29 Mar

Blackstone Saves Day for PAP Companies (Press Release)

Tampa, Fla.—Blackstone Medical Services, an IDTF specializing in sleep apnea diagnosis
and telehealth solutions, uses proprietary cloud-based technology, providing patients and physicians better quality, access and cost—matching the nation’s shift to a patient-centered medical home (PCMH) approach.

No longer do CPAP companies need to wait outside pulmonologists’ doors for
referrals. Blackstone allows preferred DME providers to utilize its cloud-based portal to increase transparency and control over therapy when tests are being performed by PCPs and other physicians. Blackstone provides real-time feedback on which patients were previously tested and where each patient is in the process, allowing a DMEs a unified approach, one that hasn’t been available until now.

“Our model works because we are superior in the continuum of patient care,” said Vick Tipnes, president of Blackstone Medical Services. “We not only have the highest patient compliance in the industry but we also work seamlessly with DMEs. We ensure that they receive the best follow-up and treatment care from their physicians and DME providers. This reduces the cost of care delivery and enables better physician to DME care coordination.”

Blackstone’s model involves the use of the industry’s top testing device and board-certified sleep physicians. Its easily accessible services increase patients’ compliance with sleep studies. Research shows that patients are more likely to complete a sleep study from the comfort of their own home.

Blackstone’s model serves as the best of both worlds for all parties involved.

“Not only do patients get to complete the study where they’re more comfortable but doctors are able to retain more of their patients because they aren’t referring to specialists,” said Tipnes. “When doctors prescribe a home sleep study for their patients, they are the ones who can follow up with these patients, resulting in higher patient retention and less out of pocket for patients.”

Blackstone works with DME companies that follow the same standard of patient care. With this philosophy, together they can change the lives of those suffering from sleep apnea one home sleep test at a time.

About Blackstone:

BlackstoneMedical Services, a Medicare-approved, JCAHO-accredited and nationally recognized IDTF for home sleep testing and telehealth solutions based in Tampa, Fla., has over 12 million covered lives. It is focused on serving those suffering from Obstructive Sleep Apnea (OSA) and its services eliminate and significantly reduce hospital re-admissions and urgent care visits. OSA is a serious health concern and you should be tested. If you or a loved one suffers from fatigue or daytime sleepiness, call toll-free at 888-710-2727 or visit www.blackstonemedicalservices.com for more information.

05 Mar

Training Makes All the Difference

Last week, eight members of the Blackstone Medical Services team, myself included, underwent an intense, two-day training session focused on sales and proper selling techniques. The majority of us went in not knowing what to expect and thinking that this would be a waste of our time. I mean, let’s face it. Who wants to get behind in their work to partake in a 16-hour training?

We started the training at eight on Thursday morning. The instructor went over the general rules, handed us our training packets and started the course. We were not able to take notes—the instructor stated that by the end of this course we will know everything we need to know. The first assignment was to read 30 basic definitions related to marketing and sales. We were partnered up and told to quiz and coach each other through the training. After reviewing the 30 words with our “twin”, we were individually drilled by the instructor. Sounds easy? Guess again. If you messed up or fumbled on one word, regardless of how far along you were, you were told to begin again. It was grueling and frustrating, and it was clear that some of us were losing our patience.

Despite how much we hated the process, we had to continue in order to pass the course. Once we successfully memorized all 30 definitions, we were clear to move on to the next phase. Each phase was comprised of readings, essay responses and drills. Some of the tasks required us to be cleared by the instructor before moving on. By lunch, we were exhausted. The day continued on at the same pace.

Friday morning started session two of the training. We quickly got to work and picked up from where we left off. It was another day full of reading, writing and memorizing. Most of us thought our heads were going to explode from all of the information. By the end of the day Friday, however, we knew the information. We could recite these definitions and puzzles back to each other upon command.

To our surprise, the sales training was enlightening. It went over the basic concepts of marketing and sales, how to communicate effectively to ensure a close, and the difference between hard selling and hard pressuring. We knew all about the proper communication required to build relationships and make the sale. The activities and exercises were challenging but they helped us remember the general concepts of the course. We all walked out feeling empowered and ready to apply these tactics in our work. The entire training was tailored to our work at Blackstone Medical Services, so it was easy to see how we can apply these ideas to each task we complete. Not only do we feel better equipped in our job duties but we have also developed a bond and trust with the other members of our team. So, would we do this again? Absolutely!

19 Feb

Increase in late-night texting causes less daytime productivity

With society engulfed in a technologically-driven world, it’s no surprise that people are sleeping less each night. What’s to blame? According to studies, cell phones and computers are the biggest distractors.

Many sleep specialists have reported that texting is still on the rise, especially among adolescents and young adults. According to studies, teenagers send an average of 100 text messages a day and are now even responding to text messages subconsciously. It happens so frequently that it’s been given a name—“sleep texting.”

“The phone will beep [and] they’ll answer the text,” said Elizabeth Dowell, a nursing professor at Villanova University. “They’ll either respond in words or gibberish. [It] can even be inappropriate. Ex-girlfriends contacting ex-boyfriends, saying ‘I miss you; I want to see you.’ The thing that happens, though, is that when they wake up, there’s no
memory.”

And this doesn’t only happen to teenagers. Dr. Michael Breus, a clinical psychologist and sleep specialist, told the Huffington Post that based on his conversations with patients, he believes that anyone who sleeps with a phone nearby is susceptible to this growing trend.

“It’s basically what we call an arousal disorder,” said Breus. “Somebody gets woken up but is not completely awake from the process of sleeping.”

The bottom line is that this behavior is negatively affecting the bottom line. According to a Harvard Medical School study, chronic exhaustion is costing the economy $63.2 billion in lost productivity. Because of this, employers nationwide are finding ways to encourage workers to sleep better at night. Experts suggest that adults should sleep seven to nine hours per night, while teenagers need more than that to function properly.

What can you do to improve your sleep schedule? The National Sleep Foundation suggests that you:

  1. Treat your bedroom as your sanctuary—by creating a comfortable, distraction-free area, your body will recognize your bedroom as a place to relax, thus allowing you to fall asleep faster.
  2. Adjust the lighting—turn off your phones, televisions and iPads one hour before hitting the hay. The light emitted from these devices stimulates your eyes and increases alertness levels. In addition, ensure your room will stay dark from the time you fall asleep until you wake up in the morning. Use curtains/shades if you don’t already.
  3. Establish a routine—when your body gets into a routine, it’s much easier to function day-to-day. It’s important to go to bed and wake up the same time every day. And yes, that means on weekends too!
  4. Cut the caffeine—it’s not a bad idea to skip that extra cup of coffee while watching the evening news. Experts recommend that you stop all caffeine consumption by 2 p.m. Eliminating large meals and alcohol before bedtime will also help you sleep better at night.
  5. Remember to exercise—Exercising isn’t just for looks. Exercising in the morning will also help you sleep better at night. Just remember to avoid rigorous exercising too close to bedtime.

15 Feb

The Real Difference Between HST and Sleep Facilities

Have you been told you need to complete a sleep
study? Are you torn between completing it at a sleep facility versus at home? What
are the differences? Are the results really the same?

Blackstone Medical Services offers those suffering from
obstructive sleep apnea the opportunity to complete a home sleep study rather
than spending the night at a sleep facility. Once you receive a prescription
for the test, a home sleep study device (about the size of a cell phone), is
shipped directly to your home. The package comes with detailed instructions,
along with an instructional video explaining how to perform the sleep study.
Once the study is completed, you ship the device back using the pre-paid
shipping label provided for you. It’s as easy that!

Because home sleep testing is a newer option, many
are skeptical to complete the test on their own. However, home sleep testing
offers many things that a sleep institute study cannot. For instance, you will
be able to move freely in any position during the study. This is highly
beneficial if you need to get up at any point during the night. At a sleep
facility, if you need to use the bathroom you must notify the sleep technician
so he/she can disconnect all of the wires. With a home sleep study, the small
device is attached around your chest and allows you to get up and move around. In
addition, your partner can sleep in the same bed during the study. This is much
more comforting and will allow you to maintain your normal sleep schedule.

Another benefit of home sleep testing is cost. Home
sleep studies, if the proper criteria are met, are covered by most insurance
plans. If you would prefer to self-pay, the out-of-pocket cost is $329. This is
significantly lower compared to the thousands it costs to have a study
conducted at a sleep lab.

Time also plays a major role in home sleep testing.
Although a home sleep test requires participation for two nights (compared to
the one night required by labs), the results arrive much quicker. Once the test
is ordered, the test may be completed in as little as 24 hours, as opposed to
the average 1-to-2 week waiting period for labs. The same can be said for the
reading of the results. Once the test is completed and the device is sent back,
it takes 24 hours to process the results. With a sleep lab, it may take up to
two weeks to receive the results upon completion.

So, is the quality of the results the same? YES! A
home sleep study device measures the same things that the sleep lab is
measuring—respiratory effort, snoring, pulse rate, oxygen saturation and body
position. However, home sleep devices do not monitor heart rhythms, brain waves
or eye and leg movements. What’s the difference? Home sleep studies specialize
in the diagnosis of sleep apnea while sleep facilities monitor for a variety of
sleep disorders, such as restless leg syndrome and REM sleep.

If you suspect that you or a loved one suffers from
sleep apnea, don’t spend thousands of dollars on traditional out-patient
facilities when you stay in your own home. Home sleep studies are more
affordable and less invasive. Visit our website for more information on home
sleep testing—www.blackstonemedicalservices.com.

06 Feb

Obstructive Sleep Apnea Worsens During Colder Months

Although obstructive sleep apnea (OSA) is an ongoing
condition, studies show that OSA symptoms tend to worsen during the winter
months and times of climate change.

A recent 10-year-study conducted by researchers at
the Chest Journal found that OSA patients experienced more breathing pauses
during colder months than warmer ones. This study,
based on findings of 7,500 patients participating in a one-night sleep study,
showed that patients stopped breathing an average of 18 times during the winter
and 15 times during summer months.

This shows that OSA may be negatively affected by
seasonal changes. In addition to temperature, weight change, allergies and
other various illnesses may cause OSA symptoms to worsen during as the year
progresses.

It’s important to understand that OSA can be life
threatening. If left untreated, sleep apnea may cause high blood pressure,
heart disease, stroke and depression. If you or someone you know suffers from
fatigue and/or daytime drowsiness, we can help! Call us toll-free at
800-710-2727 or visit www.blackstonemedicalservices.com
for more information on home sleep testing.

06 Aug

Decoding the Science of Sleep – Tampa

Zlatko Glusica was the captain of an Air India Express plane carrying 166 passengers from Dubai to Mangalore, a bustling port city on India’s southern coast. As his Boeing 737 approached the city, Mr. Glusica woke up from a nap in the cockpit and took over the controls. His co-pilot warned him repeatedly that he was coming in at the wrong angle and that he should pull up and try again. The last sound on the cockpit recorder was the co-pilot screaming that they didn’t have any runway left. The plane overshot the landing and burst into flames. Only eight people survived. An investigation found that the captain was suffering from “sleep inertia.”

The accident was a fatal reminder of the power of something prosaic that most of us typically don’t give much thought: sleep. Yet it’s a lesson that is habitually forgotten. Since that 2010 Air India flight, sleepy pilots have been at the center of several near-accidents, including two this year. In April, 16 passengers of an Air Canada flight were injured after the plane’s pilot went into a sudden dive after he mistook the planet Venus for an oncoming plane. And in July, a Texas judge found that a JetBlue pilot’s bizarre ranting in the cabin was a psychotic breakdown that may have been caused by a lack of sleep.

It isn’t just the airline industry. Some 20% of automobile accidents come as the result of drowsy drivers, according to the Centers for Disease Control and Prevention. U.S. military researchers, meanwhile, have concluded that sleeplessness is one of the leading causes of friendly fire.

Sleep wasn’t something we were supposed to worry about in the early years of the 21st century. Technology was making the world smaller by the day; the global economy blurred the lines between one day and the next, and things like time and place were supposed to be growing ever less important in the always-on workplace. Most of us never gave sleep much thought—considering it nothing more than an elegant on-off switch, like the ones on our smartphones, that the body flips when it needs to take a break from its overscheduled life. Sure, we’d like to get a bit more of it. But, beyond that, sleep likely hovers somewhere near flossing in most of our lives: something we are supposed to do more—but don’t.

Americans, however, are starting to wake up about sleep. Endless ads for dubious energy drinks and an equal number of much slicker ads for prescription sleep aids reveal a culture in 2012 that is wired and tired. Lack of sleep, it seems, has become one of the signature ailments of our modern age.

Nearly a third of working adults in America—roughly 41 million people—get less than six hours of sleep a night, according to a recent CDC report. That number of sleep-deprived people is up about 25% from 1990. About 27% of workers in the financial and insurance industries are sleep-deprived, according to the CDC, while nearly 42% of workers in the mining industry share the same complaint. A 2011 study published in the journal Sleep found that insomnia costs $2,280 per worker in lost productivity, adding up to $63.2 billion nationwide.

This skyrocketing sleeplessness has given rise to a large and growing industry: Americans now spend tens of billions of dollars on prescriptions, at sleep labs, on mattresses and for medical devices in our quest for some simple shuteye, according to Marketdata Enterprises, a market research firm based in Tampa, Fla. “Fatigue management consultants,” meanwhile, now work with more than half of the current Fortune 500 companies, law-enforcement groups and even Super Bowl-winning teams on ways to maintain a consistently high-performing workforce and prevent accidents.

So why is sleep, which seems so simple, becoming so problematic? Much of the problem can be traced to the revolutionary device that’s probably hanging above your head right now: the light bulb. Before this electrically illuminated age, our ancestors slept in two distinct chunks each night. The so-called first sleep took place not long after the sun went down and lasted until a little after midnight. A person would then wake up for an hour or so before heading back to the so-called second sleep.

Sleep wasn’t something we were supposed to worry about in the 21st century—as time and place were set to be erased by technology.

It was a fact of life that was once as common as breakfast—and one which might have remained forgotten had it not been for the research of a Virginia Tech history professor named A. Roger Ekirch, who spent nearly 20 years in the 1980s and ’90s investigating the history of the night. As Prof. Ekirch leafed through documents ranging from property records to primers on how to spot a ghost, he kept noticing strange references to sleep. In “The Canterbury Tales,” for instance, one of the characters in “The Squire’s Tale” wakes up in the early morning following her “first sleep” and then goes back to bed. A 15th-century medical book, meanwhile, advised readers to spend their “first sleep” on the right side and after that to lie on their left. A cleric in England wrote that the time between the first and second sleep was the best time for serious study.

The time between the two bouts of sleep was a natural and expected part of the night, and depending on your needs, was spent praying, reading, contemplating your dreams or having sex. The last one was perhaps the most popular. A noted 16th-century French physician named Laurent Joubert concluded that plowmen, artisans and others who worked with their hands were able to conceive more children because they waited until after their first sleep, when their energy was replenished, to make love.

Studies show that this type of sleep is so ingrained in our nature that it will reappear if given a chance. Experimental subjects sequestered from artificial lights have tended to ease into this rhythm. What’s more, cultures without artificial light still sleep this way. In the 1960s, anthropologists studying the Tiv culture in central Nigeria found that group members not only practiced segmented sleep, but also used roughly the same terms to describe it.

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That natural cycle was forever changed by Thomas Edison (whose contributions to our sleepless nights also extend to his work on the phonograph and the motion picture). Soon, sunset no longer meant the end of your social life, but the beginning of it. Night became the time when all the good stuff happens. And, for businesses, it meant that darkness no longer got in the way of production. Factories soon began running all night long. By the 1920s, the idea of a first and second sleep had entirely disappeared from our daily rhythms, completing a process that had begun 200 years earlier with the introduction of the first gas lamps and the surge in the number of coffee houses in Northern Europe. Now we have so much artificial light that after a 1994 earthquake knocked out power, some concerned residents of Los Angeles called the police to report a “giant, silvery cloud” in the sky above them. It was the Milky Way. They had never seen it before.

None of us wants to go back to a time before electric lights, of course. Yet our attempts at blending our natural sleep rhythms with the modern world look to be failing—especially as the electric light has migrated from the ceiling to the palms of our hands, where smartphones and other devices now rarely leave our side.

Caffeine may work in the short-term, but it isn’t a long-term solution for the average person because the body begins to build up a tolerance to it.

Our attempts at blending our natural sleep rhythms with the modern world look to be failing—especially as the electric light has migrated from the ceiling to the palms of our hands.

The consequences of this change in lifestyle are far more dire than a simple loss of connection to the natural world. Researchers are increasingly finding that lack of sleep is terrible for our health. Sleeplessness has been linked to increased rates of heart disease, obesity, stroke and even certain cancers. The exact reasons for these effects are still largely unknown, but give support to the theory that sleep is the time when our bodies naturally repair themselves on a cellular level.

Recently, researchers have also found how important these overlooked hours are to our mental performance. Sleep, or the lack of it, is now thought to be a complex process that underpins everything from our ability to learn a new skill to how likely we are to find a novel solution to a problem. It is also considered a vital part of happiness and one of the best forms of preventative medicine.

Many of us try to mitigate our lack of sleep with coffee and sleeping pills, but it just doesn’t work. Caffeine may work in the short-term, but it isn’t a long-term solution for the average person because the body begins to build up a tolerance to it. Soon, higher and higher doses are required to get the same effect. Strong doses of caffeine tend to make the body jittery and, once the caffeine wears off, lead to crashing in exhaustion.

And no amount of caffeine can alleviate the need for sleep. When that time comes, many adults turn to sleeping pills for help. About 60 million prescriptions for sleeping pills were filled in the U.S. last year, according to IMS Health, a data and analytics firm in Parsippany, N.J. That number is up from 48 million in 2006. Yet a number of studies have shown that drugs like Ambien and Lunesta offer no significant improvements in the quality of users’ sleep.

And they only give you the tiniest bit more in the quantity department. In one meta-analysis of sleeping pill studies sponsored by the National Institutes of Health and published in 2007, patients taking popular prescription sleeping pills fell asleep just 13 minutes faster than those given a sugar pill. They slept for a grand total of 11 minutes longer. People seem to overestimate the effectiveness of sleeping pills, partly because of the placebo effect, and partly because some of these pills cause short-term memory loss that leaves people believing they got better sleep than they actually did—they just don’t remember all their tossing and turning.

So why don’t we put more effort into dealing with our sleep problems? While we’ll spend thousands on lavish vacations to unwind, grind away hours exercising and pay exorbitant amounts for organic food, sleep remains ingrained in our cultural ethos as something that can be put off, dosed or ignored. We can’t look at sleep as an investment in our health because—after all—it’s just sleep. It is hard to feel like you’re taking an active step to improve your life with your head on a pillow.

Nonetheless, there are steps we can take to adapt the way we approach sleep to be more effective for modern life. In a new branch of sleep medicine, scientists have identified how to get a good night’s sleep naturally. Most of the suggestions come down to changing your behavior. One thing you can do is go to bed at the same time every night. Also, studies have shown that people should avoid the bluish light from computer screens, TVs and smartphones—which our brains interpret as sunlight—for at least an hour before bed. And, by doing yoga or other relaxation techniques that put the mind at ease, subjects in studies have dramatically improved both their sleep quality and quantity.

Poor sleep habits can also be a data problem. With nothing more than hazy memories of the night to go on, most of us have only rough estimates of when, exactly, we fell asleep—and whether we spent the night tossing and turning. New consumer devices, like headbands that measure brain waves during the night and pedometer-like devices that measure movement, can give the home user data rivaling what they might get in a sleep lab. Such data can allow people to pinpoint the real effects of each day’s choices on their night’s sleep.

Such tracking and behavioral adjustment isn’t that far removed from the work that fatigue-management consultants do. Their work often consists of combing accident reports and comparing them with work schedules to find out how long employees on duty had been awake. By charting the outcomes, fatigue-management consultants are often able to prove that a greater respect for sleep can lead to better results at the office, whether that office is a multinational corporation or a local fire department.

The secret to a good night’s sleep may very well be acknowledging that it takes work. And that the work is worth it. Health, mental sharpness, sex, relationships, creativity, memories—all of these things that make us who we are depend on the hours we spend each night with our eyes closed.

As Heraclitus wrote 2,500 years ago: “Even a soul submerged in sleep is hard at work and helps make something of the world.”

—Mr.
Randall is a senior reporter at Reuters and the author of “Dreamland: Adventures in the Strange Science of Sleep,” to be published Aug. 13 by W.W. Norton.

12 Jul

Pro Athletes: Sleep Helps Them Stay in the Game – Tampa

The athletes who rise to the level of professional sports in the United States are an elite bunch, some of the most physically gifted players on the planet. As difficult as it is to reach this level of sport, once they’ve been drafted into the pro leagues, their work is still just beginning. Maintaining a career in professional sports is intensely competitive and difficult, requiring serious dedication to developing and maintaining their skills.

Along with speed and agility, scoring prowess and defensive might, should an athlete’s sleep ability be a factor in determining his or her value as a player?

According to two recent studies, this may just be a pretty good strategy. Sleep researchers at Virginia’s Martha Jefferson Hospital Sleep Medicine Center have established a connection between career longevity and stability and levels of daytime sleepiness among athletes in two professional sports — football and baseball.

Both studies, which were presented at SLEEP 2012, an annual meeting of the Association of Professional Sleep Societies, investigated links between sleep and the staying power of careers for athletes in the National Football League and Major League Baseball. Researchers found that athletes in both leagues who reported experiencing high levels of daytime sleepiness were more likely to have shorter careers — and less likely to stay with the teams that originally drafted them — than players who were better rested, and reported feeling less tired during the day.

When studying NFL athletes, researchers included 55 players from around the league, all of whom went from college-level football through the draft process to professional teams. Players completed a questionnaire that enabled researchers to evaluate the athletes’ levels of daytime tiredness. They found that athletes who scored higher for excessive daytime tiredness — those who were more tired during the day — were less likely to stay with the original team that drafted them than players who scored at lower levels for excessive daytime tiredness. Among players who reported high levels of daytime sleepiness, 38 percent stayed with their drafting team, compared to 56 percent of better-rested players.

To study baseball players, researchers presented these athletes with the same questionnaire on sleep and daytime tiredness. They included 40 pro baseball players from MLB teams. Researchers discovered that those players who reported the highest levels of daytime sleepiness had significantly higher dropout rates from the league. Ballplayers who reported feeling more tired during the day had dropout rates in the range of 57-86 percent, compared to average MLB drop out rates, which are in the range of 30-35 percent.

This is important information for team organizations, players, and coaches: Protecting and encouraging sleep among these pro athletes may be one way to enhance and even prolong players’ career-long levels of performance.

This isn’t the first time we’ve seen evidence that sleep can have a powerful effect on athletes’ performance. We know from athletes’ own discussions of their training regimens that a successful training schedule often includes early bedtimes and careful attention to rest and recovery. And this 2011 study of college basketball players found that additional sleep resulted in significant improvements to speed and shooting skills, as well as diminished feelings of daytime tiredness and improvements in players’ moods and sense of well-being related to their sport.

It’s worth noting that in this college basketball study, researchers found many of the athletes suffering from chronic sleep deprivation at the study’s outset. I’d be willing to guess that with their demanding practice and game schedules, combined with near-constant traveling, many professional athletes are in a similarly sleep-deprived state. This latest study gives us reason to wonder: How much better, longer — and healthier — could our pro athletes play if that made sleep a regular part of their training regimen?

We study the health and performance of our professional athletes for many reasons. Pro sports are both big business and an important part of our culture. Leagues have a lot of incentive to push their players to play at their best — they also have a responsibility to their players’ health, and to ensure that their athletes are playing as safely as possible. In addition, what we learn from people who push their bodies to extremes can deliver lessons and insights for the broader population — those of us who don’t tackle and block against 300-pound guys for a living, or chase down 100-mph fastballs with speed and lightning-quick footwork.

Making sleep a priority — getting your seven to eight hours of sleep per night, every night, and addressing sleep problems before they become chronic or serious — can help you protect your health and your longevity on your field of play, whatever that may be. You don’t have to have a career lived out on AstroTurf or in a stadium to want to work — and live — well for a good, long time. Remember that sleep is one of your most powerful tools for helping you stay at the top of your game.

Sweet Dreams,
Michael J. Breus, PhD

01 Jun

Study: OSA Can Be Managed Successfully in Primary Care Setting

Patients with moderate-to-severe obstructive sleep apnea (OSA) can be successfully managed in a primary care setting by appropriately trained primary care physicians (PCPs) and community-based nurses, according to Australian researchers.

“With the rise in demand and growing waiting lists for sleep physician consultation and laboratory-based sleep services, there has been increasing interest in development of ambulatory strategies for the diagnosis and management of OSA involving home sleep monitoring and auto-titrating continuous positive airway pressure (CPAP),” said lead author Ching Li Chai-Coetzer, MBBS, of the Adelaide Institute for Sleep Health at Repatriation General Hospital in Australia. “While previous studies have demonstrated that ambulatory models of care for OSA in specialist settings can produce patient outcomes which are comparable to laboratory-based management, this is the first randomised controlled study to be conducted in primary care.”

The results were presented at the ATS 2012 International Conference in San Francisco.

“We randomized 155 patients to either primary care-based management or usual care in a specialist sleep center,” said Chai-Coetzer. “At 6 months, mean change in Epworth sleepiness scale (ESS) scores, the primary outcome measure of the study, was similar in the two groups (4.9 in the primary care group vs 5.1 in the specialist group).”

PCPs identified patients with symptomatic, moderate-to-severe OSA using a four-item screening tool, the ESS, and home oximetry. Primary care-based management was led by the patient’s PCP and a community-based nurse and involved use of home auto-titrating continuous positive airway pressure. Usual care in a specialist sleep center involved management by a sleep physician and laboratory-based testing.

In addition to similar changes in ESS scores at 6 months, mean change in Functional Outcomes of Sleep Questionnaire (FOSQ) score was similar in the two groups (2.3 in the primary care group vs 2.7 in the specialist group), as was compliance with CPAP. Mean daily use of CPAP was 4.8 (±2.1) hours in the primary care group and 5.4 (±1.8) hours in the specialist group.

Furthermore, within-study costs for primary care management were lower than those for specialist care, with significant savings of AUD$2,157 (95% CI: $1,293 to $3,114) per patient.

“Our results show that using a simplified, ambulatory approach for the treatment of OSA in primary care is not clinically inferior to management of these patients in a specialist sleep center,” concluded Chai-Coetzer. “This approach also offers a lower cost alternative to usual care. In addition, waiting lists for specialist sleep centers are long, and home care may be preferred by patients.”

In your opinion, can OSA be successfully managed in a primary care setting? Why or why not? How do studies like this impact the sleep profession? Join the discussion on Sleep Review’s LinkedIn page.

 

30 Apr

One-Third Of U.S. Workers Aren’t Getting Enough Sleep: Study, Tampa

Despite the recommendation that adults get between seven and nine hours of sleep a night, a new study shows that about a third of us aren’t hitting those goals.

Researchers from the Centers for Disease Control and Prevention looked at data from the 2010 National Health Interview Survey on sleep habits of U.S. workers. They found that 30 percent of people in the study — which calculates to about 40.6 million workers in the U.S. — get fewer than six hours of sleep a night. Their research was published in this week’s Morbidity and Mortality Weekly Report.

The study of 15,214 people also shed light on what kinds of jobs are linked with less sleep. The researchers found that people who work in manufacturing get less sleep than other workers, with 34.1 percent of them reporting getting less than six hours of sleep a night.

In addition, people who work the night shift were more likely to report getting inadequate sleep (44 percent), compared with those working during the day (28.8 percent).

Among people who worked the night shift, certain industries had high prevalences of inadequate sleep, including 69.7 percent of warehouse and transportation workers and 52.3 percent of health-care and social assistance workers, according to the report.

The researchers also found that people between ages 30 and 64 were more likely to report not getting enough sleep, compared with workers between ages 18 and 29 and workers age 65 and older.

People who work more than one job are also more likely to not get enough sleep during the night, compared with people who just have one job — 37 percent versus 29.4 percent. People who work more than 40 hours a week are also less likely to get enough sleep per night, compared with those who work a 40-or-under week.

Sleep deprivation is dangerous because it raises the risk of a whole host of health problems. Studies have linked inadequate rest with depression, a decreased immune system and memory issues, WebMD reported. Sleep deprivation has also been linked to obesity, high blood pressure and daytime fatigue, which could present safety issues on the job, Harvard Medical School reported.

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