Predictors of Obstructive Sleep Apnea (OSA)
- Credit Type
- CME
- Credit Amount
- 0.25
- Release Date
- 12/30/2009
- Expiration Date
- 12/29/2010
- Activity Type
- Videocast
It is estimated that 1 in 5 adults has at least mild obstructive sleep apnea (OSA) and 1 in 15 adults has at least moderate OSA. Genetic, physical, medical, and behavioral characteristics have been identified as risk factors for OSA. Patients with a family history of OSA are more likely to develop sleep-related breathing disorders. An increased risk for the development of OSA has also been reported for certain ethnic populations. For example, African-Americans, Asians, and Hispanics are at a higher risk for sleep apnea than other ethnicities. Well-characterized physical and medical features associated with OSA include snoring; neck circumference greater than 17 inches in men and 16 inches in women; abdominal obesity; craniofacial abnormalities; treatment-refractory hypertension; and hypothyroidism. Although some of these characteristics can be easily assessed during a routine physical examination, others require further testing and laboratory evaluation. Behaviors commonly associated with OSA include smoking and the use of alcohol or sedative medications. Recognition of these risk factors, supported by information elicited in a thorough patient history and physical examination, will help clinicians arrive at a diagnosis of OSA, and facilitate appropriate referral for a sleep evaluation, sleep study, and treatment.
Relevant References
- Casale M, Pappacena M, Rinaldi V, et al. Obstructive sleep apnea syndrome: from phenotype to genetic basis. Curr Genomics. 2009;10(2):119-126.
- Jacobs CK, Coffey J. Clinical inquiries. Sleep apnea in adults: how accurate is clinical prediction? J Fam Pract. 2009;58(6):327-328.
- Lieberman JA 3rd. Obstructive sleep apnea (OSA) and excessive sleepiness associated with OSA: recognition in the primary care setting. Postgrad Med. 2009;121(4):33-41.
- Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc. 2008;5(2):136-143.
- Young T, Palta M, Dempsey J, et al. Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study. WMJ. 2009;108(5):246-249.
- Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165(9):1217-1239.
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
- Recognize, evaluate, and diagnose patients presenting with excessive sleepiness and signs and symptoms associated with obstructive sleep apnea, shift-work disorder, and other common sleep/wake disorders
- Stratify patients by risk and severity of obstructive sleep apnea and other common sleep/wake disorders and develop appropriate referral and long-term treatment plans
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:
Daniel I. Silvershein, MD has no conflicts of interest with commercial interests related directly or indirectly to this educational activity.
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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