sleep Problems, Training
Wickwire EM, Albrecht JS, Towe MM
The impact of treatments for OSA on monetized health economic outcomes: a systematic review.
This article systematically reviews published literature on the impact of treatment for obstructive sleep apnea (OSA) on monetized health economic outcomes. Customized searches were conducted in PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases; 196 articles were selected for review, and 17 studies met the inclusion criteria and were included in the final synthesis. In these selected studies, positive airway pressure was the most common treatment modality, but oral appliances and surgical approaches were also included. Healthcare use (HCU) and quality-adjusted life years (QALYs) were most common health economic outcomes. The authors conclude that, although study methodologies varied widely, the evidence suggested that treatment of OSA was associated with favorable economic outcomes within accepted ranges of cost-effectiveness, as well as reduced HCU and monetized costs.
Citation: Wickwire EM, Albrecht JS, Towe MM . The impact of treatments for OSA on monetized health economic outcomes: a systematic review. Chest 2019 May;155(5):947-61. doi: 10.1016/j.chest.2019.01.009..
Keywords: Evidence-Based Practice, Healthcare Costs, Outcomes, Patient-Centered Outcomes Research, Sleep Problems, Sleep Apnea, Treatments, Value
Wickwire EM, Tom SE, Scharf SM
Untreated insomnia increases all-cause health care utilization and costs among Medicare beneficiaries.
The purpose of this study was to examine the impact of untreated insomnia on health care utilization (HCU) among a representative sample of Medicare beneficiaries. Insomnia was defined as the presence of at least one claim containing an insomnia-related diagnosis in any given year based on ICD-9 or at least one prescription filled for an insomnia-related medication in Part D prescription drug files. Researchers compared HCU in the year prior to insomnia diagnosis with non-sleep disordered controls during the same period. The researchers conclude that the individuals in this randomly selected, representative sample with untreated insomnia demonstrated increased HCU and costs across all points of service.
Citation: Wickwire EM, Tom SE, Scharf SM . Untreated insomnia increases all-cause health care utilization and costs among Medicare beneficiaries. Sleep 2019 Apr;42(4). doi: 10.1093/sleep/zsz007..
Keywords: Healthcare Costs, Healthcare Utilization, Medicare, Sleep Problems
Albrecht JS, Wickwire EM, Vadlamani A
Trends in insomnia diagnosis and treatment among Medicare beneficiaries, 2006-2013.
In this study, the investigators examined trends in insomnia diagnosis and treatment among Medicare beneficiaries over an eight-year period. In this large national analysis of Medicare beneficiaries, prevalence of physician-assigned insomnia diagnoses was low but increased over time. Prevalence of insomnia medication use was up to four-times higher than insomnia diagnoses and remained steady over time.
Citation: Albrecht JS, Wickwire EM, Vadlamani A . Trends in insomnia diagnosis and treatment among Medicare beneficiaries, 2006-2013. Am J Geriatr Psychiatry 2019 Mar;27(3):301-09. doi: 10.1016/j.jagp.2018.10.017..
Keywords: Diagnostic Safety and Quality, Elderly, Medicare, Sleep Problems
Starr P, Agarwal A, Singh G
Obstructive sleep apnea with chronic obstructive pulmonary disease among Medicare beneficiaries.
This letter to the editor describes a claims-based study of Medicare beneficiaries conducted by the authors that examined the diagnosed prevalence and trend of overlap syndrome (the coexistence of chronic obstructive pulmonary disease [COPD] and obstructive sleep apnea [OSA] in a single individual). A total of 159,084 patients with COPD were included in the study; 11 percent had coexisting OSA. Data were gathered from multiple files: the Medicare Denominator File, the Medicare Provider Analysis and Review File, the Outpatient Standard Analytic File, the 100% Physician/Supplier Data File, and the Durable Medical Equipment File. Medicare enrollment files were used to gather information on patient characteristics and categorize subjects by age, sex, race, and socioeconomic status. The authors note that the prevalence of diagnosed overlap syndrome has increased fourfold during the 10-year study period.
AHRQ-funded; HS020642; HS022134.
Citation: Starr P, Agarwal A, Singh G . Obstructive sleep apnea with chronic obstructive pulmonary disease among Medicare beneficiaries. Ann Am Thorac Soc 2019 Jan;16(1):153-56. doi: 10.1513/AnnalsATS.201712-932OC..
Keywords: Chronic Conditions, Respiratory Conditions, Medicare, Sleep Problems, Sleep Apnea
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.
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.
Keywords: Risk, Risk, Sleep Problems
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.
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.
Keywords: Medication: Safety, Medication, Risk, Sleep Problems, Stroke