Seeing the Right Doctor for Sleep Apnea

Obstructive sleep apnea treatment by primary care doctor just as good as by specialist

(RxWiki News) Sleep apnea is associated with a long list of other possible health problems. These problems include obesity, diabetes and heart disease risks, so it's important to treat sleep apnea.

However, whether you receive treatment from a primary care doctor or a sleep medicine specialist may not make a difference if the primary care doctor is familiar with sleep disorder treatments.

A recent study found that patients seeing primary care doctors or sleep specialists to treat obstructive sleep apnea appeared to have similar outcomes.

Regardless of what kind of doctor they saw, the patients improved about the same amount in their daytime sleepiness and seemed similarly satisfied with their treatment.

"Seek treatment for sleep apnea."

The study, led by Ching Li Chai-Coetzer, PhD, of the Adelaide Institute for Sleep Health at Repatriation General Hospital in Australia, aimed to see if there were differences in care depending on what kind of doctor treated patients with sleep apnea.

The researchers randomly assigned 155 patients with obstructive sleep apnea to be treated either by a primary care doctor or a specialist. While 81 were treated in primary care practices, 74 were treated at a university hospital sleep medicine center.

In both groups, the patients were treated with continuous positive airway pressure (CPAP), "mandibular advancement splints" or specific instructions related to maintaining a healthy sleep schedule.

CPAP is a standard treatment for obstructive sleep apnea in which air is delivered into a person's airways through a face mask. Mandibular advancement splits are devices that fit into a person's mouth over the teeth to treat sleep apnea or snoring.

After six months, the researchers assessed the men's sleepiness during the day, a common measure to determine whether sleep apnea treatment is working. The scale runs from 9 to 24.

The researchers also assessed the men's quality of life, symptoms of obstructive sleep apnea, satisfaction, healthcare costs and how well they followed directions in using CPAP.

The sleepiness scores in both groups improved over the course of the study, which means the men felt less sleepy during the daytime.

In the group seeing a primary care doctor, the patients' average score dropped form 12.8 at the start of the study to 7 at the end of the study, six months later.

In the group seeing the sleep specialist, the average score for the patients dropped form 12.5 to 7. Therefore, no difference was seen between the sleepiness of these two groups.

When the researchers looked at the other secondary factors they were assessing in both groups, they also did not find any differences between the patients treated by primary care doctors and the patients treated by specialists.

There was a higher percentage of patients (17 patients, or 21 percent) in the primary care group who withdrew from the study compared to the six patients (8 percent) who withdrew from the specialist group.

Overall, however, the two methods of treatment appeared to be similar enough in outcomes that one was not necessarily superior to the other.

The study was published March 12 in the journal JAMA. The research was funded by the National Health and Medical Research Council of Australia and a small grant from the Flinders Medical Centre Foundation.

Equipment donations were received from ResMed (oximetry monitors and CPAP machines), Philips Respironics (CPAP machines), and SomnoMed (mandibular advancement splints). Most of the authors had received donations of equipment or grant funding from various manufacturers of sleep disorder treatment devices.

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Review Date: 
March 12, 2013