title: Comparison of primary-care practitioners and sleep specialists in the treatment of obstructive sleep apnea.
abstract: We wished to determine if being treated for sleep apnea by a sleep specialist increased patient awareness or long-term continuous positive airway pressure (CPAP) compliance. We performed a retrospective telephone survey and laboratory chart review in patients with a diagnosis of sleep apnea evaluated either at a laboratory in which only sleep specialists can order polysomnography (University Specialty Hospital, noted as USH) or at a laboratory serving the medical community at large (Kernan Hospital, noted as K). Both laboratories are under the same medical director, use the same policies and procedures, equipment, and technician pool. One hundred three patients participated in the survey (approximately 37% of those contacted), 59 from USH and 44 from K. The groups were comparable in terms of demographics, presenting complaints, and apnea severity. In patients treated by sleep specialists, awareness of the disease process was greater and the evaluation was timelier than in patients treated by generalists. However, there was no difference between the groups' long-term self-reported CPAP acceptance or compliance. The most robust predictor of continued CPAP use was the patient's self-report of feeling better.
authors.affiliation: Sleep Disorders Center, Division of Pulmonary and Critical Care, University of Maryland, Baltimore, Maryland 21209, USA. sscharf@medicine.umaryland.edu
authors.forename: Steven M
authors.initials: SM
authors.lastname: Scharf
authors.forename: Jennifer
authors.initials: J
authors.lastname: DeMore
authors.forename: Talia
authors.initials: T
authors.lastname: Landau
authors.forename: Patricia
authors.initials: P
authors.lastname: Smale
mesh_terms: D000328:Adult; D001364:Awareness; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010821:Physicians, Family; D017286:Polysomnography / Q000295:instrumentation; D012189:Retrospective Studies; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000628:therapy*; D013038:Specialization