0426 A real-world exploration of non-CPAP therapies for mild obstructive sleep apnea in the veteran population

Abstract

Abstract Introduction Obstructive sleep apnea (OSA) is a common sleep disorder that is characterized by repetitive episodes of upper airway obstruction during sleep. Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for OSA, but it is not always well-tolerated by patients. As a result, alternative treatment options for mild OSA have been investigated. This study aims to explore the usage of non-CPAP alternatives in the veteran population. Methods Informed consent was obtained from the participants. The desired target cohort included veterans newly diagnosed with mild obstructive sleep apnea (OSA) on home sleep study (HSAT) or primary snoring on polysomnography (PSG). Specifically, mild OSA was considered pAHI < 15, pRDI < 15, and ODI < 15 and primary snoring was diagnosed if snoring is a primary symptom on e-consult, technically adequate study and pAHI < 5 and pRDI < 5. During a one-week period, sleep medicine providers assigned to sleep study interpretations determined eligible veterans that met inclusion criteria. Veterans who had nocturnal hypoxemia (5% sleep time with saturation 88%), active home oxygen order, commercial driver, significant heart disease (e.g., heart failure, atrial fibrillation) or other sleep concern (parasomnia) were excluded from this study. Upon meeting selection criteria, eligible subjects were cosigned to nursing staff to discuss and choose non-CPAP treatment altervatives. A second point of contact was made 90 days later (T=90) to evaluate progress of the initial intervention. A standardized script was use for both communications. Results There were 62 subjects that were ultimately included in the study, of which 3 chose weight loss/lifestyle therapy, 5 chose positional therapy, 17 chose oral appliance, 19 chose nasal EPAP and 12 chose oral stimulator. Analysis of the treatment pathways is pending. Conclusion Data analysis is pending with conclusions to follow. Support (if any)