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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.
Results
1 to 23 of 23 Research Studies Displayed
Xu L, Xie D, Griffin KS
Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea.
Although mandibular advancement device (MAD) treatment of adults with obstructive sleep apnea (OSA) is generally less efficacious than positive airway pressure (PAP), the two treatments are associated, with similar clinical outcomes. As a sub-analysis of a randomized trial comparing the effect of MAD versus PAP on blood pressure, this study compared objectively measured adherence to MAD versus PAP treatment in adults with OSA.
AHRQ-funded; HS019738.
Citation:
Xu L, Xie D, Griffin KS .
Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea.
J Sleep Res 2021 Aug;30(4):e13240. doi: 10.1111/jsr.13240..
Keywords:
Sleep Apnea, Sleep, Patient Adherence/Compliance, Treatments
Makarem N, Alcántara C, Williams N
Effect of sleep disturbances on blood pressure.
This review summarizes recent literature addressing the association of short sleep duration, shift work, and obstructive sleep apnea with hypertension risk, blood pressure (BP) levels, and 24-hour ambulatory BP. Recommendations include efforts to educate patients and health care providers about the importance of identifying and treating sleep disturbances for hypertension prevention and management. Empirically supported sleep health interventions represent a critical next step to advance this research area and establish causality.
AHRQ-funded; HS024274.
Citation:
Makarem N, Alcántara C, Williams N .
Effect of sleep disturbances on blood pressure.
Hypertension 2021 Apr;77(4):1036-46. doi: 10.1161/hypertensionaha.120.14479..
Keywords:
Sleep Apnea, Sleep, Blood Pressure, Hypertension
Leu GR, Links AR, Ryan MA
Assessment of parental choice predisposition for tonsillectomy in children.
The decision to proceed with tonsillectomy to treat pediatric obstructive sleep-disordered breathing (OSDB) often falls on individual families. Despite emphasis on shared decision-making between parents and surgeons about tonsillectomy for OSDB, the extent to which parents have already decided about surgery prior to the child's consultation is not known. The objective of this study was to identify predictors of parent choice predisposition for surgical treatment of OSDB with tonsillectomy and describe its association with parent-clinician communication.
AHRQ-funded; HS022932.
Citation:
Leu GR, Links AR, Ryan MA .
Assessment of parental choice predisposition for tonsillectomy in children.
JAMA Otolaryngol Head Neck Surg 2021 Mar;147(3):263-70. doi: 10.1001/jamaoto.2020.5031..
Keywords:
Children/Adolescents, Caregiving, Decision Making, Surgery, Sleep Apnea, Sleep
Oka S, Goto T, Hirayama A
Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002.
Researchers investigated the association of obstructive sleep apnea (OSA) with acute asthma severity in a retrospective cohort study that used State Inpatient Databases from eight geographically diverse states. Outcomes examined were markers of acute severity such as mechanical ventilation use, hospital length of stay, and in-hospital mortality. The researchers found that, among patients hospitalized for acute asthma, OSA was associated with a higher risk of noninvasive positive pressure ventilation use and longer length of stay compared with those without OSA.
AHRQ-funded; HS023305.
Citation:
Oka S, Goto T, Hirayama A .
Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002.
Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002..
Keywords:
Healthcare Cost and Utilization Project (HCUP), Sleep Apnea, Sleep, Asthma, Respiratory Conditions, Hospitalization, Outcomes, Patient-Centered Outcomes Research
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.
AHRQ-funded; HS024560.
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, Sleep Apnea, Treatments, Value
Singh G, Agarwal A, Zhang W
Impact of PAP therapy on hospitalization rates in Medicare beneficiaries with COPD and coexisting OSA.
This retrospective cohort study analyzed data from a national sample of fee-for-service Medicare beneficiaries with a diagnosis of chronic obstructive pulmonary disease (COPD) and coexisting obstructive sleep apnea (OSA) who had begun positive airway pressure (PAP) therapy in 2011. The effect of PAP therapy on emergency room visits and hospitalizations for all-cause and COPD-related conditions was also examined. PAP therapy was more beneficial for older adults, those with higher COPD complexity, and those with three or more comorbidities. PAP therapy in elderly patients with overlap syndrome is associated with a reduction in hospitalization for COPD-related conditions, but not for all-cause hospitalizations or ER visits.
AHRQ-funded; HS020642; HS022134.
Citation:
Singh G, Agarwal A, Zhang W .
Impact of PAP therapy on hospitalization rates in Medicare beneficiaries with COPD and coexisting OSA.
Sleep Breath 2019 Mar;23(1):193-200. doi: 10.1007/s11325-018-1680-0..
Keywords:
Respiratory Conditions, Chronic Conditions, Hospitalization, Medicare, Sleep Apnea
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, Sleep Apnea
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:
Behavioral Health, Lifestyle Changes, Obesity, Obesity: Weight Management, Sleep, Sleep Apnea
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 Apnea
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, Sleep Apnea, Urban Health
Donovan LM, Rise PJ, Carson SS
Sleep disturbance in smokers with preserved pulmonary function and chronic obstructive pulmonary disease.
This study compared the magnitude and correlates of sleep disturbance between smokers with preserved pulmonary function and those with airflow obstruction. It found that among smokers with clinically identified chronic obstructive pulmonary disease (COPD), the severity of sleep disturbance is greater among those with preserved pulmonary function compared to those with airflow obstruction. Non-respiratory symptoms, such as depression, were associated with sleep disturbance in both groups.
AHRQ-funded; HS017894.
Citation:
Donovan LM, Rise PJ, Carson SS .
Sleep disturbance in smokers with preserved pulmonary function and chronic obstructive pulmonary disease.
Ann Am Thorac Soc 2017 Dec;14(12):1836-43. doi: 10.1513/AnnalsATS.201706-453OC.
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Keywords:
Respiratory Conditions, Sleep, Sleep Apnea, Tobacco Use, Chronic Conditions
Zenga J, Suko J, Kallogjeri D
Postoperative hemorrhage and hospital revisit after transoral robotic surgery.
The researchers investigated the incidence and complications related to postoperative hemorrhage (POH) after transoral robotic surgery (TORS). Using HCUP data, they found that the incidence of POH after TORS was low, and few of these patients had a severe complication related to this event. Medical comorbidity and tonsillar subsite may be independent risk factors for POH.
AHRQ-funded; HS019455.
Citation:
Zenga J, Suko J, Kallogjeri D .
Postoperative hemorrhage and hospital revisit after transoral robotic surgery.
Laryngoscope 2017 Oct;127(10):2287-92. doi: 10.1002/lary.26626.
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Keywords:
Adverse Events, Healthcare Cost and Utilization Project (HCUP), Sleep Apnea, Surgery
Taylor HA, Morales C, Wilfond BS
A trial to test a novel approach to diabetes prevention.
This report presents a case introduction and summary in which the study under consideration planned to randomize patients at risk of diabetes (Type 2) to positive airway pressure (PAP) therapy to prevent the progression from prediabetes to diabetes (Type 2).
AHRQ-funded; HS000029.
Citation:
Taylor HA, Morales C, Wilfond BS .
A trial to test a novel approach to diabetes prevention.
Am J Bioeth 2017 Oct;17(10):74-75. doi: 10.1080/15265161.2017.1366200..
Keywords:
Diabetes, Prevention, Sleep, Sleep Apnea
McNellis RJ, Thomas S
Screening for obstructive sleep apnea in adults.
This case study involves a 52-year-old white man who presents to your office for a preventive health visit. He is overweight and has a history of hypertension and hyperlipidemia, which are stable and well controlled with medication. The study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation:
McNellis RJ, Thomas S .
Screening for obstructive sleep apnea in adults.
Am Fam Physician 2017 Jul 15;96(2):123-24.
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Keywords:
U.S. Preventive Services Task Force (USPSTF), Sleep Apnea, Screening, Sleep, Case Study
Boss EF, Links AR, Saxton R
Parent experience of care and decision making for children who snore.
The researchers identified factors associated with parental experience and decision making in pediatric sleep-disordered breathing (SDB) and adenotonsillectomy (AT) surgery. They found that while clinical factors were influential for decision making, interpersonal factors helped parents feel comfortable and influenced their overall experience
AHRQ-funded; HS022932.
Citation:
Boss EF, Links AR, Saxton R .
Parent experience of care and decision making for children who snore.
JAMA Otolaryngol Head Neck Surg 2017 Mar;143(3):218-25. doi: 10.1001/jamaoto.2016.2400.
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Keywords:
Patient Experience, Decision Making, Children/Adolescents, Sleep Apnea, Clinician-Patient Communication
Chinnadurai S, Jordan AK, Sathe NA
Tonsillectomy for obstructive sleep-disordered breathing: a meta-analysis.
This meta-analysis compared sleep, cognitive or behavioral, and health outcomes of tonsillectomy versus watchful waiting with supportive care in children with sleep-disordered breathing. It determined that, relative to watchful waiting, most studies reported better sleep-related outcomes in children who had a tonsillectomy.
AHRQ-funded; 290201500003I.
Citation:
Chinnadurai S, Jordan AK, Sathe NA .
Tonsillectomy for obstructive sleep-disordered breathing: a meta-analysis.
Pediatrics 2017 Feb;139(2). doi: 10.1542/peds.2016-3491.
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Keywords:
Sleep Apnea, Surgery, Patient-Centered Outcomes Research, Evidence-Based Practice, Children/Adolescents
Jonas DE, Amick HR, Feltner C
Screening for obstructive sleep apnea in adults: evidence report and systematic review for the US Preventive Services Task Force.
The effectiveness of stool-based colorectal cancer (CRC) screening is contingent on colonoscopy completion in patients with an abnormal fecal immunochemical test (FIT). This study found that FIT positive patients never referred to gastroenterology or who missed their appointment after referrals were more likely to have comorbid conditions and documented illicit substance use compared with patients who completed a colonoscopy.
AHRQ-funded; 290201200015I.
Citation:
Jonas DE, Amick HR, Feltner C .
Screening for obstructive sleep apnea in adults: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Jan 24;317(4):415-33. doi: 10.1001/jama.2016.19635.
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Keywords:
U.S. Preventive Services Task Force (USPSTF), Screening, Sleep Apnea, Evidence-Based Practice
Links AR, Tunkel DE, Boss EF
Stakeholder-engaged measure development for pediatric obstructive sleep-disordered breathing: the obstructive sleep-disordered breathing and adenotonsillectomy knowledge scale for parents.
The researchers developed a measure of parental knowledge about obstructive sleep-disordered breathing (oSDB) and adenotonsillectomy (AT). An 85-item prototype measure and 39-item modified measure were evaluated for consensus/approval and psychometric integrity Five themes (oSDB symptoms, treatment options, AT risks, anesthesia, and AT benefits) and 39 items composed the final scale.
AHRQ-funded; HS022932.
Citation:
Links AR, Tunkel DE, Boss EF .
Stakeholder-engaged measure development for pediatric obstructive sleep-disordered breathing: the obstructive sleep-disordered breathing and adenotonsillectomy knowledge scale for parents.
JAMA Otolaryngol Head Neck Surg 2017 Jan;143(1):46-54. doi: 10.1001/jamaoto.2016.2681.
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Keywords:
Children/Adolescents, Sleep Apnea, Surgery, Education: Patient and Caregiver, Decision Making
Carballo NJ, Alessi CA, Martin JL
Perceived effectiveness, self-efficacy, and social support for oral appliance therapy among older veterans with obstructive sleep apnea.
Adherence to oral appliance therapy may be influenced by patients' perceived effectiveness of the therapy, self-efficacy, and availability of social support. The researchers examined these perceptions among older adults with obstructive sleep apnea who were prescribed oral appliance therapy. They concluded that only about one third of older adults perceived it as an effective treatment, were confident about oral appliance use, and/or believed that they would receive needed support.
AHRQ-funded; HS024379.
Citation:
Carballo NJ, Alessi CA, Martin JL .
Perceived effectiveness, self-efficacy, and social support for oral appliance therapy among older veterans with obstructive sleep apnea.
Clin Ther 2016 Nov;38(11):2407-15. doi: 10.1016/j.clinthera.2016.09.008.
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Keywords:
Sleep Apnea, Patient Adherence/Compliance, Sleep, Veterans, Patient Self-Management
Sloan CD, Gebretsadik T, Rosas-Salazar C
Seasonal timing of infant bronchiolitis, apnea and sudden unexplained infant death.
The researchers analyzed ecological associations between timing of Sudden Unexplained Infant Death (SUID) cases, bronchiolitis, and apnea healthcare visits. They found a temporal relationship between infant bronchiolitis and apnea, but no peak in SUID cases during peaks of bronchiolitis. They concluded that consistent trends between bronchiolitis, apnea, and SUID were not established due to small numbers of SUID cases.
AHRQ-funded; HS018454.
Citation:
Sloan CD, Gebretsadik T, Rosas-Salazar C .
Seasonal timing of infant bronchiolitis, apnea and sudden unexplained infant death.
PLoS One 2016 Jul 12;11(7):e0158521. doi: 10.1371/journal.pone.0158521.
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Keywords:
Newborns/Infants, Mortality, Respiratory Conditions, Sleep Apnea, Tobacco Use
Abdelsattar ZM, Hendren S, Wong SL
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
The purpose of this study was to determine whether preoperatively untreated obstructive sleep apnea (OSA) affects postoperative outcomes. It found that compared with treated OSA, untreated OSA was independently associated with more cardiopulmonary complications (risk-adjusted rates 6.7 percent versus 4.0 percent; particularly unplanned reintubations and myocardial infarction.
AHRQ-funded; HS000053.
Citation:
Abdelsattar ZM, Hendren S, Wong SL .
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
Sleep 2015 Aug;38(8):1205-10. doi: 10.5665/sleep.4892..
Keywords:
Sleep Apnea, Surgery, Patient Safety, Risk, Patient-Centered Outcomes Research
Boss EF, Benke JR, Tunkel DE
Public insurance and timing of polysomnography and surgical care for children with sleep-disordered breathing.
The purpose of this study was (1) to evaluate receipt and timing of polysomnography (PSG) in relation to ultimate surgical therapy with adenotonsillectomy for children undergoing evaluation for sleep-disordered breathing and (2) to evaluate differences based on socio-economic status. It found that referral for PSG resulted in significant loss to follow-up for all children and delayed definitive surgical treatment for children with public insurance.
AHRQ-funded; HS022932.
Citation:
Boss EF, Benke JR, Tunkel DE .
Public insurance and timing of polysomnography and surgical care for children with sleep-disordered breathing.
JAMA Otolaryngol Head Neck Surg 2015 Feb;141(2):106-11. doi: 10.1001/jamaoto.2014.3085..
Keywords:
Socioeconomic Factors, Surgery, Sleep Apnea, Access to Care, Health Insurance
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:
Sleep Apnea, Risk, Hospitalization, Elderly
