Clinical Studies & Research





Below are links to research studies, papers and other information about sleep apnea, as well as diseases that can be affected by sleep apnea.


Clinical Validation of the Bedbugg™ [the NovaSom device] in Detection of Obstructive Sleep Apnea

David Claman, Andrew Murr, Kimberly Trotter

Otolaryngology- Head and Neck Surgery. 2001; 125: 227-230

Objective: To validate the accuracy of the Bedbugg™, a new home monitoring device for diagnosis of sleep apnea. Study design and setting: Simultaneous sleep monitoring was performed by formal polysomnography and by Bedbugg. Monitoring was performed in a university sleep center in 42 subjects who h... Read Now

Comparison of the NovaSom QSG™, a New Sleep Apnea Home-Diagnostic System, and Polysomnography

James A. Reichert, Daniel A. Block, Elizabeth Cundiff, Bernhard A Votteri

Sleep Medicine. 2003; 4:213-218

Obstructive sleep apnea (OSA) is a serious, common, and underdiagnosed disorder that challenges health care resources. While polysomnography (PSG) represents the standard diagnostic test for OSA, portable devices provide an alternative diagnostic tool when issues of cost, time, geographic availabili... Read Now

“The Times They Are A Changin:” Home Diagnosis of Sleep Apnea Has Arrived

Charles W. Atwood, Jr., MD

The HomePAP Study. SLEEP 2013;35:757-767

As anyone in the clinical practice of sleep medicine is keenly aware, the traditional approach to the diagnosis of and initiation of continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) is undergoing a sea change. Since 2008, and the Centers for Medicare and Medicaid ... Read Now

Unattended Home Diagnosis and Treatment of Obstructive Sleep Apnea Without Polysomnography

Eugene C. Fletcher, MD; Jacqueline Stich, RN; Karl L. Yang, MD

Archives of Family Medicine. 2000; 9: 168-174

Obstructive Sleep Apnea (OSA) is recognized as a frequent cause of symptomatic daytime sleepiness in the general population. The importance of this disorder as a contributor to cardiovascular disease, including systemic hypertension, stroke, and coronary artery disease, is being increasingly recogni... Read Now

Diagnosis of Obstructive Sleep Apnea Syndrome and Its Outcomes With Home Portable Monitoring

Moreira and Flávio Danni Fuchs, Costa Fuchs, Miguel Gus, Erlon Oliveira de Abreu-Silva, Leila Beltrami Vasconcelos, Sandro Cadaval Gonçalves, Maria do Carmo Lenz, Sandra Ana Claudia Tonelli de Oliveira, Denis Martinez, Luiz Felipe T.

Chest 2009; 135; 330-336

The use of portable respiratory monitoring (PM) has been proposed for the diagnosis of obstructive sleep apnea syndrome (OSAS), but most studies that validate PM accuracy have not followed the best standards for diagnostic test validation. The objective of the present study was to evaluate the accur... Read Now

Home Versus Laboratory Diagnosis and Treatment of OSA

Carol L Rosen, MD; Dennis Auckley, MD; Ruth Benca, MD; Nancy Foldvary-Schaefer, DO; Conrad Iber, MD; Vishesh Kapur, MD; Michael Rueschman, MPH; Phyllis Zee, MD; Susan Redline, MD

The HomePAP Study. SLEEP 2012;35(6):757-767

Obstructive sleep apnea (OSA) is a common disorder with multiple comorbidities, many of which may be reduced with effective OSA treatment. In response to the growing recognition of the disorder and benefits of treatment in the community, the number of American Academy of Sleep Medicine (AASM)-accred... Read Now

Expenditure on Health Care in Obese Women With and Without Sleep Apnea

K. Banno, C. Ramsey, R. Walld, MH. Kryger

Sleep. (32)2. 1-FEB-2009. pp 247-52

STUDY OBJECTIVES: To determine the effect of obesity and sleep apnea on health care expenditure in women over 10 years. DESIGN: Retrospective observational study SETTING: Tertiary university-based medical center PATIENTS AND CONTROLS: Three groups of age-matched women: 223 obese women with OSAS (bod... Read Now

Obstructive Sleep Apnea and the Subsequent Risk of Depressive Disorder: A Population-based Follow-up Study

Chen YH, Keller JK, Kang JH, Hsieh HJ, Lin HC.

Journal of Clinical Sleep Medicine. 2013;9(5):417-423

Empirical findings on the prospective link between obstructive sleep apnea (OSA) and subsequent depression are mixed. This nationwide, population-based study thus aimed at assessing the risk of depressive disorder within the first year following a diagnosis with OSA. Gender effects were further exam... Read Now

Evidence Supporting Routine Polysomnography Before Bariatric Surgery

O'Keeffe T, Patterson EJ.

Obesity Surgery 2004; 14(1):23-26

Obstructive sleep apnea (OSA) is common in morbidly obese patients, with a reported prevalence from 12 to 40%. Preoperative diagnosis of OSA is important for both perioperative airway management and the prevention of postoperative pulmonary complications. BMI has been reported to be an independent r... Read Now

Sleep-disordered Breathing and Mortality: a Prospective Cohort Study

Punjabi NM, Caffo BS, Goodwin JL, et al.

PLoS Medicine. 2009; 6(8):e1000132

Sleep-disordered breathing is a common condition associated with adverse health outcomes including hypertension and cardiovascular disease. The overall objective of this study was to determine whether sleep-disordered breathing and its sequelae of intermittent hypoxemia and recurrent arousals are as... Read Now

Patients with Type 2 Diabetes or Hypertension must be evaluated for Sleep Apnea

American Academy of Sleep Medicine

June 3, 2013. http://www.aasmnet.org/articles.aspx?id=3935

The American Academy of Sleep Medicine (AASM) is advising anyone with Type 2 diabetes or hypertension to be evaluated for sleep apnea by a board-certified sleep medicine physician. The recommendation comes as the group of international clinicians and researchers meets in Baltimore for SLEEP 2013, th... Read Now

Prevalence of Sleep Apnea in a Population in Adults with Type 2 Diabetes Mellitus

Einhorn D, Stewart DA, Erman MK, Gordon N, Philis-Tsimikas A, Casal E.

Endocrine Practice 2007; 13(4):355-362

Sleep Apnea is a common disorder associated with major morbid conditions, including hypertension, obesity, cardiovascular disease, and insulin resistance. Predisposing factors for Sleep Apnea and Type 2 Diabetes Mellitus are similar. This study showed that Sleep Apnea has a high prevalence in adults... Read Now

Obstructive Sleep Apnea Is Independently Associated With Insulin Resistance

Mary S. M. IP, Bing Lam, Matthew M.T. NG, Wah Kit Lam, Kenneth W.T. Tsang, Karen S. L. Lam

American Journal of Respiratory and Critical Care Medicine Vol 165. pp 670–676, 2002

Epidemiological studies have implicated obstructive sleep apnea (OSA) as an independent comorbid factor in cardiovascular and cerebrovascular diseases. It is postulated that recurrent episodes of occlusion of upper airways during sleep result in pathophysiological changes that may predispose to vasc... Read Now

Sleep-disordered Breathing and Insulin Resistance in Middle-aged and Overweight Men

Punjabi MN, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL

American Journal of Respiratory and Critical Care Medicine 2002;165(5):677-682

Multivariable linear regression analyses revealed that increasing AHI was associated with worsening insulin resistance independent of obesity. Thus, sleep-disordered breathing is a prevalent condition in mildly obese men and is independently associated with glucose intolerance and insulin resistance... Read Now

Obstructive Sleep Apnea and Type 2 Diabetes: Interacting Epidemics

Esra Tasali, Babak Mokhlesi and Eve Van Cauter

Chest 2008; 133; p 496-506

Type 2 diabetes is a major public health concern with high morbidity, mortality, and health-care costs. Recent reports have indicated that the majority of patients with type 2 diabetes also have obstructive sleep apnea (OSA). There is compelling evidence that OSA is a significant risk factor for car... Read Now

The Association of Sleep-Disordered Breathing and Sleep Symptoms With Quality of Life in the Sleep Heart Health Study

Carol M. Baldwin RN, PhD,1 Kent A. Griffith MPH,2 F. Javier Nieto MD, PhD,3 George T. O’Connor MD, MS,4 Joyce A. Walsleben PhD,5 and SusanRedline MD, MPH6

SLEEP, Vol. 24, No. 1, 2001

This study assessed the extent to which sleep-disordered breathing (SDB), difficulty initiating and maintaining sleep (DIMS), and excessive daytime sleepiness (EDS) were associated with impairment of quality of life (QoL) using the SF-36. Participants (n=5,816; mean age=63 years; 52.5% women) were e... Read Now

Resistant Hypertension: Diagnosis, Evaluation, and Treatment: A Scientific Statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research

Calhoun DA, Jones D, Textor S, et al

Circulation. 2008; 117(25):e510-e526

Studies of resistant hypertension are limited by the high cardiovascular risk of patients within this subgroup, which generally precludes safe withdrawal of medications; the presence of multiple disease processes (eg, sleep apnea, diabetes, chronic kidney disease, atherosclerotic disease) and their ... Read Now

Investigating the Relationship Between Stroke and Obstructive Sleep Apnea

Dyken ME, Somers VK, Yamada T, Ren ZY, Zimmerman MB

Stroke. 1996; 27(3):401-407

Patients with stroke have an increased incidence of obstructive sleep apnea compared with normal sex- and age-matched control subjects. Hypoxia and hemodynamic responses to obstructive sleep apnea may have predisposed these patients to stroke.... Read Now

Association of Atrial Fibrillation and Obstructive Sleep Apnea

Gami AS, Pressman G, Caples SM et al.

Circulation. 2004; 110(4):364-367

The novel finding of this study is that a strong association exists between OSA and AF, such that OSA is strikingly more prevalent in patients with AF than in high-risk patients with multiple other cardiovascular diseases. The coinciding epidemics of obesity and AF underscore the clinical importance... Read Now

Obstructive Sleep Apnea and Cardiovascular Disease

Jo-Dee L. Lattimore, MBCHB, FRACP, David S. Celermajer, MBBS, MSC, PHD, FRACP, Ian Wilcox, BMEDSCI, MBBS, PHD, FRACP, FCCP

Journal of the American College of Cardiology Vol. 41, No. 9, 2003

Obstructive sleep apnea (OSA) is a common disorder associated with an increased risk of cardiovascular disease and stroke. As it is strongly associated with known cardiovascular risk factors, including obesity, insulin resistance, and dyslipidemia, OSA is an independent risk factor for hypertension ... Read Now

High Prevalence of Unrecognized Sleep Apnoea in Drug-Resistant Hypertension

Logan AG, Perlikowski SM, Mente A. et al.

Journal of Hypertension. 2001; 19(12):2271-2277

To determine the prevalence of obstructive sleep apnoea (OSA) in adult patients with drug-resistant hypertension, a common problem in a tertiary care facility.The extraordinarily high prevalence of OSA in these patients supports its potential role in the pathogenesis of drug-resistant hypertension, ... Read Now

Sleep-disordered breathing in Patients with Symptomatic Heart Failure: A Contemporary Study of Prevalence in and Characteristics of 700 Patients.

Oldenburg O, Lamp B, Faber L, Teschler H, Horstkotte D, Topfer V

European Journal of Heart Failure. 2007:9;251-257

Evaluation of the prevalence and nature of sleep-disordered breathing (SDB) in patients with symptomatic chronic heart failure (CHF) receiving therapy according to current guidelines. This study confirms the high prevalence of SDB, particularly CSA in CHF patients. CSA seems to be a marker of heart... Read Now

Obstructive Sleep Apnea as a Risk Marker in Coronary Artery Disease

Schafer H, Koehler U, Ewig S, Hasper E, Tasci S, Luderitz B.

Cardiology. 1999;92(2):79-84

There is a high prevalence of OSA among patients with angiographically proven Coronary Artery Disease. OSA of moderate severity  is independently associated with myocardial infarction. Thus, in the care of patients with Coronary Artery Disease, particular vigilance for OSA is important.... Read Now

Sleep Apnea and Cardiovascular Disease: An American Heart Association/ American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing

Somers VK, White DP, Amin R, et al.

Circulation. 2008;118:1080-1111

 The purpose of this Scientific Statement is to describe the types and prevalence of sleep apnea and its relevance to individuals who either are at risk for or already have established cardiovascular disease. Special emphasis is given to recognizing the patient with cardiovascular disease who ... Read Now

Obstructive Sleep Apnea as a Risk Factor for Stroke and Death

H. Klar Yaggi, M.D., M.P.H., John Concato, M.D., M.P.H., Walter N. Kernan, M.D., Judith H. Lichtman, Ph.D., M.P.H., Lawrence M. Brass, M.D., and Vahid Mohsenin, M.D.

New England Journal of Medicine 2005; 353: 2034-41

Previous studies have suggested that the obstructive sleep apnea syndrome may be an important risk factor for stroke. It has not been determined, however, whether the syndrome is independently related to the risk of stroke or death from any cause after adjustment for other risk factors, including hy... Read Now

Utilization of Healthcare Resources in Obstructive Sleep Apnea Syndrome: a 5-year Follow-up Study in Men Using CPAP

Albarrak M; Banno K; Sabbagh AA; Delaive K; Walld R; Manfreda J; Kryger MH

SLEEP. (28)10. 2005. pp 1306-1311

Study Objectives: Patients with untreated obstructive sleep apnea syndrome (OSAS) have higher healthcare utilization than matched controls. However, the long-term impact of continuous positive airway pressure (CPAP) use on healthcare utilization is unknown. Design: Retrospective observational cohort... Read Now

Health Care Utilization in Males With Obstructive Sleep Apnea Syndrome Two Years after Diagnosis and Treatment

Ahmed Bahammam, MD, MRCP†, Kenneth Delaive, BSc, John Ronald BSc, Jure Manfreda, MD, Les Roos, PhD* and Meir H. Kryger, MD, FRCPC

SLEEP, Vol. 22, No. 6, 1999

Objective: To document changes in health care utilization (physician claims and hospitalizations) two years after diagnosis and treatment of patients with OSAS. Design: Prospective observational cohort study. Setting: The study was done in the Canadian Province of Manitoba. OSAS patients were select... Read Now

The Long-Term Health Plan and Disability Cost Benefit of Obstructive Sleep Apnea Treatment in a Commercial Motor Vehicle Driver Population

Benjamin Hoffman, MD, MPH, Dustin D. Wingenbach, MBA, Amy N. Kagey, MS, Justin L. Schaneman, MS, David Kasper

Journal of Occupational and Environmental Medicine Volume 52, Number 5, May 2010

To assess the impact on health plan and disability costs associated with continuous positive airway pressure or bi-level positive airway pressure treatment of obstructive sleep apnea in a commercial motor vehicle driver population. Methods: A retrospective, pre/post claims-based comparison analysis ... Read Now

The Medical Cost of Undiagnosed Sleep Apnea

Vishesh Kapur MD, MPH, David K. Blough PhD, Robert E. Sandblom MD, Richard Hert MD, James B. de Maine MD, Sean D. Sullivan PhD, Bruce M. Psaty MD PhD

SLEEP, Vol. 22, No. 6, 1999 749-755

Obstructive sleep apnea is an under-diagnosed, but common disorder with serious adverse consequences. Cost data from the year prior to the diagnosis of sleep-disordered breathing in a consecutive series of 238 cases were used to estimate the potential medical cost of undiagnosed sleep apnea and to d... Read Now

Management of Obstructive Sleep Apnea in Adults: a Clinical Practice Guildeline from the American College of Physicians

Qaseem A, Holty J-E, Owens DK, et al, for the Clinical Guidelines Committee of the American College of Physicians Management of Obstructive Sleep Apnea in Adults

Annals of Internal Medicine. 2013;159:471-483

The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of obstructive sleep apnea (OSA) in adults.... Read Now