Results Summary

What was the research about?

Obstructive sleep apnea is a health problem that causes the throat muscles to relax and block the airway, making breathing stop and start during sleep. Continuous positive airway pressure, or CPAP, is a common treatment for sleep apnea. CPAP machines use an air hose and mask to give patients constant, steady air pressure while they sleep.

In this study, the research team tested a program in which trained peers helped patients who were starting treatment for sleep apnea. Peers were people who had sleep apnea, too, and used a CPAP machine regularly. The team compared patients who had peer support with those who didn’t. They looked at how satisfied patients were with their care and how often patients used their CPAP machines.

What were the results?

After six months, compared with patients who didn’t work with a peer, patients who had peer support

  • Were more satisfied with the support they got from their sleep doctor and clinic
  • Were happier with the coordination of their care
  • Used their CPAP machines more often

Patients who did and didn’t have peer support reported similar overall experiences of care.

Who was in the study?

The study included 263 patients with sleep apnea who were about to start using a CPAP machine. Of these, 84 percent were white, 6 percent were African American, 2 percent were American Indian or Alaska Native, and 8 percent were another race. Patients received care at four sleep centers in in Tucson, Arizona. The average age was 49, and 53 percent were men.

What did the research team do?

The research team assigned patients by chance to one of two groups. The first group received six months of peer support. The second group received brochures and DVDs about sleep apnea and using CPAP machines.

In the peer support group, the research team trained peers to help patients based on the peers’ own experiences with CPAP machines. When possible, the research team matched peers and patients by age, gender, and other traits. For the first two months, peers and patients had 10 phone calls. Peers helped patients use the CPAP machines and prepare for doctors’ appointments. For the next four months, peers supported patients as needed. Patients used a special phone system to connect with their peers so they wouldn’t have to look up their phone numbers. The system also sent reminders about future peer meetings. The system connected to patients’ CPAP machines and sent data to the team about how often patients used their machines.

At the start of the study and six months later, patients filled out a survey about their CPAP use and how happy they were with their care.

Patients with sleep apnea, doctors, and sleep disorder professionals helped the research team develop the study.

What were the limits of the study?

Most patients in the study were white. The study took place in one city. Results might differ for people from other backgrounds or locations.

Future studies could look at patients from other backgrounds or locations.

How can people use the results?

Sleep centers can consider these results when deciding how best to support patients with sleep apnea.

Final Research Report

View this project's final research report.

More to Explore...

Blogs

Experiencing the Much-Needed Benefits of Sleep
Talking About Men's Health, March 20, 2019
In a contribution to the TAMH Blog, Dr. Parthasarathy highlights the importance of including patients in his project and how one of them proposed the idea for peer counseling to help people with sleep apnea and their use of a CPAP machine.

Related PCORI Dissemination and Implementation Project

Journal Citations

Related Journal Citations

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:

  • The reviewers found the report to be well written, of high scientific quality, and to have minimal limitations.
  • Reviewers recommended that the researchers include a cost-benefit analysis of the peer intervention, as this would likely be important to providers and patients. This was not possible because of funding restrictions. However, the researchers included information on the amount of time peer buddies spent doing in-person visits and on telephone calls with clients. Researchers noted that this information would also be helpful for implementing the program in different settings.
  • Reviewers asked whether the intervention addressed issues of sleep hygiene, particularly short sleep duration, as this was known to differ based on race, ethnicity, and socioeconomic status. Habitual short sleep duration could look like participants were not consistently using their continuous positive airway pressure machines, even when they were. The researchers acknowledged this issue and that they did not account for sleep duration in the intervention.

Project Information

Sairam Parthasarathy, MD
University of Arizona
$2,117,118
10.25302/04.2020.IHS.130602505
Peer-Driven Intervention as an Alternative Model of Care Delivery and Coordination for Sleep Apnea

Key Dates

December 2013
February 2019
2013
2018

Study Registration Information

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Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
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Last updated: November 30, 2022