Screening for obstructive sleep apnea on the internet: randomized trial.
BACKGROUND
Obstructive sleep apnea is underdiagnosed. We conducted a pilot randomized controlled trial of an online intervention to promote obstructive sleep apnea screening among members of an Internet weight-loss community.


METHODS
Members of an Internet weight-loss community who have never been diagnosed with obstructive sleep apnea or discussed the condition with their healthcare provider were randomized to intervention (online risk assessment+feedback) or control. The primary outcome was discussing obstructive sleep apnea with a healthcare provider at 12 weeks.


RESULTS
Of 4700 members who were sent e-mail study announcements, 168 (97% were female, age 39.5 years [standard deviation 11.7], body mass index 30.3 [standard deviation 7.8]) were randomized to intervention (n=84) or control (n=84). Of 82 intervention subjects who completed the risk assessment, 50 (61%) were low risk and 32 (39%) were high risk for obstructive sleep apnea. Intervention subjects were more likely than control subjects to discuss obstructive sleep apnea with their healthcare provider within 12 weeks (11% [9/84] vs 2% [2/84]; P=.02; relative risk=4.50; 95% confidence interval, 1.002-20.21). The number needed to treat was 12. High-risk intervention subjects were more likely than control subjects to discuss obstructive sleep apnea with their healthcare provider (19% [6/32] vs 2% [2/84]; P=.004; relative risk=7.88; 95% confidence interval, 1.68-37.02). One high-risk intervention subject started treatment for obstructive sleep apnea.


CONCLUSIONS
An online screening intervention is feasible and likely effective in encouraging members of an Internet weight-loss community to discuss obstructive sleep apnea with their healthcare provider.
Department of Internal Medicine, Division of General Medicine, The University of Texas Medical School at Houston, Houston, TX 77030, USA. Kevin.o.hwang@uth.tmc.edu
Kevin O
KO
Hwang
Abdurrahman M
AM
Hamadah
Craig W
CW
Johnson
Eric J
EJ
Thomas
G Ken
GK
Goodrick
Elmer V
EV
Bernstam
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D016001:Confidence Intervals; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000628:therapy; D010865:Pilot Projects; D011159:Population Surveillance; D011336:Probability; D012016:Reference Values; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy; D015431:Weight Loss