Pharmacotherapy and Obstructive Sleep Apnea (OSA)
- Credit Type
- CME
- Credit Amount
- 0.25
- Release Date
- 12/30/2009
- Expiration Date
- 12/29/2010
- Activity Type
- Videocast
Positive airway pressure (PAP) is a first-line treatment modality for obstructive sleep apnea (OSA). Although PAP is highly effective in patients with OSA, patient adherence, including acceptance of therapy and hours of nightly use, is required to maximize benefits. Studies suggest that approximately 50% of patients prescribed PAP will discontinue use within the first year, often because of social stigma and discomfort associated with mask use, lack of education about the effectiveness of PAP therapy, and/or failure of clinicians to follow-up with patients and encourage PAP compliance. Pharmacologic approaches that have been investigated for the direct treatment of OSA include serotonergic agents, rapid eye movement suppressants, antidepressants, and ventilatory stimulants, although none have proven more beneficial than PAP. For PAP-compliant patients experiencing excessive sleepiness, pharmacologic approaches to manage these symptoms may prove beneficial.
Relevant References
- Hedner J, Grote L, Zou D. Pharmacological treatment of sleep apnea: current situation and future strategies. Sleep Med Rev. 2008;12(1):33-47.
- Hirshkowitz M, Black J. Effect of adjunctive modafinil on wakefulness and quality of life in patients with excessive sleepiness-associated obstructive sleep apnoea/hypopnoea syndrome : a 12-month, open-label extension study. CNS Drugs. 2007;21(5):407-416.
- Jayaraman G, Sharafkhaneh H, Hirshkowitz M, Sharafkhaneh A. Pharmacotherapy of obstructive sleep apnea. Ther Adv Respir Dis. 2008;2(6):375-386.
- Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc. 2008;5(2):173-178.
Jointly sponsored by Albert Einstein College of Medicine, Montefiore Medical Center, and Asante Communications
This activity is supported by an educational grant from Cephalon, Inc.
Release Date: 12/30/2009
Expiration Date: 12/29/2010
Activity Goal
This activity is designed to improve the recognition, continuous assessment, and multi-specialty treatment of patients with sleep/wake disorders. This concerted educational effort is structured to demonstrate the enduring value of education and its effects on clinician management of sleep/wake disorders/symptoms and patient care.
Intended Audience
This activity is intended for sleep clinicians, primary care physicians, physician assistants, nurse practitioners, and other healthcare providers interested in improving their knowledge base and skill sets in sleep/wake medicine. There are no prerequisites for this educational activity.
Statement of Need
Developed for community-based sleep clinicians and designed to provide a scientific rationale for individualized assessment and treatment of patients with sleep/wake disorders, this program serves as an educational consortium dedicated to improving sleep/wake education in communities across the country to improve patient care.
Learner’s Gap
Sleep/wake disorders significantly reduce the restorative value of sleep. Characterized by their heterogeneity and profound effects on patient function, the disorders are often prevalent, underrecognized, and undertreated. Inadequate treatment is associated with significant morbidity and mortality, an association gaining increased attention among clinical researchers. Healthcare- associated costs are prohibitively burdensome, estimated at nearly USD 100 billion per annum. Data from numerous epidemiologic and randomized controlled studies clearly demonstrate that patients with disrupted sleep/wake patterns have significantly impaired daytime function and experience excessive sleepiness, a debilitating symptom with far-reaching consequences. Sleep clinicians need to improve their understanding of the morbidity associated with sleep/wake disorders, to communicate the issues to their colleagues and to their patients, and to tailor therapies accordingly.
Learning Objectives
Upon completion of this activity, participants will be better prepared to:
- Discuss the morbidity associated with obstructive sleep apnea, shift-work disorder and other common sleep/wake disorders across cognitive, medical, and quality-of-life domains
- Employ nonpharmacologic and pharmacologic treatment modalities to ameliorate underlying causes, signs, and symptoms of common sleep/wake disorders
- Monitor treatment compliance and therapeutic progress of patients with obstructive sleep apnea and other common sleep/wake disorder–related signs and symptoms
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Albert Einstein College of Medicine and Montefiore Medical Center, and Asante Communications. Albert Einstein College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation
Albert Einstein College of Medicine designates this educational activity for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Credit Designation Conflict of Interest Statement
The Conflict of Interest Disclosure Policy of Albert Einstein College of Medicine requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical, product, or device company. Any presenter whose disclosed relationships prove to create a conflict of interest with regard to their contribution to the activity will not be permitted to present. Albert Einstein College of Medicine also requires that faculty participating in any CME activity disclose to the audience when discussing any unlabeled or investigational use of any commercial product or device not yet approved for use in the United States. Faculty participating in this activity have indicated the following disclosure information:
Max Hirshkowitz, PhD
Cephalon (Grant/Research, Speakers Bureau); GlaxoSmithKline (Grant/Research); Merck (Grant/Research); sanofi-aventis(Grant/Research, Speakers Bureau); Takeda (Speakers Bureau)
The staff at Albert Einstein College of Medicine has no disclosures to report other than the following:
Steven Jay Feld, or a member of his household, owns securities in Bioheart, Inc.; Chelsea Therapeutics, Inc.; and Pharmacopeia, Inc.
Chris Ontiveros, PhD, (senior scientific associate, Asante Communications) has no conflicts of interest with commercial interests related directly or indirectly to this educational activity.
Method of Participation
There are no fees for participating in and receiving credit for this activity. The participant must read the objectives and enduring material, and fill-out the attestation statement. Please complete the evaluation form which provides each participant with the opportunity to comment on the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and his/her views on future educational needs. Credit is available through December 29, 2010.
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Copyright Information
Copyright © 2009 Albert Einstein College of Medicine and Montefiore Medical Center, and Asante Communications. All rights reserved. No part of this syllabus may be used or reproduced in any manner whatsoever without written permission, except in the case of brief quotations embodied in articles or reviews.
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