Abstract
BackgroundLack of adherence to recommended treatment for obstructive sleep apnea remains an ongoing public health challenge. Despite evidence that continuous positive airway pressure (CPAP) is effective and improves overall quality of life, adherence with the use of CPAP in certain racial/ethnic groups, especially blacks, is suboptimal. Evidence indicates that the incidence and prevalence of obstructive sleep apnea are higher among blacks, relative to whites, and blacks are less likely to adhere to recommended treatment compared with other racial/ethnic groups.MethodsUsing a two-arm randomized controlled design, this study will evaluate the effectiveness of a culturally and linguistically tailored telephone-delivered intervention to promote adherence to physician-recommended sleep apnea assessment and treatment among blacks with metabolic syndrome, versus an attention-control arm. The intervention is designed to foster adherence to recommended sleep apnea care using the stages-of-change model. The intervention will be delivered entirely over the telephone. Participants in the intervention arm will receive 10 phone calls to address challenges and barriers to recommended care. Outcomes will be assessed at baseline, and at 6- and 12-months post-randomization.DiscussionThis tailored behavioral intervention will improve adherence to sleep apnea assessment and treatment among blacks with metabolic syndrome. We expect to demonstrate that this intervention modality is feasible in terms of time and cost and can be replicated in populations with similar racial/ethnic backgrounds.Trial registrationThe study is registered at clinicaltrials.gov NCT01946659 (February 2013)
Highlights
Lack of adherence to recommended treatment for obstructive sleep apnea remains an ongoing public health challenge
In our previous work (conducted by the principal investigator (PI, Dr Jean-Louis), we demonstrated that among blacks in Brooklyn, a history of cardiovascular disease (CVD) was the most important predictor of the likelihood of expressing symptoms of sleep apnea, with a corresponding multivariate-adjusted odds ratio of 11 (95% confidence interval = 3.03 to 40.63) [18]
We propose to achieve an adherence rate of 47% among participants exposed to the telephone intervention (TTI)
Summary
Lack of adherence to recommended treatment for obstructive sleep apnea remains an ongoing public health challenge. Obstructive sleep apnea is a major public health problem in the United States, affecting an estimated 18 million Americans [1,2,3]. It is a serious, potentially life-threatening condition characterized by repeated cessation of breathing while sleeping. It is estimated that sleep apnea is probably responsible for 38,000 cardiovascular deaths yearly, with an associated 42 million dollars spent on related hospitalizations [9] Despite these alarming data, 82% of men and 93% of women with sleep apnea in the United States remain undiagnosed
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