AUGUST 8, 2011 – Research at the University of Oklahoma Health Sciences Center provides an eye-opening look at why sleep problems in some patients  go undiagnosed.

James Mold, M.D. University of Oklahoma Health Sciences Center

Sleep disorders can be an underlying cause of serious illness. However, the study by James Mold, M.D., found they often go unreported or unnoticed in primary care settings. Mold is director of the Research Division of the OU College of Medicine’s  Department of Family and Preventive Medicine. He also sees patients as part of OU Physicians Family Medicine.

Mold conducted surveys at 44 primary care practices in five different states, obtaining data from patients, clinicians, sleep consultants and medical records. He found that on any given day, nine of 10 primary care patients are having trouble sleeping and one-third of patients are at high risk of having obstructive sleep apnea.

However, the study showed that most patients don’t discuss their sleep problems with primary care providers, and few providers routinely screen for sleep issues like sleep apnea. Mold said the latter is due, in part, to a lack of clear guidelines for primary care providers regarding who to screen, how to screen and how often to screen.

The study points to the need for appropriate guidelines for primary care physicians to help better guide them in this important area of medicine,” Mold said.

Obstructive sleep apnea is a serious disorder strongly associated with obesity, insulin resistance, diabetes, hypertension, heart attacks, heart failure and strokes.

“It appears to put you at an increased risk for future health problems including a significantly higher risk of motor vehicle accidents,” Mold said.

He added that the study underlines the importance of proper diagnosis. Mold said primary care clinicians should consider routinely asking patients about sleep problems and then should refer them for sleep studies, if warranted.

It is amazing the difference that many patients experience in their overall health and well-being when a sleep disorder has been diagnosed and then is treated,” said Kellie Jones, M.D., medical director of OU Medical Center’s Sleep Disorders Center.

If diagnosed with sleep apnea, patients are often treated with a continuous positive airway pressure device (CPAP), which keeps the airway open during the night, leading to less snoring, better sleep quality and better health.   But Mold said patients must be adequately trained to use the device or they won’t continue with the therapy.

About 50 percent of people who start on a CPAP don’t continue to use it,” Mold said. “They often need help to find the right mask and to overcome the common challenges associated with this form of treatment.”

Mold’s research is detailed in a recent issue of the Journal of the American Board of Family Medicine. It was funded by a $199,889 grant from the Agency for Healthcare Research and Quality.

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