Exploring Alternative Treatments for Non-Compliant PAP Therapy Patients
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Questions and Answers

Which of the following is true about home sleep apnea testing (HSAT) devices?

  • HSAT devices are more accurate than in-lab sleep studies
  • HSAT devices are not accepted for the diagnosis of OSA
  • HSAT devices can provide a comprehensive evaluation of patients' symptoms
  • HSAT devices can be less reliable for ruling out mild OSA (correct)

    • What is the purpose of using HSAT devices in the diagnosis of OSA?

  • To accurately measure sleep time
  • To assess comorbidities
  • To determine the severity of OSA (correct)
  • To exclude treatment modalities

    • What recent advancements in technology have improved the accuracy of HSAT devices?

  • Artificial intelligence determining sleep time based on airflow (correct)
  • Peripheral/external sensors
  • In-lab sleep studies
  • Assessment of patients' symptoms

    • Which of the following is a key factor in the impact of untreated sleep disordered breathing on cardiovascular disease?

    <p>Intermittent hypoxemia</p> Signup and view all the answers

    What is the estimated overall direct health care cost of untreated sleep disordered breathing?

    <p>$94.9 billion per year</p> Signup and view all the answers

    Which cardiovascular condition has the highest comorbid rate with sleep apnea?

    <p>Atrial fibrillation</p> Signup and view all the answers

    What effect does CPAP therapy for OSA have on atrial fibrillation?

    <p>Increases atrial fibrillation-free periods</p> Signup and view all the answers

    According to the text, what is the primary outcome measure of the STAR trial?

    <p>Change in AHI at 12 months</p> Signup and view all the answers

    How many patients were enrolled in the STAR trial?

    <p>929</p> Signup and view all the answers

    What is the age range of the pediatric Down syndrome patient population that is included in the FDA approval of UAS as a second line treatment option?

    <p>13 to 18</p> Signup and view all the answers

    What is the baseline AHI (Apnea-Hypopnea Index) of the patients in the STAR trial?

    <p>32.0</p> Signup and view all the answers

    According to the text, what are the three overarching goals of the Triple Aim proposed by the Institute for Healthcare Improvement?

    <p>Improving the patient experience of care, improving the health of populations, reducing the per capita cost of healthcare</p> Signup and view all the answers

    What is the estimated prevalence of undiagnosed OSA (Apnea Hypopnea Index (AHI) >5) in the United States (U.S.) according to the report commissioned by AASM in 2016?

    <p>23.5m</p> Signup and view all the answers

    Which population has a greater prevalence of sleep apnea compared to Caucasians at the same age and body mass index, according to the text?

    <p>African Americans</p> Signup and view all the answers

    Which therapy is currently recommended as the first line treatment for patients with moderate to severe OSA?

    <p>CPAP</p> Signup and view all the answers

    What is the goal of the HOME study?

    <p>To compare the outcomes of two post-implant care algorithms</p> Signup and view all the answers

    What is the indication for Upper Airway Stimulation (UAS) in the study involving adolescents and young adults with Down syndrome?

    <p>Cognition and language changes</p> Signup and view all the answers

    What is the current status of UAS approval for pediatric Down syndrome patients?

    <p>FDA approved</p> Signup and view all the answers

    Which therapy option is a dynamic therapy for patients who are intolerant of CPAP or in whom CPAP may not be effective?

    <p>Hypoglossal nerve stimulation</p> Signup and view all the answers

    What is the indicated criteria for surgical implant of a UAS device?

    <p>All of the above</p> Signup and view all the answers

    What is the recommended BMI threshold for considering UAS therapy?

    <p>BMI ≥ 32</p> Signup and view all the answers

    What is the reference standard for the diagnosis of OSA and the quantification of respiratory events?

    <p>Polysomnography (PSG)</p> Signup and view all the answers

    According to the text, what is the primary outcome measure of the ADHERE registry?

    <p>Changes to AHI and ESS from baseline to 12 months</p> Signup and view all the answers

    What did the sub-analysis of the ADHERE registry demonstrate about therapy efficacy in an older population?

    <p>Older patients had improved AHI reduction and higher usage than a younger population</p> Signup and view all the answers

    What is the Sher criteria for success in the ADHERE registry?

    <p>50% reduction in AHI and an AHI &lt; 20</p> Signup and view all the answers

    What did the sub-analysis comparing 3-incision vs. 2-incision technique in the ADHERE registry demonstrate?

    <p>The 2-incision technique reduced operative time by 33%</p> Signup and view all the answers

    According to the text, what is the estimated overall direct health care cost of untreated sleep disordered breathing?

    <p>$94.9 billion</p> Signup and view all the answers

    According to the text, what is the impact of untreated sleep disordered breathing on the health system?

    <p>All of the above</p> Signup and view all the answers

    According to the text, what is the prevalence of sleep apnea within the population with cardiovascular disease?

    <p>83%</p> Signup and view all the answers

    According to the text, what factors contribute to the impact of sleep apnea on cardiovascular disease?

    <p>All of the above</p> Signup and view all the answers

    According to the text, what are the three overarching goals of the Triple Aim proposed by the Institute for Healthcare Improvement?

    <p>Improving patient experience, improving population health, reducing healthcare cost</p> Signup and view all the answers

    What is the estimated prevalence of undiagnosed OSA (Apnea Hypopnea Index (AHI) >5) in the United States (U.S.) according to the report commissioned by AASM in 2016?

    <p>23.5 million</p> Signup and view all the answers

    What is the indicated criteria for surgical implant of a UAS device?

    <p>Moderate to severe OSA with BMI &gt;30 kg/m^2</p> Signup and view all the answers

    Which of the following is a limitation of home sleep apnea testing (HSAT) devices?

    <p>HSAT devices can overestimate or underestimate AHI</p> Signup and view all the answers

    What is the recommended AHI range for considering Upper Airway Stimulation (UAS) therapy?

    <p>5-15</p> Signup and view all the answers

    What is the primary purpose of using home sleep apnea testing (HSAT) devices in the diagnosis of OSA?

    <p>To assess patients' symptoms and comorbidities</p> Signup and view all the answers

    Which therapy option is a dynamic therapy for patients who are intolerant of CPAP or in whom CPAP may not be effective?

    <p>Hypoglossal Nerve Stimulation (HNS)</p> Signup and view all the answers

    What is the age range of the pediatric Down syndrome patient population that is included in the FDA approval of UAS as a second line treatment option?

    <p>13-18 years</p> Signup and view all the answers

    What is the recommended BMI threshold for considering UAS therapy?

    <p>BMI ≥ 32</p> Signup and view all the answers

    What is the reference standard for the diagnosis of OSA and the quantification of respiratory events?

    <p>Polysomnography (PSG)</p> Signup and view all the answers

    According to the text, what is the primary outcome measure of the STAR trial?

    <p>Change in AHI</p> Signup and view all the answers

    What is the baseline AHI (Apnea-Hypopnea Index) of the patients in the STAR trial?

    <p>32.0</p> Signup and view all the answers

    What is the purpose of using HSAT devices in the diagnosis of OSA?

    <p>To screen for the presence of OSA</p> Signup and view all the answers

    What is the current status of UAS approval for pediatric Down syndrome patients?

    <p>Approved for ages 13 to 18</p> Signup and view all the answers

    According to the text, how many patients were enrolled in the ADHERE registry as of April 2023?

    <p>Over 4,800</p> Signup and view all the answers

    What is the primary outcome measure of the ADHERE registry?

    <p>Changes to AHI and ESS from baseline to 12 months</p> Signup and view all the answers

    What is the benchmark for success according to the Sher criteria in the ADHERE registry?

    <p>50% reduction in AHI and AHI&lt;20</p> Signup and view all the answers

    What did the sub-analysis comparing 3-incision vs. 2-incision technique in the ADHERE registry demonstrate?

    <p>The 2-incision technique reduced operative time by 33%</p> Signup and view all the answers

    According to the text, what is the first line therapy for patients with moderate to severe OSA?

    <p>Continuous Positive Airway Pressure (CPAP)</p> Signup and view all the answers

    What is the primary outcome measure of the HOME study?

    <p>Comparison of post-activation care between HSAT and in-laboratory PSG</p> Signup and view all the answers

    What is the indication for Upper Airway Stimulation (UAS) in the study involving adolescents and young adults with Down syndrome?

    <p>Moderate to severe sleep apnea</p> Signup and view all the answers

    What is the estimated prevalence of undiagnosed OSA (Apnea Hypopnea Index (AHI) >5) in the United States (U.S.) according to the report commissioned by AASM in 2016?

    <p>50 million</p> Signup and view all the answers

    Which of the following is a leading cause of both morbidity and mortality around the world?

    <p>Cardiovascular disease</p> Signup and view all the answers

    What is the estimated overall direct health care cost of untreated sleep disordered breathing?

    <p>$94.9 billion</p> Signup and view all the answers

    What is the prevalence of sleep apnea within the population with refractory hypertension?

    <p>83%</p> Signup and view all the answers

    What is the primary outcome measure of the HOME study?

    <p>Reduction in cardiovascular events</p> Signup and view all the answers

    According to the text, what are the three overarching goals of the Triple Aim proposed by the Institute for Healthcare Improvement?

    <p>Improving patient satisfaction, reducing healthcare costs, and improving population health</p> Signup and view all the answers

    What is the estimated prevalence of undiagnosed OSA (Apnea Hypopnea Index (AHI) >5) in the United States (U.S.) according to the report commissioned by AASM in 2016?

    <p>Approximately 23.5 million</p> Signup and view all the answers

    What is the prevalence of sleep apnea within the population with cardiovascular disease according to the text?

    <p>15-30% in men and 10-15% in women</p> Signup and view all the answers

    Which of the following is a limitation of home sleep apnea testing (HSAT) devices?

    <p>HSAT devices cannot accurately measure sleep time.</p> Signup and view all the answers

    What is the recommended AHI range for considering Upper Airway Stimulation (UAS) therapy?

    <p>AHI &gt;30</p> Signup and view all the answers

    What recent advancements in technology have improved the accuracy of HSAT devices?

    <p>Peripheral/external sensors</p> Signup and view all the answers

    According to the ADHERE registry, what percentage of patients with a BMI less than 32 had a higher Sher responder rate compared to those with a BMI of 32-35?

    <p>72%</p> Signup and view all the answers

    What was the reduction in operative time when comparing the 2-incision technique to the 3-incision technique in the ADHERE registry sub-analysis?

    <p>33%</p> Signup and view all the answers

    What was the patient-reported reduction in the Epworth Sleepiness Scale (ESS) score from baseline to 12 months in the therapy withdrawal group in the 12-month visit of the study?

    <p>2.9</p> Signup and view all the answers

    How many patients have been enrolled in the ADHERE registry as of April 2023?

    <p>4,800</p> Signup and view all the answers

    According to the STAR trial, what was the mean baseline AHI (Apnea-Hypopnea Index) of the patients?

    <p>32.0</p> Signup and view all the answers

    What was the primary outcome measure of the STAR trial?

    <p>Change in the severity of OSA as assessed by AHI and ODI-4 at 12 months, post-implant</p> Signup and view all the answers

    What was the mean baseline ODI-4 (Oxygen Desaturation Index) of the patients in the STAR trial?

    <p>25.4</p> Signup and view all the answers

    What was the reduction in AHI (Apnea-Hypopnea Index) at 12 months, post-implant in the STAR trial?

    <p>9.0 events/hour</p> Signup and view all the answers

    According to the text, what is the primary outcome measure of the Cognition and Language study?

    <p>Changes in cognition and expressive language</p> Signup and view all the answers

    What is the purpose of the feasibility study of hypoglossal nerve stimulation in children with Down syndrome and moderate to severe obstructive sleep apnea?

    <p>To evaluate the safety and efficacy of UAS in this population</p> Signup and view all the answers

    What is the current status of UAS approval for pediatric Down syndrome patients?

    <p>UAS has received FDA approval for pediatric Down syndrome patients</p> Signup and view all the answers

    What is the primary purpose of using home sleep apnea testing (HSAT) devices in the diagnosis of OSA?

    <p>To screen for the presence of sleep apnea</p> Signup and view all the answers

    Which therapeutic option is a dynamic therapy for patients who are intolerant of CPAP or in whom CPAP may not be effective?

    <p>Hypoglossal nerve stimulation (HNS)</p> Signup and view all the answers

    Which surgical procedure is an option for patients who have not been successful or wish to discontinue PAP therapy?

    <p>Otolaryngologic procedures</p> Signup and view all the answers

    What is the indicated criteria for surgical implant of a Upper Airway Stimulation (UAS) device?

    <p>Moderate to severe obstructive sleep apnea - AHI events between 15 to 65/hr with &lt; 25% central and mixed apneas</p> Signup and view all the answers

    What is the primary purpose of sleep testing in the diagnosis of OSA?

    <p>To rule out other types of sleep disordered breathing</p> Signup and view all the answers

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