In this open-label randomized controlled trial we found that nurse-communicated management of uncomplicated OSA in the sleep clinic was non-inferior to standard of care physician-directed management, with respect to improvement in self-reported
sleepiness at 6 months, quality of life, and PAP adherence at 3 months and 6 months.
he diagnosis and management of chronic diseases by practician or specialized, registered nurses have been proven successful in numerous pathologies, namely diabetes, hypertension, and heart failure. Until recently, the role of nurses in the sleep clinic has been centered on the management of OSA after treatment initiation, often with PAP, and promoting its adherence. A prior open-label non-inferiority randomized controlled trial found that a simplified model of care, consisting of ambulatory overnight oximetry for the diagnosis of OSA and nurse-communicated management, was similar to a standard management trajectory where OSA was diagnosed by poly-somnography and managed by a physician. In this study, participants had to be willing to try PAP to be included, with those refusing or failing PAP being referred to a sleep physician. This
differs from our nurse-communicated management model, where after receiving extensive training on the different modalities available for OSA treatment, the nurses would discuss the appropriate therapy with the participants based on their OSA
characteristics and preferences.
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