Exploring Alternative Treatments for Non-Compliant PAP Therapy Patients

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

HSAT devices can be less reliable for ruling out mild OSA

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

To determine the severity of OSA

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

Artificial intelligence determining sleep time based on airflow

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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