Management of Sleep Apnea Patients by a Clinical Nurse (Supernurse)

Sleep apnea is a prevalent problem and references for the evaluation of this condition often exceeds the sleep clinic's capacity thus creating important delays in the patients' care. The overall goal of this project is to assess the feasibility and the non-inferiority of integrating a clinical nurse, or supernurse, to the initial consultation team. The hypothesis is that the integration of a clinical nurse to the sleep clinic's evaluation team is non inferior in terms of patients' outcomes such as improvement of symptoms and quality of life as well as adherence to treatment. This study is supported by funding dedicated to teaching and research activities related to sleep-disordered breathing.

Patients randomized in this group will have their first sleep clinic evaluation with the clinical nurse. She will then discuss each case with the pulmonologist and validate the diagnostic and therapeutic avenue.

Patients randomized in this group will have their first sleep clinic evaluation with the pulmonologist.

The first evaluation of the patient refered to the sleep clinic will be performed by the clinical nurse then discussed with the pulmonologist in charge.

The first evaluation of the patient refered to the sleep clinic will be performed only by the pulmonologist.

Based on the Epworth Sleepiness scale (ranging from 0 to 24 points, higher values indicates increased sleepiness)

Based on the Epworth Sleepiness scale (ranging from 0 to 24 points, higher values indicates increased sleepiness)

Inclusion Criteria: Patients referred to the ''Institut Universitaire de Cardiologie et Pneumologie de Québec'' 's sleep clinic who have undergone a cardiorespiratory polygraphy. Body mass index (BMI) between 27-35 kg/m2; Apnea-Hypopnea Index (ADI) equal or above 20 events per hour with less than 5 events per hour of central origin; Oxygen Desaturaton Index (ODI) equal or above 10 events per hour; Percentage of time spent below 90% of oxygen saturation equal or less than 10% Exclusion criteria : - Patients not meeting the above inclusion criteria.

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Lajoie AC, Prive A, Roy-Halle A, Page D, Simard S, Series F. Diagnosis and management of sleep apnea by a clinical nurse: a noninferiority randomized clinical trial. J Clin Sleep Med. 2022 Jan 1;18(1):89-97. doi: 10.5664/jcsm.9502.