Comparisons of measures used to screen for obstructive sleep apnea in patients referred to a sleep clinic

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Comparisons of measures used to screen for obstructive sleep apnea in patients referred to a sleep clinic

Jennifer N. Miller a, *, Kevin A. Kupzyk b, 1, Lani Zimmerman b, 1, Bunny Pozehl b, 1, Paula Schulz b, 1, Debra Romberger b, 1, Ann M. Berger b, 1

a Nebraska Pulmonary Specialties, LLC, 1500 S. 48th St. #800, Lincoln, NE, 68506, USA
b The University of Nebraska Medical Center College of Nursing, 985330 Nebraska Medical Center, 4111 Dewey Avenue, Omaha, NE, USA

link to study can be found here*

 

Study objectives: Obstructive Sleep Apnea (OSA) contributes to all-cause mortality. An American Academy
of Sleep Medicine task force is focusing on improving detection and categorization of OSA symptoms
and severity to promote screening, assessment, and diagnosis. The purpose of this study was to psychometrically
compare measures used in OSA screening (Berlin, Epworth Sleepiness Scale (ESS), STOP
Bang) and a portable sleep monitor (PSM) to apnea-hypopnea index (AHI) and levels from polysomnogram
(PSG).
Methods: An observational, cross-sectional design was used. Patients referred to a sleep specialist were
enrolled at initial sleep evaluation. Participants completed measures used in OSA screening, then sent
home for one night using PSM. PSGs were ordered by the physician and AHI results were obtained from
the medical record.
Results: Participants (N ¼ 170) were enrolled in the study. Almost all participants completed the OSA
measures, approximately half-completed PSM measurement, and the majority completed laboratory
PSG. The STOP Bang had the highest levels of sensitivity; the ESS had the lowest. The ESS had the highest
specificity and reliability levels; the STOP Bang had the lowest. The PSM measure had the highest positive
predictive value (PPV) and the strongest psychometric properties of the screening measures.
Conclusions: The STOP Bang was the preferred self-report OSA screening measure because of high levels
of sensitivity. The ESS was the least desirable measure. PSM measurement consistently predicted the
presence of OSA but at the expense of low sensitivity at AHI levels 30. This expands the knowledge of
validity testing of screening measures used for OSA.
© 2018 Elsevier B.V. All rights reserved.

Methodological strategies in using home sleep apnea testing in research and practice

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Methodological strategies in using home sleep apnea testing in research and practice

Jennifer N. Miller PhD, APRN-NP , Paula Schulz PhD, RN , Bunny Pozehl PhD, RN, APRN-NP, FAHA, FAAN , Douglas Fiedler M.D., FCCP , Alissa Fial, MA, MLIS , Ann M. Berger PhD, APRN, AOCNS, FAAN

link to study can be found here*

*Courtesy of Springer Nature

 

Home sleep apnea testing has increased due to improvements in technology, accessibility, and changes in the third party reimbursement requirements. Research studies using HSAT have not consistently reported procedures and methodological challenges. This paper had two objectives: (1) summarize the literature on the use of HSAT in research of adults and (2) identify methodological strategies to use in research and practice to standardize HSAT procedures and information.
Methods: Search strategy included studies of participants undergoing sleep testing for OSA using HSAT, MEDLINE via PubMed, CINAHL, and Embase with the following search terms: “polysomnography,” “home,” level III,” “obstructive sleep apnea,” and “out of center testing.”
Results: Research articles that met inclusion criteria (n=34) inconsistently reported methods and methodological challenges in terms of: (a) participant sampling; (b) instrumentation issues; (c) clinical variables; (d) data processing; and (e) patient acceptability. Ten methodological strategies were identified for adoption when using HSAT in research and practice.
Conclusion: Future studies need to address the methodological challenged summarized in this paper as well as identify and report consistent HSAT procedures and information.

How to Manage Your Severe Asthma

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How to Manage Your Severe Asthma

Vinay Mehta, MD & John Trapp, MD

https://www.bryanhealth.com/bryan-health-radio/?item=35728

*Courtesy of Bryan Health

 

Doctors at Bryan Medical Center are the first in Nebraska to perform an innovative new procedure for severe asthma patients called bronchial thermoplasty (BT). It is an outpatient procedure for adults whose asthma is not controlled with medications.

In this segment, Dr. John Trapp, pulmonologist with Nebraska Pulmonary Specialties and Dr. Vinay Mehta, allergist-immunologist with Allergy, Asthma and Immunology Associates, discuss how Bryan Medical Center offers innovative severe asthma treatment with proven results that include fewer visits to the ED and fewer asthma attacks so that you can start enjoying life.

Air Quality & Its Effect On Those With Lung Issues

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As many of us know, Lincoln’s air quality has been affected by fires burning in Kansas.  Dr. Reichmuth spoke recently about how this could affect those with lung issues.

Channel 8 segment

Channel 10/11 segment

Meet the Doctors

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News Channel Nebraska’s Grant Otten brings another Meet the Docs segment featuring Dr. Kevin Reichmuth.

Read more →

Flu Vaccine May Also Protect Against Pneumonia

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Study suggests about 57 percent of hospitalizations for flu-related pneumonia might be prevented

Read the article from HealthDay

Prevnar & Pneumovax – Pneumonia Vaccinations

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The CDC recommends vaccination with Pneumovax 23 alone for everyone at or after age 65 and for people age 19 through 64 who are at increased risk for pneumococcal infection. People in the latter group can receive more than one dose of the vaccine. However, once you have received a dose of Pneumovax 23 at or after age 65—whether it is your initial dose or a subsequent dose—there is no need for an additional dose of it.

The new ACIP proposal recommends vaccination with both Pneumovax 23 and Prevnar 13 for all adults, regardless of age, who are considered to be at greatly increased risk of infection. According to ACIP, the combination regimen is likely to provide greater protection against S. pneumoniae than either vaccine alone.

The dosing schedule that follows is recommended for people at greatly increased risk. Again, once you’ve received a dose of Pneumovax 23 at or after age 65, there is no need for more doses. If you have not previously received Prevnar 13 or Pneumovax 23 and are at greatly increased risk, ACIP recommends:

    • a dose of Prevnar 13
    • a dose of Pneumovax 23 after at least eight weeks have passed
    • a second dose of Pneumovax 23 after at least five years have passed

If you have previously received one dose of Pneumovax 23, ACIP recommends:

    • a dose of Prevnar 13 no sooner than one year after the Pneumovax 23 dose
    • a second dose of Pneumovax 23 no sooner than five years after the initial Pneumovax 23 dose and after allowing at least eight weeks to pass following the Prevnar 13 dose

If you have previously received two doses of Pneumovax 23, ACIP recommends:

    • a dose of Prevnar 13 after at least one year has passed.
    • a third dose of Pneumovax 23 after at least five years have passed since your previous dose of Pneumovax 23 and eight weeks since your Prevnar 13 dose

If you received three doses of Pneumovax 23 (the third dose would have been given at or after age 65), ACIP recommends:

    • a dose of Prevnar 13 after at least one year has passed since the last dose of Pneumovax 23

Article courtesy of healthcommunities.com. See more at: http://www.healthcommunities.com/evaluating-lung-problems/pneumonococcal-vaccine-types_jhmwp.shtml#sthash.4h4WaNkA.dpuf

Flu Season

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Flu vaccine may be more effective this year, CDC says

The CBS Evening News (9/17, story 12, 1:45, Pelley) reported that this year’s influenza vaccine may be more effective than last year’s. According to Dr. Jon Lapook, “Last year, the vaccine was only 23% effective because the predominant strain mutated after the vaccine had already been manufactured.” CDC “officials say this year’s flu vaccine is well-matched right now to circulating viruses.”

The Los Angeles Times (9/18, Kaplan) reports that this year, “flu watchdogs at the CDC have scrutinized 199 flu specimens collected in the United States and elsewhere between May 24 and Sept. 5.” They found that “the majority of those specimens – 118 of them – were H3N2 viruses, and all of them were built in a way that should make them vulnerable to this year’s vaccines.”

McClatchy (9/18, Mueller) reports that “by including components of H3N2 in this season’s flu vaccine, health care professionals hope to raise vaccine effectiveness against predominant strains back up to the 50 to 60% range.”

The AP (9/18, Neergaard) reports that, “all told, at least 171 million doses of flu vaccine are expected this year.”

Live & Learn – Sleep for Aging Adults

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Dr. Kevin Reichmuth, M.D. discusses sleep disorder for older adults

Bronchial Thermoplasty – New Procedure

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[button link=”http://www.btforasthma.com” newwindow=”yes”] Click here for BT Information[/button]  Learn more about Bronchial Thermoplasty (a new treatment for Asthma)