Translational Medical Research Commons^™

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 …

Primary Care Obstructive Sleep Apnea Screening, Benjamin Espenhorst, Grant Gillan, Cynthia Cheng, Md, Phd

Phase 1

Introduction: Obstructive sleep apnea (OSA), a disorder characterized by upper airway collapse during sleep, is currently underdiagnosed and undertreated. The goal of this project is to evaluate the efficacy of utilizing a targeted screening protocol to identify previously undiagnosed OSA in an adult primary care population.

Methods: This prospective quality improvement project included 210 patients in the Jefferson Department of Family Medicine not previously diagnosed with OSA. These patients were targeted based on 3 STOP-BANG criteria: hypertension, age >50 years, and BMI >35 kg/m2. Patients were initially contacted by mail, followed by 3 weekly phone calls. Patients were screened …

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

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

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

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 …

Impact Of Sleep And Circadian Disruption On Energy Balance And Diabetes: A Summary Of Workshop Discussions, Deanna M. Arble, Joseph Bass, Cecilia Diniz Behn, Matthew P. Butler, Etienne Challet, Charles Czeisler, Christopher M. Depner, Joel Elmquist, Paul Franken, Michael A. Grandner, Erin C. Hanlon, Alex C. Keene, Michael J. Joyner, Ilia Karatsoreos, Philip A. Kern, Samuel Klein, Christopher J. Morris, Allan I. Pack, Satchidananda Panda, Louis J. Ptacek, Naresh M. Punjabi, Paolo Sassone-Corsi, Frank A. Scheer, Richa Saxena, Elizabeth R. Seaquest, Matthew S. Thimgan, Eve Van Cauter, Kenneth P. Wright

Clinical and Translational Science Faculty Publications

A workshop was held at the National Institute for Diabetes and Digestive and Kidney Diseases with a focus on the impact of sleep and circadian disruption on energy balance and diabetes. The workshop identified a number of key principles for research in this area and a number of specific opportunities. Studies in this area would be facilitated by active collaboration between investigators in sleep/circadian research and investigators in metabolism/diabetes. There is a need to translate the elegant findings from basic research into improving the metabolic health of the American public. There is also a need for investigators studying the impact …