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Current estimates reveal that 93% of women and 82% of men with moderate to severe sleep apnea remain undiagnosed. 15 In areas in which access is not an issue, some patients may be unwilling to undergo a sleep-laboratory study, even when recommended by their physician. 14 Although effective treatment for sleep apnea is available, referral for diagnosis and treatment of sleep apnea may be difficult in some settings due to limited access to or availability of sleep specialists and sleep laboratories for diagnostic evaluation. 11, 12 Studies have also demonstrated that sleep apnea is associated with increased rates of traffic accidents 13 and has been identified as a major public health concern. 3 Sleep apnea has been shown to have an increased prevalence in, or association with, morbid conditions such as heart failure, 4, 5 hypertension, 6, 7 cardiovascular disease, 8, 9 cerebrovascular disease, 10 and insulin resistance. 1 It is associated with poor sleep quality, excessive daytime sleepiness, 2 and decreased quality of life.
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MT decreased his OSA severity to the point that CPAP treatment may not be indicated for him, sparing him the potential cost and inconvenience of the CPAP device.Sleep apnea is a common disorder that affects more than 20 million adult Americans. Through participation in this training study, Mr. While effective at eradicating apnea and hypopnea events when worn, these devices are cumbersome many patients report that they are unable to tolerate these devices and, therefore, do not use them. It is important to note, however, that CPAP must be worn for AHI to be reduced. ( 22) noted that when independently comparing exercise training to CPAP and dietary weight loss, exercise was effective at AHI reduction, second only to CPAP. Further, a follow-up analysis, by Iftikhar et al. A meta-analysis by Iftikhar et al., reported AHI was decreased by 6.3 events per hour, with no significant changes in BMI, through exercise training. Aerobic Training ProgramĬontrary to studies showing body composition improvements leading to improvements in OSA severity, two recent meta-analyses found that exercise appears have a positive impact on OSA severity independent of body weight changes ( 22, 23).
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Upon completion of his time with the PDTS, full diagnosis and treatment had yet to occur. MT was informed of these findings and encouraged to seek further evaluation through his primary care physician and a local sleep clinic. MT would have been diagnosed with moderate severity OSA. Were this AHI derived by full polysomnography (PSG), in a sleep clinic, Mr. The apnea hypopnea index (AHI) score derived from the ApneaLink device was 20 events per hour of sleep, placing Mr. Data from the sleep assessment were downloaded and scored by ApneaLink software. The evaluation consisted of snoring and airflow detection, heart rate and oxygen saturation measurement, and thoracic breathing effort. Presence of OSA was determined through an unattended, limited home sleep evaluation over a single night utilizing a validated device ( 4, 5).
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MT was provided instructions on how to set up and wear the device used to screen for the presence of OSA (ApneaLink Air, ResMed Corp, San Diego, CA).