Screening for Obstructive Sleep Apnea on the Internet: Randomized Trial
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.
aDepartment of Internal Medicine, Division of General Medicine, The University of Texas Medical School at Houston, The University of Texas Medical School at Houston
bThe University of Texas Medical School at Houston
cThe University of Texas School of Health Information Sciences at Houston
dThe University of Texas at Houston-Memorial Hermann Center for Healthcare Quality and Safety
eDepartment of Cardiothoracic Surgery, The University of Texas Medical School at Houston
Requests for reprints should be addressed to Kevin O. Hwang, MD, MPH, 6410 Fannin St, UPB 1100.41, Houston, TX 77030
Funding: The study was supported in part by the Center for Clinical Research and Evidence Based Medicine, the Center for Clinical and Translational Sciences (a National Center for Research Resources, Clinical and Translational Sciences Award program), and the Medical School Summer Research Program at the University of Texas Health Science Center at Houston.
Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript.
Authorship: All authors had access to the data and played a role in writing this manuscript.
ABSTRACT
