Article

P385 Enhancing patients’ self-regulation of obstructive sleep apnea: The effect of self-monitoring and objective monitoring at 30-day follow-up

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Cardiac disease was also viewed as a "man's disease", while women were under diagnosed and inappropriately treated leading to adverse outcomes. Self-regulation in OSA has been studied by Peach (Peach, 2006) using the self-regulation theory of Zimmerman, Bonner, Evans, and Mellins (Zimmerman, Bonner, Evans, & Mellins, 1999). ...
Article
This qualitative descriptive (QD) study examined the experience of the woman newly diagnosed with obstructive sleep apnea (OSA). The study employed Leventhal’s Self- Regulatory Theory to understand women’s illness representation of OSA, cognitive and emotional coping, and situational appraisal skills in coming to terms with OSA. The specific aims were to: 1) Describe the illness representation of women with a recent diagnosis (within one year) of OSA; 2) Describe the cognitive perceptions and emotional response to diagnosis and treatment of OSA in this sample of women; and, 3) Describe the meaning of OSA and the coping strategies used by this sample of women. The overarching theme of this study of a life-altering diagnosis required participants to process the health threatening information in both a conceptual and concrete process for dealing with both the physical and emotional aspects. The first two subthemes that emerged were Making sense of it, and Making it work as the women came to terms with their symptoms, diagnosis, and adapted to their treatment. For this sample of women, both acceptance (acknowledging the diagnosis of OSA and embracing treatment), and denial (not convinced of diagnosis or need for treatment, seeking alternatives) were factors in how they made sense of the situation. The making it work subtheme dealt with the women’s experiences adapting to treatment both physically and emotionally, including the appraisal, reconsideration and adjustments when they encountered difficulties and delays. A fluid iterative process included women participants describing how they appraised their situation often moving back and forth between acceptance, denial, seeking alternatives, struggling with treatment and moving forward. In both of these subthemes, family support and the stigma of OSA and CPAP were involved in how the women accepted and adapted to treatment. The third subtheme that emerged was Paying it forward as many women felt the obligation to help themselves by adapting a healthier lifestyle for themselves, their families and to assist others impacted by OSA. Women spoke of paying it forward by offering information and support to others not yet diagnosed, or are struggling with diagnosis and treatment. Many of these women were staunch advocates for other women to be tested, for HCPs to be more aware, to be more attuned to women’s sleep history, and to refer women for treatment. Implications of these findings include enhancing recognition and awareness by women of OSA symptoms, the need for diagnostic evaluation, and partner awareness as an important component of diagnosis and successful treatment for women. Study findings support recognition of women’s presentation of OSA including unusual symptoms for earlier diagnosis and treatment. Sleep partner awareness and support appear to be relevant to women in acceptance of a life altering diagnosis. Further exploration of modifiable factors such as prompt diagnosis and individualized treatment of women with OSA could also impact potential co-morbidities. Provision of further education and awareness by HCPs and insurance companies that women may not present with classic symptoms of OSA is also needed. Targeted interventions specific to women’s experiences with OSA include development of screening tools, care guidelines and treatments that enhance applicability, acceptability, and patient satisfaction. Future advocacy work will also require supporting women in “paying it forward” to help other women diagnosed with OSA.
Article
We recently proposed an equation predicting the optimal level of continuous positive airway pressure (CPAP) that abolishes sleep apnea from three simple and easily available parameters: body mass index (BMI), neck circumference, and apnea/hypopnea index (AHI). The present study was designed to validate this equation in a prospective group of patients with sleep apnea returning to the sleep laboratory for CPAP titration study. We studied 26 patients and found that the optimal CPAP was equal to the predicted value in 10 of 26 patients, within +/- 1 cm H2O of the predicted value in another 10 of 26 patients, within +/- 2 cm H2O in four of 26 patients, and outside +/- 4 cm H2O in the remaining two patients. We conclude that (1) optimal CPAP can be predicted to within +/- 2 cm H2O from a few simple measurements, and (2) using predicted CPAP as a starting pressure for CPAP titration, it may be possible to optimize and/or shorten the titration study--a fact with significant implications for reducing the cost of "diagnosis-to-treatment" polysomnography.