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Understanding and Recognizing Obstructive Sleep Apnea

Please read through the following information and click the link at the bottom of the page.

Release Date: October 20, 2008
Expiration Date: October 20, 2009
Estimated Time to Complete Activity: 1 hour

Target Audience:
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:
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.

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.

Learning Objectives:
Upon completion of this activity, participants will be able to:

  • Recognize common symptoms associated with sleep deprivation.
  • Identify individuals at high risk of obstructive sleep apnea (OSA).
  • Choose appropriate methods for diagnosing OSA.
  • Manage OSA using evidence-based recommendations.
  • Anticipate and address barriers to patient adherence to treatment.

Dr. Leonard Fromer Leonard Fromer, MD click here for bio
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.

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.

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.

Method of Participation

  • Read the learning objectives and faculty disclosures.
  • 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.
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 program.

There is no fee for participation in this activity.

Commercial Support:
This activity is supported by an educational grant from Cephalon.

Antidote 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 activity:

Leonard Fromer, MD
Presenting Faculty
Dr. Fromer discloses that he has received honoraria from AstraZeneca, Merck and Sanofi-Aventis

Michael Fleming, MD, FAAFP
Program Development
Dr. Fleming has no relevant financial relationships to disclose.

Leigh McKinney
Ms. McKinney has no relevant financial relationships to disclose.

Disclosure of Unlabeled Use:
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 Policies.

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.

Software Requirements:
Internet Explorer (v5.5 or greater), or Firefox
Windows 2000 or greater
Sound Card & Speakers
800 x 600 Minimum Monitor Resolution
(1024 x 768 Recommended)
Flash Player Plugin (9.0 or later) | Check your version here

MAC OS 10.2.8
Sound Card & Speakers
800 x 600 Minimum Monitor Resolution
(1024 x 768 Recommended)
Flash Player Plugin (9.0 or later) | Check your version here
Adobe Acrobat Reader*
Internet Explorer is not supported on the Macintosh.

* Required to view printable (PDF) version of the lesson.

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