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.
Hwang
Kevin O
KO
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
Hamadah
Abdurrahman M
AM
Johnson
Craig W
CW
Thomas
Eric J
EJ
Goodrick
G Ken
GK
Bernstam
Elmer V
EV
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