Outcomes assessment


Regardless of the form of OSA treatment chosen, a proper outcomes assessment should be performed following initiation of therapy (Table 4). Outcome indicators include resolution of daytime somnolence, improved scores on objective testing such as on the Epworth Sleepiness Scale, patient reports of feeling more alert and more awake during the day, adherence to prescribed therapy, weight loss, and avoidance of factors that exacerbate OSA such as smoking and alcohol use. The patient’s bed partner can confirm whether the patient has had less snoring, less restlessness, and fewer nighttime awakenings. 


Persons undergoing treatment for OSA who continue to experience excessive daytime somnolence or other residual symptoms should be referred to a sleep specialist. 


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Table 4: OSA treatment-outcome indicators

Resolution of daytime sleepiness
Improvements on Epworth Sleepiness Scale and/or other objective tests
Patient self-reports of increased alertness/wakefulness during day
Bed-partner reports of less snoring, less restlessness, and fewer nighttime awakenings by patient
Adherence to therapy
Weight loss
Avoidance of factors exacerbating OSA, such as smoking and alcohol

Conclusion


OSA treatment is aimed at alleviating airway obstruction through numerous approaches including PAP, positional therapy, weight management, smoking cessation and other behavioral changes, oral appliances, and surgical procedures. Each OSA patient should be followed closely to ensure adherence to primary therapy. The primary-care provider is an integral part of a multidisciplinary approach of OSA treatment and effective outcomes management.

Susan Collazo, RN, MSN, APN-CNP, who specializes in thoracic surgery at Northwestern Memorial Hospital in Chicago, is experienced in pulmonary medicine and internal medicine. 


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From the December 01, 2014 Issue of Clinical Advisor

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CME/CE