Primary Care Providers Can Effectively Treat Sleep Apnea

Primary care providers were able to manage patients with severe obstructive sleep apnea just as successfully as specialized sleep centers, after providers underwent a short training program. 

The trial randomly assigned 155 participants to the care of either a specialized sleep center or primary care providers who underwent a short education program teaching proper use of a 4-item screening tool, the Epworth sleepiness scale, and home oximetry.  Researchers measured change in the Epworth scale after 6 months of treatment, the outcomes of a sleep questionnaire, and compliance with continuous positive airway pressure (CPAP) therapy. 

Changes in the Epworth scale were 4.9 points for primary care patients and 5.1 for those in sleep centers.  For the questionnaire, changes of 2.3 and 2.7 points for primary care and sleep centers were recorded, respectively.  The two groups used CPAP machines for 4.8 hours (primary care) and 5.4 hours (sleep center) a night.

Also significant, researchers noted, was the $2000 difference in treatment between primary care and sleep centers. 

“Outcomes for patients with symptomatic, moderate to severe OSA managed in primary care using a simplified, ambulatory approach which utilizes the skills of appropriately trained GPs and community-based nurses are not clinically inferior to usual management in a specialist sleep centre,” they concluded.

-Michael Potts