Screening for Obstructive Sleep Apnea on the Internet: Randomized Trial

• Published in: The American journal of medicine Vol. 122; no. 10; pp. 961.e1 - 961.e6
• Main Authors: Hwang, Kevin O., MD, MPH, Hamadah, Abdurrahman M., BS, Johnson, Craig W., PhD, Thomas, Eric J., MD, MPH, Goodrick, G. Ken, PhD, Bernstam, Elmer V., MD, MSE
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2009
• Subjects: Adult; Age Factors; Body Mass Index; Confidence Intervals; Female; Health Promotion - methods; Humans; Internal Medicine; Internet; Male; Mass Screening - methods; Middle Aged; Obesity; Obesity - diagnosis; Obesity - therapy; Obstructive sleep apnea; Pilot Projects; Population Surveillance; Probability; Reference Values; Screening; Sex Factors; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - therapy; Weight Loss; Obesity; Screening; Internet; Obstructive sleep apnea
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2009.03.031

Abstract 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. Conclusion 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.