Integrative Physiology
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21659
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Browsing Integrative Physiology by Author "Burgess, Lauren"
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Item Optimizing Treatment Success in Sleep Apnea(2018-03-14) Davis, Tyler; Burgess, Lauren; Burk, John; Smith, Michael; Elias, ChristopherAbstract Purpose: Obstructive Sleep Apnea (OSA) is an exceedingly common disorder in America with estimates of disease prevalence ranging from 3-7% of the entire population, and it is likely that this is a gross underestimation. OSA is considered a multifactorial disorder with a diverse range of influences including developmental, environmental, and genetic factors. The current gold standard of treatment is Positive Airway Pressure (PAP). PAP treatment, while proven to be effective, is heavily influenced by many patient features. As a result, treatment success of OSA is difficult to predict and current standards do not take all the critical factors into account. The purpose of this study was to determine which patient traits can be used to predict treatment success. Methods: We performed a retrospective analysis (IRB #2018-019) of de-identified patient data from sleep studies in 150 patients over time to calculate a newly developed Treatment Success Index (TSI). TSI is a novel measure that comprehensively measures patient treatment success by combining Apnea Hypopnea Index derived from the sleep data (AHI, a clinical measurement of disease severity) and specific measures of patient PAP compliance. We performed predictive statistical analyses to determine how several different parameters affected the calculated TSI. Results: A linear regression was performed between BMI and TSI, which revealed a significant increase in treatment success secondary to increasing patient BMI (p=0.00002). In addition, patients were divided into three groups based on their length of treatment (LoTx), and a linear regression between the group average LoTx’s and their respective TSI’s revealed significant results (p=0.003). Conclusions: These findings present new insights into factors that best predict treatment efficacy for OSA and may assist in optimizing patient treatment. Future studies will expand the scope of the utility of TSI as a new measure of treatment efficacy for OSA.Item Sex-related Effects on Treatment Success in Obstructive Sleep Apnea(2018-03-14) Elias, Christopher; Burgess, Lauren; Burk, John; Smith, Michael; Davis, TylerAbstract Purpose: Obstructive Sleep Apnea (OSA) has a high prevalence in adults in the US (over 20 million estimated diagnoses) for which the current gold standard treatment for OSA is Positive Airway Pressure (PAP). Current literature suggests a much higher occurrence in men than women and there appear to be sex-related disparities for treatment compliance as well. Current standards for treatment adequacy only require 4 hours/night and 5 days/week. We have developed a more rigorous Treatment Success Index (TSI) that combines key measures of PAP patient compliance and treatment efficacy. The purpose of this study was to determine whether there is a gender difference in TSI and, if so, what factors appear to contribute to these differences. Methods: Retrospective analyses of sleep data from 150 patients were performed (#2018-019) to assess sex-related differences in TSI and determine how several treatment parameters and demographic factors affect the TSI. Results: The findings revealed three main points. First, length of treatment versus TSI was significant for the males (P = 0.0307) but not the females (P = 0.0760). Second, age versus TSI was not significant for either gender (P [greater than] 0.05). Third, BMI versus TSI was significant for females (P = 0.0031) but not males (P = 0.1182). This suggests a longer treatment time in males and a higher baseline BMI in females are significant predictors of treatment success. Conclusions: These data further define sex-related distinctions in the treatment efficacy of OSA and should be considered when physicians consider the management of their patients with OSA. Further studies will focus on the effects these factors might have on clinical outcomes.