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Nurse-led care was non-inferior to physician-directed care in symptomatic moderate to severe obstructive sleep apnoea

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Question

Is nurse-led care non-inferior to physician-directed care in patients with symptomatic moderate to severe obstructive sleep apnoea (OSA)?

Methods

Design:

randomised controlled trial (RCT). ACTRN 012605000064606.

Allocation:

concealed.

Blinding:

blinded (research assistants).

Follow-up period:

3 months.

Setting:

3 academic sleep medicine services in Australia.

Patients:

195 patients (mean age 50 y, 74% men) 18–75 years of age, who had Epworth Sleepiness Scale (ESS) scores ⩾8, history of snoring “most nights” or “every night,” and oxygen saturation (SaO2) dip >2% at a rate of >27 dips/hour. Exclusion criteria were unstable cardiovascular disease, neuromuscular disease affecting or potentially affecting respiratory muscles, moderate to severe respiratory disease or documented hypoxemia or awake SaO2 <92%, and psychiatric disease.

Intervention:

nurse-led care (n = 100) or physician-directed care (n = 95). Nurse-led care involved autotitrating CPAP between 4 and 20 cm H2O for 4 consecutive …

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