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Increasing prevalence and recognition of obstructive sleep apnea (OSA) have stretched thin the availability of sleep specialists and laboratory-based polysomnography (PSG). Australian investigators developed an ambulatory, primary care–based approach to diagnosing and treating OSA that included a 6-hour didactic and 5-day clinical educational program for registered nurses; supervisory primary care physicians also attended the 6-hour course.
A total of 155 adults who were screen-positive for OSA (positive result on a questionnaire about daytime sleepiness) and experienced at least 16 oxygen desaturation episodes hourly during home oximetry were randomized to primary or specialty care; 132 completed the 6-month protocol. Most patients in each …