and Recognizing Obstructive Sleep Apnea
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Release Date: October 20, 2008
Expiration Date: October 20, 2009
Estimated Time to Complete Activity:
This activity has been developed for members of the
primary care team including practicing physicians, physician assistants
and nurse practitioners in the specialty areas of family, general,
internal and emergency medicine and obstetrics and gynecology and other
practitioners involved in the care of patients with difficulties
obtaining a good night's sleep.
Statement of Need:
Obstructive sleep apnea is a syndrome characterized
by cessation of breathing during sleep caused by repetitive partial or
complete obstruction of the airway by pharyngeal structures. It affects
approximately 4% of adult men and 2% of adult women in the US. Older
obese men seem to be at higher risk, though as many as 40% of people
with obstructive sleep apnea are not obese. The pathophysiology of
obstructive sleep apnea is likely multifactorial with contributions
from airway anatomy, the state-dependent control of upper airway
dilator muscles, and ventilatory stability, as well as other probable
factors that are not well recognized. During airway obstruction,
hypoxemia and hypercapnia develop. Obstructive sleep apnea should be
suspected in patients who are overweight, snore loudly, and have
chronic daytime sleepiness. The diagnosis can be confirmed by sleep
laboratory studies. Patients' symptoms and the frequency of respiratory
events on laboratory testing are important factors in determining the
severity of disease. This syndrome may adversely affect other co-morbid
conditions such as hypertension.
One of the most common complaints heard in primary
care offices is lack of sleep, and that's not surprising in light of
what the literature tells us. We are a sleep-deprived nation, and this
increasingly cultural problem causes more than 50,000 unnecessary
deaths per year, and more than $100 billion per year to accidents
related to sleep loss and sleep disorders. There are multiple public
health and safety concerns related to excessive sleep debt, including
increased school failures and dropouts, accidents in the transportation
industry, issue in patient safety due to sleep-deprived physicians and
nurses, diminished workplace productivity and performance, and
exacerbation and worsening of medical conditions such as hypertension
in patients with obstructive sleep apnea.
Upon completion of this activity, participants will be able to:
Recognize common symptoms associated with sleep
individuals at high risk of obstructive sleep apnea (OSA).
appropriate methods for diagnosing OSA.
OSA using evidence-based recommendations.
and address barriers to patient adherence to treatment.
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Assistant Clinical Professor, UCLA School of
Medicine, Los Angeles, CA
Antidote Education Company is accredited by the
Accreditation Council for Continuing Medical Education to provide
continuing medical education for physicians. Antidote designates this
educational activity for a maximum of 1.0 AMA PRA Category 1
Credit™. Physicians should only claim credit commensurate
with the extent of their participation in the activity.
The EB CME credit awarded for this activity was based on practice recommendations that were the most current with the strongest level of evidence available at the time this activity was approved. Since clinical research is ongoing, AAFP recommends that learners verify sources and review these and other recommendations prior to implementation into practice.
This activity has been reviewed and is acceptable for up to 2 Prescribed credits by the American Academy of Family Physicians. Of these credits, 1 conforms to the AAFP criteria for evidence-based CME clinical content. CME credit has been increased to reflect 2 for 1 credit for only the EB CME portion. AAFP accreditation begins 10/20/08. The term of approval is for one-year(s) from this date, with option for yearly renewal. When reporting AAFP credit, report total Prescribed and Elective credit for this activity. It is not necessary to label credit as evidence-based CME for reporting purposes.
Method of Participation
A statement of credit will be issued automatically
upon receipt of a completed activity evaluation form and a completed
post-test with a score of 70% or better. There is no limit to the
number of opportunities you will have to successfully complete the
- Read the learning objectives and faculty
- Complete the pre-survey questions.
- Study the educational activity.
- Complete the post-test by recording the best answer
to each question.
- Complete the activity evaluation form.
There is no fee for participation in this activity.
This activity is supported by an educational grant from Cephalon.
Education Company assesses conflict of interest with its instructors,
editors, and other individuals who are in a position to control the
content of CME activities. All relevant conflicts of interest that are
identified are thoroughly vetted by Antidote for fair balance,
scientific objectivity of studies utilized in this activity, and
patient care recommendations. Antidote is committed to providing its
learners with relevant, high quality CME activities that promote
practice improvements or quality in healthcare to enable learners to
provide better care to their patients.
The faculty reported the following financial relationships or
relationships to products or devices they or their spouse/life partner
have with commercial interests related to the content of this CME
Leonard Fromer, MD
Dr. Fromer discloses that he has received honoraria
from AstraZeneca, Merck and Sanofi-Aventis
Michael Fleming, MD, FAAFP
Dr. Fleming has no relevant financial relationships
Disclosure of Unlabeled Use:
Ms. McKinney has no relevant financial
relationships to disclose.
The learner is advised that this CME activity may
contain references to off-label or experimental or investigational uses
of drugs or devices. The use of these agents outside currently approved
labeling is considered experimental, and participants are advised to
consult prescribing information for these products. This CME activity
was planned and produced in accordance with ACCME Essential Areas and
The material presented at this course is being made
available by Antidote Education Company for educational purposes only.
This material is not intended to represent the only, nor necessarily
best methods or procedures appropriate for the medical situations
discussed, but rather is intended to present an approach, view,
statement or opinion of the faculty which may be helpful to others who
face similar situations.
Every effort has been made to assure the accuracy
of the data presented at this course. Physicians may care to check
specific details such as drug doses and contraindications in standard
sources prior to clinical application.