Classic SleepCast

Sleep Apnea Patient Centered Outcomes Network (SAPCON): Part 7


Barry Krakow MD - February 02, 2017 - Expert Insight
Now that we have completed a look at the six challenges, we move to the second main heading in the SAPCON article in Sleep Review, entitled PATIENT-SUGGESTED SOLUTIONS. This section is remarkable for its brevity and yet includes nearly all essential resources and strategies that must be considered in optimizing the care of OSA/UARS patients. Not only is the information the epitome of “less is more,” but also I would argue most sleep professionals would gain more by reading and attending to this set of prescriptive steps than sifting through lengthy review articles on the topic of PAP adherence. My comments on each of their bullet points (below) attempts to provide some clarifying approaches to the steps they have outlined, but reading this section for yourself whether a patient or professional will expand your understanding of how to tackle numerous obstacles that interfere with any PAP management model. In the... Read more

Sleep Apnea Patient Centered Outcomes Network (SAPCON): Part 6


Barry Krakow MD - January 27, 2017 - Expert Insight
This article is the sixth in a series, following: Part 1 – They said I need a machine, that’s it?Part 2 – So I have sleep apnea? So what?Part 3 – Are there options besides CPAP?Part 4 – Frustration rapidly leads to non-adherencePart 5 – Delays in diagnosis or outright misdiagnosis. The sixth challenge, “So, who do I call?” segues into their second main heading, entitled PATIENT-SUGGESTED SOLUTIONS, so we will lay the groundwork for the solutions section with our comments on this final challenge. The first quote of the challenge says it all: “I often get the sense that equipment providers expect physicians to educate patients, and physicians expect home care providers to educate patients.” And, of course the unhappy ending: “This expectation on each side often leads to little or no education for the patient.“ The bottom line is the patient does not know what he or she does not know, and... Read more

Sleep Apnea Patient Centered Outcomes Network (SAPCON): Part 5


Barry Krakow MD - January 19, 2017 - Expert Insight
Last year, Sleep Review Magazine published an introductory story about the SAPCON project, which focuses on collecting input from patients with sleep apnea as a way to “democratize” research and gain valuable insights to promote more effective treatments. Sleep Review published a follow-up story to discuss the preliminary findings, which you can read about here on pages 26-28.  This article is the fifth in a series, following: Part 1 – They said I need a machine, that’s it?Part 2 – So I have sleep apnea? So what?Part 3 – Are there options besides CPAP?Part 4 – Frustration rapidly leads to non-adherence Fifth Challenge: Delays in diagnosis or outright misdiagnosis. In this section of the study, the authors focus on the long-standing problem of diagnostic delays, which, for some patients, may be up to a decade or more. In particular, females and ethnic minorities demonstrated disproportionately low rates of referrals and thus diagnoses. The authors infer the crucial point regarding so... Read more

Sleep Apnea Patient Centered Outcomes Network (SAPCON): Part 4


Barry Krakow MD - January 05, 2017 - Expert Insight
Last year, Sleep Review Magazine published an introductory story about the SAPCON project, which focuses on collecting input from patients with sleep apnea as a way to “democratize” research and gain valuable insights to promote more effective treatments. Sleep Review published a follow-up story to discuss the preliminary findings, which you can read about here on pages 26-28.  This article is the fourth in a series, following: Part 1 – They said I need a machine, that’s it?Part 2 – So I have sleep apnea? So what?Part 3 – Are there options besides CPAP? Fourth Challenge: Frustration rapidly leads to non-adherence Overwhelming frustration with PAP therapy can be triggered by a wide array of issues, and along with this vexation follows a pack of other emotional responses. These emotions must be attended to by the patient with thorough coaching from medical providers, sleep technologists, sleep administrative staff, and DME staff, else the patient risks dropping out of therapy... Read more

Sleep Apnea Patient Centered Outcomes Network (SAPCON): Part 3


Barry Krakow MD - December 29, 2016 - Expert Insight
Last year, Sleep Review Magazine published an introductory story about the SAPCON project, which focuses on collecting input from patients with sleep apnea as a way to “democratize” research and gain valuable insights to promote more effective treatments. Sleep Review published a follow-up story to discuss the preliminary findings, which you can read about here on pages 26-28.  This article is a continuation from Part 1 that covered the first challenge: They said I need a machine, that’s it? And Part 2 that covered the second challenge: So I have sleep apnea? So what? Third Challenge: Are there options besides CPAP? This section was brief and to the point: CPAP is usually offered as the first and only option. Scant remarks are apparently offered about oral appliance therapy (OAT) or the newer neurostimulation devices. One patient commented it took several years to find out about OAT and only after learning from a friend. With this small amount of information... Read more

Sleep Apnea Patient Centered Outcomes Network (SAPCON): Part 2


Barry Krakow MD - December 21, 2016 - Expert Insight
Last year, Sleep Review Magazine published an introductory story about the SAPCON project, which focuses on collecting input from patients with sleep apnea as a way to “democratize” research and gain valuable insights to promote more effective treatments. Sleep Review published a follow-up story to discuss the preliminary findings, which you can read about here on pages 26-28.  This article is a continuation from Part 1 that covered the first challenge: They said I need a machine, that’s it? Second Challenge: So I have sleep apnea? So what? The summary provided by the authors outlines how patients may not be properly educated after diagnosis, focusing on three main gaps in understanding: there is a relationship between sleep apnea and other co-occurring health problems, treatment of sleep apnea may prevent or improve these comorbid problems, and treatment may lead to overall health improvements. Included quotes from patients confirmed they were not aware of the above, in addition to... Read more

Sleep Apnea Patient Centered Outcomes Network (SAPCON): Part 1


Barry Krakow MD - December 16, 2016 - Expert Insight
Last year, Sleep Review Magazine published in an introductory story about the SAPCON project, which focuses on collecting input from patients with sleep apnea as a way to “democratize” research and gain valuable insights to promote more effective treatments. Just last month, Sleep Review published a follow-up story to discuss some of the preliminary findings, which you can read about here on pages 26-28. The article, which was written by three leaders of the project, reported initial information gathered through the www.MyApnea.org forum (the location of the SAPCON project), where patients described, “significant gaps in the care and information they receive from sleep medicine professionals.” With this background material, they sought additional feedback from users of the website via an extensive list of interesting SAPCON surveys that inquired about what patients see as information gaps, what they are missing from their clinicians, and their suggestions for best practices. The article... Read more