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Articles 1 - 18 of 18
Full-Text Articles in Sleep Medicine
J Mich Dent Assoc January 2022
J Mich Dent Assoc January 2022
The Journal of the Michigan Dental Association
Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists! In this January 2022 issue, the reader will find the following original content:
- A cover feature, “Eating Disorders in Adolescents: Facts and Recommendations for the Oral Health Team”
- An introduction to the Pediatric Health Series, “Psychosocial Factors of COVID-19 Impact Oral Health”
- A DEI Feature, “Inclusion of the Mobility Impaired in Our Community”
- A 10-Minute EBD, “Factors Impacting Gingival Margin Position Following Esthetic Crown Lengthening”
- News you need, an …
Disability Injustice: A Latino’S Creative Autoethnographic Testimonio On The Organizational Culture Of Higher Education, Leonel A. Diaz Jr.
Disability Injustice: A Latino’S Creative Autoethnographic Testimonio On The Organizational Culture Of Higher Education, Leonel A. Diaz Jr.
Organization, Information and Learning Sciences ETDs
Using creative autoethnographic testimonio (CAT), a story is told about the injustices within the learning environment and work environment of higher education toward a person with disabilities: sleep apnea, learning disabilities, negative mental health. The author explores the health difficulties of addressing sleep deprivation while attending graduate school and working full-time as a professional. With sleep apnea impacting his health, his mental health declines. As his health declines, there is an increase in discrimination, hostility, oppression, bullying, and toxic masculinity. Initially, the medical system dismisses his declining health and refuses to look further into it. Once he receives medical care …
Improving Follow Up Compliance For Patients With Sleep Disordered Breathing At Jefferson Sleep Center, E. Fares, Md, A. Ananth, Md, Z. Fast, Md
Improving Follow Up Compliance For Patients With Sleep Disordered Breathing At Jefferson Sleep Center, E. Fares, Md, A. Ananth, Md, Z. Fast, Md
House Staff Quality Improvement and Patient Safety Conference (2020-)
Despite the high effectiveness of CPAP therapy, patient adherence remains variable and a hurdle towards appropriate treatment of their sleep-disordered breathing.
Patients often stop using their CPAP and are then lost to follow-up, which increases their risk of previously mentioned complications that are associated with OSA.
Goals for Improvement
To increase the follow-up rate for patients with OSA.
Effects Of Continuous Positive Airway Pressure (Cpap) Sleep Apnea Treatment On Mild Cognitive Impairment (Mci) And Cardiovascular Risk, Olivia Taylor, Cynthia Cheng, Md, Phd
Effects Of Continuous Positive Airway Pressure (Cpap) Sleep Apnea Treatment On Mild Cognitive Impairment (Mci) And Cardiovascular Risk, Olivia Taylor, Cynthia Cheng, Md, Phd
Phase 1
There is a documented association between sleep apnea and earlier onset of cognitive impairment later in life. We hypothesize that nightly treatment with CPAP therapy will improve MCI status as estimated by a panel of neuropsychiatry tests in patients >55 with OSA and concomitant memory complaints. With a prospective cohort design, patients compliant with CPAP therapy are being compared to noncompliant patients and a non-OSA control group. My role in this multi-site project was to screen potential patients from Jefferson’s sleep clinic for eligibility for study enrollment. This study is still ongoing. OSA’s high prevalence makes it a worthwhile endeavor …
J Mich Dent Assoc December 2020
J Mich Dent Assoc December 2020
The Journal of the Michigan Dental Association
Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!
In this issue, the reader will find the following original content:
- A cover story on “The Dentist’s Role in Recognizing Sleep-Related Breathing Disorders: A Two-Part Series”.
- The “2020 Author/Title Index to the Journal of the Michigan Dental Association”.
- News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news.
This issue also includes three articles reprinted …
A Positive Framed Message To Improve Cpap Compliance For Patients With Osa, Frances Clark
A Positive Framed Message To Improve Cpap Compliance For Patients With Osa, Frances Clark
Evidence-Based Practice Project Reports
Obstructive sleep apnea (OSA) affects 24% of the US population (DiNapoli, 2014). Untreated OSA causes many diseases, affects one’s quality of life, and increases mortality (Pengo et al., 2018). Continuous positive airway pressure (CPAP) is the lifelong treatment for OSA; yet 30%-80% of OSA patients are CPAP noncompliant within one year. The purpose of this EBP project was to determine if implementing a positive frame message intervention would improve CPAP compliance for newly diagnosed OSA patients. Based on the evidence, implementation of behavioral interventions, such as a positive framed message, was effective in improving CPAP compliance (Pengo et al., 2018). …
Motivational Interviewing For Cpap Adherence, Caitlin Green, Grayton Downing, Cindy Cheng, Md, Phd
Motivational Interviewing For Cpap Adherence, Caitlin Green, Grayton Downing, Cindy Cheng, Md, Phd
Phase 1
Background: Continuous Positive Air Pressure (CPAP), is the gold standard for obstructive sleep apnea (OSA) treatment. If left untreated, patients with OSA can experience serious and potentially life-threatening consequences. However, patient CPAP adherence is an ongoing problem, as compliance rates are historically low (typically 30-60%). Engaging patients in motivational interviewing (MI) by trained providers could promote increased CPAP adherence.
Question/Purpose: Assess CPAP compliance in patients who receive motivational interviewing compared to a control attention intervention.
Methods: A team of medical students were trained in MI interviewing techniques through a novel training protocol. The training protocol includes reading articles and watching …
Cognitive Changes In Patients Treated For Obstructive Sleep Apnea With Upper Airway Stimulation, Maxillomandibular Advancement, Or Expansion Sphincter Pharyngoplasty, Nicolas Zingas, Colin Huntley, Matthew Stewart, Ramez Philips
Cognitive Changes In Patients Treated For Obstructive Sleep Apnea With Upper Airway Stimulation, Maxillomandibular Advancement, Or Expansion Sphincter Pharyngoplasty, Nicolas Zingas, Colin Huntley, Matthew Stewart, Ramez Philips
Phase 1
Introduction: Obstructive sleep apnea (OSA) is a prevalent diagnosis that has been shown to not only affect sleepiness, but daytime cognitive function — specifically attention, working memory, and executive function. CPAP treatment is troublesome for some patients and it is possible that superior treatment options, specifically novel surgical techniques, are available, though none have been evaluated for their long-term effects on neurocognition. We hypothesize that treating patients with upper airway stimulation surgery (UAS) UAS, maxillomandibular advancement surgery (MMA), and expansion sphincter pharyngoplasty surgery (ESP) for OSA produces a significant improvement in cognition from baseline.
Methods: For inclusion in the study, …
Mci: Cpap Treatment Of Osa, Kaitlin Berry, Cindy Cheng, Md, Phd, Karl Doghramji, Md
Mci: Cpap Treatment Of Osa, Kaitlin Berry, Cindy Cheng, Md, Phd, Karl Doghramji, Md
Phase 1
Introduction: An estimated 30 percent of adults (20% of men and 10% of women) in the US have sleep apnea. Approximately 60% of patients with Mild Cognitive Impairment (MCI) are also diagnosed with Obstructive Sleep Apnea (OSA). The suggested mechanism of this is damage to the brain due to hypoxia during sleep. Few studies have investigated the effect of Continuous Positive Airway Pressure (CPAP) treatment for OSA, on mild cognitive impairment.
Methods: Patients are screened for eligibility based on specific inclusion and exclusion criteria. Potentially eligible patients who screen positive for MCI using the Telephone Interview for Cognitive Status …
Motivational Interviewing For Cpap Adherence, Grayton Downing, Caitlin Green, Cynthia Cheng, Md, Phd
Motivational Interviewing For Cpap Adherence, Grayton Downing, Caitlin Green, Cynthia Cheng, Md, Phd
Phase 1
Introduction: Untreated obstructive sleep apnea (OSA) leads to negative health outcomes. Yet, compliance rates for continuous positive airway pressure (CPAP), the gold standard of treatment, range from 30-60%. This study examines how motivational interviewing (MI), a goal-oriented form of psychotherapy, increases CPAP adherence. We hypothesize that MI increases CPAP compliance when incorporated into CPAP follow-up care.
Methods: We developed and trained our staff with a novel MI training protocol consisting of MI background readings and videos, CPAP technician shadowing, and MI role-play for certification. For the clinical trial, newly diagnosed OSA patients from Jefferson’s sleep center will be randomized …
Primary Care Obstructive Sleep Apnea Screening (Pcosa), Alyssa Givens, Risa Goldberg, Cynthia Cheng, Md, Phd
Primary Care Obstructive Sleep Apnea Screening (Pcosa), Alyssa Givens, Risa Goldberg, Cynthia Cheng, Md, Phd
Phase 1
Introduction: Obstructive sleep apnea (OSA) is a largely underdiagnosed disorder of upper airway collapse during sleep. Primary care providers do not routinely screen for OSA. This project aims to determine the yield of using the STOP-BANG questionnaire to identify previously undiagnosed OSA in a primary care population.
Methods: This prospective quality improvement pilot project included 181 patients of the Jefferson Department of Family Medicine identified as high-risk for OSA based on 3 EMR-based search criteria taken from STOP-BANG: hypertension, age >50 years, and BMI >35 kg/m2. We attempted contact with patients by mail, followed by up to …
Identifying The Prevalence Of Underdiagnosed Obstructive Sleep Apnea (Osa) In The Primary Care Population Via Targeted Screening Measures, Risa Goldberg, Alyssa Givens, Cynthia Cheng, Md, Phd
Identifying The Prevalence Of Underdiagnosed Obstructive Sleep Apnea (Osa) In The Primary Care Population Via Targeted Screening Measures, Risa Goldberg, Alyssa Givens, Cynthia Cheng, Md, Phd
Phase 1
Introduction: Obstructive sleep apnea (OSA) is a condition with detrimental health consequences, yet over 75% of OSA cases remain undiagnosed in the United States. This study aimed to determine the efficacy of using targeted screening measures to determine the prevalence of undiagnosed OSA in a primary care population.
Methods: This prospective pilot study utilized a primary care population from Thomas Jefferson University’s family medicine department. Participants were selected using three risk criteria for OSA from STOP-BANG identifiable from their EMR records (BMI >35, age over 50, and hypertension). After screening out patients previously diagnosed with OSA, patients were called and …
Current Practice Patterns In The Diagnosis And Management Of Sleep-Disordered Breathing In Infants., Rachana Kombathula, David G. Ingram Md, Zarmina Ehsan Md
Current Practice Patterns In The Diagnosis And Management Of Sleep-Disordered Breathing In Infants., Rachana Kombathula, David G. Ingram Md, Zarmina Ehsan Md
Manuscripts, Articles, Book Chapters and Other Papers
STUDY OBJECTIVES: Currently, there are no universally accepted guidelines for diagnosis and management of sleep-disordered breathing (SDB) in infants. The purpose of this study was to survey pediatric sleep medicine providers regarding their current practice patterns for diagnosis and management of SDB in infants.
METHODS: An anonymous, web-based survey with 71 questions was distributed via the PEDSLEEP and Ped-Lung listserv, which serve as a hub of communication for pediatric sleep and pulmonary medicine providers worldwide.
RESULTS: Fifty-four providers from eight countries completed the survey. Ninety-six percent of providers reported performing sleep studies in infants with 53% performing more than 30 …
Comparing Treatment Efficacy Of Upper Airway Stimulation To Cpap For Obstructive Sleep Apnea, Alec Furstenberg, Colin Huntley, Md, Adam Vasconcellos, Md, Ayan Kumar, Karl Doghramji, Md, Maurits Boon, Md
Comparing Treatment Efficacy Of Upper Airway Stimulation To Cpap For Obstructive Sleep Apnea, Alec Furstenberg, Colin Huntley, Md, Adam Vasconcellos, Md, Ayan Kumar, Karl Doghramji, Md, Maurits Boon, Md
Phase 1
Introduction
Upper airway stimulation (UAS) is newer treatment option for the management of Obstructive Sleep Apnea (OSA) and presents an alternative to the traditional Continuous Positive Airway Pressure (CPAP). Previously published data has shown good control of disease severity utilizing UAS with high patient tolerance and compliance. We aim to compare a cohort of patients treated with UAS and CPAP and evaluate therapy usage and disease control through use of the mean disease alleviation concept.
Methods
We evaluated demographic, pre and post-treatment sleep study, and therapy utilization data of cohorts of patients with OSA treated with CPAP and UAS. We …
Diagnostic Accuracy Of Home Sleep Apnea Testing (Hsat) Based On Recording Duration, Angela Alnemri, Theodora Fynn, Prakash Vasudevan, Ritu Grewa, Karl Doghramji
Diagnostic Accuracy Of Home Sleep Apnea Testing (Hsat) Based On Recording Duration, Angela Alnemri, Theodora Fynn, Prakash Vasudevan, Ritu Grewa, Karl Doghramji
Phase 1
Introduction: Obstructive Sleep Apnea (OSA) is a chronic sleeping disorder with serious health consequences. Currently, standard diagnosis is through in-lab polysomnography; however, there has been a shift to greater use of Home Sleep Apnea Testing (HSAT) for patients with a high pre-test probability of having OSA.
Objective: To investigate the minimum recording time needed during HSAT to accurately diagnose the presence and severity of OSA.
Methods: A retrospective review was conducted of HSATs done from January-October 2017. Each study was divided into 1-, 2-,3-,4-,5-, 6-, and 7 hour intervals beginning at the recording start time. The respiratory event index (REI) …
Treatment Of Obstructive Sleep Apnea With Maxillo-Mandibular Advancement Surgery: Evaluation And Predictors Of Success, Daniel Taub, Dmd, Md, Michael Courtney, Dmd, Md, Karl Doghramji, Md
Treatment Of Obstructive Sleep Apnea With Maxillo-Mandibular Advancement Surgery: Evaluation And Predictors Of Success, Daniel Taub, Dmd, Md, Michael Courtney, Dmd, Md, Karl Doghramji, Md
Department of Oral and Maxillofacial Surgery Posters
Obstructive sleep apnea (OSA) is a well-recognized disease entity affecting approximately 2% to 4% of the population. Maxillomandibular advancement (MMA) surgery is a highly successful surgical alternative to poorly tolerated CPAP therapy and achieves a success rate of 89% in the current literature. Our present study evaluates the effectiveness of MMA surgery in the treatment of patients with moderate to severe OSA based on Shers criteria of 50% reduction in AHI and AHI < 20. Radiographic and clinical treatment variables were evaluated in determining predictors of success for MMA in individuals with OSA.
Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv
Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv
Theses and Dissertations
Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home
patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical.
Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity …
Longitudinal Association Of Sleep-Disordered Breathing And Nondipping Of Nocturnal Blood Pressure In The Wisconsin Sleep Cohort Study, Khin Mae Hla, Terry Young, Laurel Finn, Paul E. Peppard, Mariana Szklo-Coxe, Maryan Stubbs
Longitudinal Association Of Sleep-Disordered Breathing And Nondipping Of Nocturnal Blood Pressure In The Wisconsin Sleep Cohort Study, Khin Mae Hla, Terry Young, Laurel Finn, Paul E. Peppard, Mariana Szklo-Coxe, Maryan Stubbs
Community & Environmental Health Faculty Publications
Study objectives: The association of sleep-disordered breathing (SDB) and blunting of normal nocturnal lowering of blood pressure (BP) (nondipping) has only been examined cross-sectionally. The purpose of this study is to investigate whether SDB is prospectively associated with nondipping.
Methods: The longitudinal association between SDB and incident nondipping was examined in a subsample of 328 adults enrolled in the Wisconsin Sleep Cohort Study who completed 2 or more 24-hour ambulatory BP studies over an average of 7.2 years of follow-up. SDB identified by baseline in-laboratory polysomnography was defined by apnea-hypopnea index (AHI) categories. Systolic and diastolic nondipping was defined by …