Evidence map›Paper›PMID 40184007›Full record

Trial reportSleep & breathing = Schlaf & Atmung2025

Impact of a multidisciplinary sleep apnea management group clinic on positive airway pressure adherence and patient-reported outcomes: a randomized controlled trial.

Sepideh Khazaie, Reena Mehra, Raman Bhambra, Douglas E Moul, Nancy Foldvary-Schaefer, Robon Vanek, James Bena, Shannon Morrison, Harneet K Walia

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Sleep & breathing = Schlaf & Atmung, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Neuro-Ophthalmological Disorders Associated with Obstructive Sleep Apnoea.International journal of molecular sciences · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sepideh KhazaieDepartment of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. khazais@ccf.org.ORCID 0000-0001-6007-1407
Reena MehraCritical Care and Sleep Medicine, Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA, USA.
Raman BhambraSleep Disorders Center, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Douglas E MoulSleep Disorders Center, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Nancy Foldvary-SchaeferSleep Disorders Center, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Robon VanekSleep Disorders Center, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
James BenaSleep Disorders Center, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Shannon MorrisonSleep Disorders Center, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Harneet K WaliaBaptist Health, Miami Cardiac and Vascular Institute, Miami, FL, USA.

Funding

Elucidation of the Influence of Sleep Apnea on Risk of Atrial FibrillationR01HL109493 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI MEHRA, REENA · 2011 to 2015
$3.7M
NHLBI NIH HHS NHLBI R01 HL109493NHLBI NIH HHS R01 HL109493
6 · The paper itself

Abstract

introductionPositive airway pressure (PAP) is the mainstay of treatment for obstructive sleep apnea (OSA). However, suboptimal adherence significantly limits its effectiveness. This study examined the impact of a Sleep Apnea Management (SAM) clinic-an innovative, interactive group intervention providing interpersonal support, education, and resources-on PAP adherence and patient-reported outcomes (PROs) compared to usual care.

methodsParticipants with OSA who were newly prescribed PAP therapy and demonstrated suboptimal adherence (defined using CMS criteria during the first two weeks) were randomized to the SAM clinic (n = 26) or usual care (n = 30) from April 2019 to November 2022 (NCT-03835702). The primary outcome was the change in average daily PAP usage. Secondary outcomes included changes in the Epworth Sleepiness Scale (ESS), Patient Health Questionnaire-9 (PHQ-9), and PROMIS scales from baseline to 1 and 3 months. Baseline-adjusted mixed-effects linear and logistic models estimated differences between and within groups.

resultsFifty-six participants were enrolled with a mean age of 55 years, 57% female, 63% Caucasian, median AHI of 22.8 (IQR: 9.3,39.6), and median baseline PAP usage of 172 min. After 3 months, the mean (95% CI) SAM clinic daily PAP use was 193 (139, 247) minutes vs usual care at 148 (110, 185) minutes with a mean difference of 46(-8, 99) minutes per day (p = 0.093). Within each group, a mean daily difference of 11(-36,57) minutes (p = 0.65) in SAM clinic and -32(-75,12) (p = 0.15) in the usual care was observed. No significant differences were observed in PROs between SAM and usual care. Within each group, ESS change was -0.7(-2.5,1.2) (p = 0.48) in SAM clinic and -2.5(-4.2, -0.83) (p = .004) in usual care. Significant decrease was noted in PHQ-9 within both SAM clinic at-2.2(-3.9, -0.4) (p = 0.019) and in usual care at -2.3(-4.0, -0.7) (p = 0.006). Improvement in PROMIS sleep-related impairment was noted within both groups: SAM clinic at -3.0(-6.2,0.1) (p = 0.059) and usual care group at -3.5(-6.4, -0.60) (p = 0.019). Similar changes in PAP adherence and PROS were seen at the 1-month follow-up.

conclusionThe SAM clinic demonstrated trends toward improved PAP adherence and PROs compared to usual care, though differences were not statistically significant, likely reflecting the study's small sample size and other methodological constraints, larger, adequately powered studies are needed to confirm these findings and further explore the impact of SAM clinics on PAP adherence and patient outcomes.

Indexed as

Continuous Positive Airway PressurePatient CompliancePatient Reported Outcome MeasuresSleep Apnea, ObstructiveAdultAgedFemaleHumansMaleMiddle AgedObstructive sleep apneaPAP adherencePatient-reported outcomesPositive airway pressure

Identifiers

PMID40184007
PMCPMC11971166

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.