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

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

https://doi.org/10.1136/ebn.12.4.112

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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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    Footnotes

    • Sources of funding National Health and Medical Research Council of Australia; oximeters donated by Masimo (Irvine, CA), and CPAP equipment loaned by ResMed (Sydney, Australia).