Person: Omobomi, Olabimpe
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Omobomi
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Olabimpe
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Omobomi, Olabimpe
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Publication Prevalence and correlates of periodic limb movements in OSA and the effect of CPAP therapy(Ovid Technologies (Wolters Kluwer Health), 2019-12-27) Budhiraja, Rohit; Javaheri, Sogol; Epstein, Lawrence; Omobomi, Olabimpe; Pavlova, Milena; Quan, StuartObjective We sought to assess the prevalence, correlates, and consequences of periodic limb movements of sleep (PLMS) in persons with obstructive sleep apnea (OSA) and the effect (worsening or improvement) of continuous positive airway pressure (CPAP) therapy on PLMS in a large prospective multicenter randomized controlled trial. Methods We performed retrospective analyses of data from the Apnea Positive Pressure Long-term Efficacy Study, a prospective multicenter randomized controlled trial. A total of 1,105 persons with OSA enrolled in this study underwent a polysomnographic investigation at baseline, another one for CPAP titration, and another study 6 months after randomization to either active CPAP or sham CPAP. Results Of all participants, 19.7% had PLM index (PLMI) ≥10/hour, 14.8% had PLMI ≥15/hour, 12.1% had PLMI ≥20/hour, 9.3% had PLMI ≥25/hour, and 7.5% had PLMI ≥30/hour. The odds of having a PLMI ≥10 were higher in older participants (odds ratio [OR] 1.03, p < 0.001), men (OR 1.63. p = 0.007), those using antidepressants (OR 1.48. p = 0.048), and those with higher caffeine use (OR 1.01, p = 0.04). After controlling for OSA and depression, PLMS were associated with increased sleep latency, reduced sleep efficiency, and reduced total sleep time. No significant relationships were noted between PLMS frequency and subjective sleepiness (Epworth Sleepiness Scale score) or objective sleepiness (Maintenance of Wakefulness Test). There was no differential effect of CPAP in comparison to sham CPAP on PLMS after 6 months of therapy. Conclusions PLMS are common in patients with OSA and are associated with a significant reduction in sleep quality over and above that conferred by OSA. Treatment with CPAP does not affect the severity of PLMS.Publication The effect of CPAP on HRQOL as Measured by the quality of Well-Being Self-Administered Questionnaire (QWB-SA)(Southwest Journal of Pulmonary and Critical Care, 2020-01-14) Batool-Anwar, Salma; Omobomi, Olabimpe; Quan, StuartBackground: To examine the effect of continuous positive airway pressure (CPAP) on Health-related quality of life (HRQoL) as measured by the Quality of Well Being Self-Administered questionnaire (QWB-SA). Methods: Participants from The Apnea Positive Pressure Long-term Efficacy Study (APPLES); a 6-month multicenter randomized, double-blinded intention to treat study, were included in this analysis. The participants with an apnea-hypopnea index >10 events/hour initially randomized to CPAP or Sham group were asked to complete QWB-SA at baseline, 2, 4, and 6-month visits. Results: There were no group differences among either the CPAP or Sham groups. “Mean age was 52±12 [SD] years, AHI 40±25 events/hr, BMI 32±7.1 kg/m2, and Epworth Sleepiness Score (ESS) 10±4 of 24 points.” QWB-SA scores were available at baseline, and 2, 4 & 6 months after treatment in CPAP (n 558) and Sham CPAP (n 547) groups. There were no significant differences in QWB scores among mild, moderate or severe OSA participants at baseline. Modest improvement in QWB scores was noted at 2, 4 and 6- months among both Sham and CPAP groups (P <0.05). However, no differences were observed between Sham CPAP and CPAP at any time point. Comparison of the QWB-SA data from the current study with published data in populations with chronic illnesses demonstrated that the impact of OSA is no different than the effect of AIDS and arthritis. Conclusion: Although the QoL measured by the QWB-SA was impaired in OSA it did not have direct proportionality to OSA severity.Publication Clinical and Polysomnographic Correlates of Subjective Sleepiness in Mild Obstructive Sleep Apnea(Springer Science and Business Media LLC, 2019-06-19) Omobomi, Olabimpe; Batool-Anwar, Salma; Quan, StuartPurpose: The decision to treat mild obstructive sleep apnea (OSA) often hinges on the presence of subjective daytime sleepiness. This study was done to identify clinical and polysomnographic features which correlate with subjective sleepiness in mild OSA. Methods: Utilizing data from the Apnea Positive Pressure Long-term Efficacy Study, 199 participants with mild OSA were identified. Participants were grouped as “sleepy” or “non-sleepy” based on their responses to a question regarding excessive daytime sleepiness, and Epworth Sleepiness Scores. We compared demographic, clinical and baseline polysomnographic data between the groups. Results: The prevalence of subjective sleepiness was 74.4%. The sleepy group was younger (46.1 ± 12.6 vs. 53.3 ± 13.1 years, p=0.001), reported lower quality of life (4.5 ± 0.69 vs. 4.9 ± 0.61, p=0.0002), had higher depression scores (5.4 ± 4.7 vs. 3.1 ± 3.5, p=0.003) and reported more naps per week (2.6 ± 2.9 vs. 1.3 ± 1.9, p=0.01). Total sleep time and sleep efficiency were notably higher in the sleepy (254.2 ± 106 vs. 220.4 ± 114 min, p=0.08) and (80.2 ± 12.6 vs. 75.7 ± 14.9 %, p=0.06), approaching statistical significance. The non-sleepy group had slightly higher apnea hypopnea index (AHI: 12.2 ± 1.5 vs. 11.2 ± 2.4 events/hour, p=0.01) and worse desaturation indices. Conclusions: Subjective sleepiness in mild OSA is associated with younger age, worsened mood and quality of life. This study suggests that evidence of increased sleep drive on polysomnography may correlate with subjective sleepiness in mild OSA.Publication A Requiem for the Clinical Use of the Epworth Sleepiness Scale(American Academy of Sleep Medicine (AASM), 2018) Omobomi, Olabimpe; Quan, StuartPublication Positional therapy in the management of positional obstructive sleep apnea—a review of the current literature(Springer Nature, 2017) Omobomi, Olabimpe; Quan, StuartMore than 50% of obstructive sleep apnea (OSA) patients have worsening of their OSA in the supine position (positional obstructive sleep apnea [POSA], commonly defined as supine to non-supine apnea hypopnea index (AHI) ratio of ≥ 2). Positional therapy (PT) aims to prevent patients from sleeping in the supine position. One of the major limiting factors to the routine use of PT in clinical practice is the lack of validated tools to measure compliance objectively. Furthermore, there are no universal guidelines to determine if PT will be effective as standalone or as adjunctive therapy. This paper assesses recent literature on PT demonstrating its effectiveness in management of POSA. It also outlines the proposed subclassification systems for POSA. Electronic literature review was done on EMBASE. Since the last review of PT by Ravesloot et al. (2012), ten studies were identified which demonstrate effectiveness of PT in POSA. We found three publications proposing different subclassification systems for POSA. There were three studies validating different compliance monitoring tools for PT. One study showed the cost benefits of incorporating PT into OSA management. Positional therapy is an effective treatment for POSA and progress has been made in development of tools for measuring compliance. Creating a subclassification of POSA may help develop targeted therapy for patients and determine its use as standalone or adjunct therapy. The integration of PT into POSA management may be cost-effective when compared to the use of CPAP alone.Publication BPAP for CPAP failures: For the many or the few(Wiley, 2019-08-22) Omobomi, Olabimpe; Quan, Stuart