Best Approaches to Treating Sleep Apnea in COPD Patients to Be Focus of Likely $2.5M Study

The American Sleep Apnea Association (ASAA), a patient-led nonprofit organization to promote sleep health, has received approval from the Patient-Centered Outcomes Research Institute (PCORI)’s board of governors for a three-year, $2.5 million demonstration project into chronic obstructive pulmonary disease (COPD) and sleep apnea, called the O2VERLAP Study.

The award for the study, whose formal title is “Monitoring and Peer Support to Improve Treatment Adherence and Outcomes in Patients with Overlap Chronic Obstructive Pulmonary Disease (COPD) and Sleep Apnea via a Large PCORnet Collaboration,” is pending the completion of a business and programmatic review by PCORI staff.

Obstructive sleep apnea (OSA), characterized by repeated stops or near stops of breathing during sleep, is prevalent in about 10 percent to 15 percent of patients with COPD, according to the COPD Foundation. The co-occurrence of both disorders is referred to as “overlap syndrome.” Treatment of sleep apnea, usually through positive airway pressure (PAP) therapy, is important as COPD patients with this syndrome are at an increased risk of acute exacerbations and hospitalizations.

The demonstration project, a collaboration with multiple patient-powered research networks, aims to compare the efficacy of proactive care, such as web-based peer coaching and support intervention, to that of reactive care in improving adherence to nocturnal oxygen and PAP therapies in patients with overlap syndrome, as well as the effectiveness of both types of intervention on patient outcomes, such as sleep quality and symptoms.

Study results also may help clinicians identify the best ways of improving treatment adherence and patient education, and help patients better understand the benefits of treatment.

“Other PCORI-funded projects have shown that ‘peer’ support is successful in increasing PAP adherence, and my own research has shown that a group self-management approach led by a sleep provider with sleep apnea facilitating group support sessions results in an increase in PAP adherence,” Dr. Carl Stepnowsky, the co-principal investigator and ASAA’s chief science officer, said in a press release. “This line of research has resulted in an approach called the Sleep Apnea Self-Management Program, which will be the basis of the material and content for this intervention.”

Researchers expect that the study will also provide guidance in the use social media, viral messaging, and Apple ResearchKit iPhone apps (including the ASAA’s SleepHealth Mobile App study) to recruit and enroll new participants in The National Patient-Centered Clinical Research Network (PCORnet).