Maximizing Sleep Apnea Treatment at the Community Level to Reduce CVD Risks

阻塞性睡眠呼吸暂停（OSA）每年导致38，000例心血管死亡，花费4200万美元 根据国家睡眠障碍委员会的估计， research.未治疗的OSA会导致心血管疾病、车祸、认知缺陷， 白天过度嗜睡和死亡率过高。幸运的是，阻塞性睡眠呼吸暂停综合症治疗可以降低患上 心血管疾病64%虽然OSA是一个公共卫生问题， 没有系统的研究记录了对推荐的OSA评估和治疗的依从性 在社区一级。我们进行的一项以社区为基础的研究的初步证据表明， 43%接受战神筛查的黑人有高度OSA风险，但只有27%坚持推荐的OSA 考核证据还表明，黑人不太可能坚持OSA治疗。少数黑人 病人遵守医生的建议，证据来自我们在布鲁克林的睡眠障碍中心， 纽约显示，90%的人得到了诊断。需要采取有效的行为干预措施， 接受OSA评估和治疗的黑人人数。在一项两组随机对照试验中， 380名患有阻塞性睡眠呼吸暂停高风险的黑人，我们将评估在文化和语言上定制电话的效果。 行为干预可提高OSA评估率和CPAP治疗依从性。 我们还将评估干预对临床结局（体重指数、血脂水平、血压、 空腹血糖/HbA1C和C-反应蛋白）。志愿者将从黑人拥有的 理发店，美容院，教堂和社区中心在布鲁克林，纽约。长期目标是 在以社区为基础的环境中应用这种干预模式，从而将社区健康促进与 医疗保健系统。因此，我们的计划可以作为一种替代的，非传统的模式， 在全国黑人中传播这种降低心血管风险的干预措施。的潜力 传播率很高，因为有超过18000个黑人理发店和13000个黑人教堂， 美国的城市中心。

Obstructive Sleep Apnea (OSA) Is responsible for 38,000 cardiovascular deaths yearly and costs 42 million dollars on related hospitalizations, according to estimates from the National Commission on Sleep Disorders Research. Untreated OSA leads to cardiovascular morbidity, automobile accidents, cognitive deficits, excessive daytime sleepiness and excess mortality. Fortunately, OSA treatment reduces risk for cardiovascular disease by 64%. Although OSA is a public health problem that disproportionately affects blacks, no systematic study has documented adherence to recommended OSA assessment and treatment at the community level. Preliminary evidence from a community-based study we conducted suggests that 43% of blacks screened with the ARES are at high OSA risk, but only 27% adhered to recommended OSA assessment. Evidence also suggests that blacks are less likely to adhere to OSA treatment. While few black patients adhered to physician's recommendations, evidence from our Sleep Disorders Center in Brooklyn, NY showed that 90% received a diagnosis. Effective behavioral interventions are needed to increase the number of blacks receiving OSA assessment and treatment. In a two-arm randomized controlled trial among 380 blacks at high OSA risk, we will evaluate effects of a culturally and linguistically tailored telephonedelivered behavioral intervention in increasing rates of OSA assessment and adherence to CPAP treatment. We will also evaluate Intervention effects on clinical outcomes (body mass index, lipid level, blood pressure, fasting plasma glucose/HbAIC, and C-reactive protein). Volunteers will be recruited from black-owned barbershops, beauty salons, churches, and community centers in Brooklyn, NY. The long-term goal is to apply this Intervention modality in community-based settings, thereby linking community health promotion to the healthcare system. Thus, our program could serve as an alternative, non-traditional model of disseminating this intervention for cardiovascular risk reduction among blacks nationwide. The potential for dissemination Is high, as there are over 18-thousand black barbershops and 13-thousand black churches in urban centers across the United States.