1017 An Integrated Behavioral Therapy for Positive Airway Pressure Adherence and Insomnia Reduces Nocturia Frequency
Abstract Introduction Nocturia is common among patients with both insomnia disorder and obstructive sleep apnea (OSA) and adversely affects quality of life. Within a randomized controlled trial testing an integrated behavioral therapy for positive airway pressure (PAP) adherence and insomnia for pat...
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| Veröffentlicht in: | Sleep (New York, N.Y.) N.Y.), 2020-05, Vol.43 (Supplement_1), p.A386-A387 |
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| creator | Fung, C H Martin, J L Dzierzewski, J M Fiorentino, L Stepnowsky, C Song, Y Zeidler, M Mitchell, M Vaughan, E C Huang, A Markland, A Josephson, K Alessi, C |
| description | Abstract
Introduction
Nocturia is common among patients with both insomnia disorder and obstructive sleep apnea (OSA) and adversely affects quality of life. Within a randomized controlled trial testing an integrated behavioral therapy for positive airway pressure (PAP) adherence and insomnia for patients with coexisting OSA and insomnia disorder, we examined the impact of the integrated therapy on nocturia frequency.
Methods
Patients aged > 50 years with untreated OSA (apnea hypopnea index > 15) and chronic insomnia disorder were recruited from a VA medical center and randomized to 5 weekly individual integrated behavioral treatment sessions versus control (general sleep education). Nocturia frequency (self-reported average number of nocturia events per night) was assessed at baseline, 3 months, and 6 months. Linear regression models were used to examine relationships between objective PAP adherence (# nights used > 4hrs over the last 30 days) and Insomnia Severity Index (ISI) score (0 [none] - 28 [severe]) and nocturia frequency (0 - 5+/night), and change in nocturia frequency associated with integrated therapy.
Results
Nocturia data were available for 112 participants (treatment=56, control=56; mean age 63 [SD 7], 95% male). Mean nocturia frequency (episodes/night) was 2.1 (SD 1.3; baseline), 1.6 (SD 1.1; 3 months), and 1.7 (SD 1.2; 6 months). Overall, higher PAP adherence (B=.029, p=.008) and ISI score improvement (B=0.05, p=.004) were associated with decreased nocturia frequency at 3-month follow-up. No differences were observed in nocturia frequency between treatment and control participants at baseline (p=.429). Integrated therapy reduced nocturia frequency at 3 months (B=-0.56, p=.020) but not at 6 months follow-up (B=-0.4, p=.081) compared to control.
Conclusion
Nocturia frequency improved with integrated behavioral therapy for PAP adherence and insomnia in veterans (primarily male) with co-existing OSA and insomnia. Additional studies are needed to examine the mechanisms underlying the relationship between the behavioral therapy for PAP adherence and insomnia and nocturia.
Support
VA HSR NIA; VA GRECC |
| doi_str_mv | 10.1093/sleep/zsaa056.1013 |
| format | Article |
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Introduction
Nocturia is common among patients with both insomnia disorder and obstructive sleep apnea (OSA) and adversely affects quality of life. Within a randomized controlled trial testing an integrated behavioral therapy for positive airway pressure (PAP) adherence and insomnia for patients with coexisting OSA and insomnia disorder, we examined the impact of the integrated therapy on nocturia frequency.
Methods
Patients aged > 50 years with untreated OSA (apnea hypopnea index > 15) and chronic insomnia disorder were recruited from a VA medical center and randomized to 5 weekly individual integrated behavioral treatment sessions versus control (general sleep education). Nocturia frequency (self-reported average number of nocturia events per night) was assessed at baseline, 3 months, and 6 months. Linear regression models were used to examine relationships between objective PAP adherence (# nights used > 4hrs over the last 30 days) and Insomnia Severity Index (ISI) score (0 [none] - 28 [severe]) and nocturia frequency (0 - 5+/night), and change in nocturia frequency associated with integrated therapy.
Results
Nocturia data were available for 112 participants (treatment=56, control=56; mean age 63 [SD 7], 95% male). Mean nocturia frequency (episodes/night) was 2.1 (SD 1.3; baseline), 1.6 (SD 1.1; 3 months), and 1.7 (SD 1.2; 6 months). Overall, higher PAP adherence (B=.029, p=.008) and ISI score improvement (B=0.05, p=.004) were associated with decreased nocturia frequency at 3-month follow-up. No differences were observed in nocturia frequency between treatment and control participants at baseline (p=.429). Integrated therapy reduced nocturia frequency at 3 months (B=-0.56, p=.020) but not at 6 months follow-up (B=-0.4, p=.081) compared to control.
Conclusion
Nocturia frequency improved with integrated behavioral therapy for PAP adherence and insomnia in veterans (primarily male) with co-existing OSA and insomnia. Additional studies are needed to examine the mechanisms underlying the relationship between the behavioral therapy for PAP adherence and insomnia and nocturia.
Support
VA HSR NIA; VA GRECC</description><identifier>ISSN: 0161-8105</identifier><identifier>EISSN: 1550-9109</identifier><identifier>DOI: 10.1093/sleep/zsaa056.1013</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Behavior modification ; Insomnia ; Nocturia ; Sleep apnea</subject><ispartof>Sleep (New York, N.Y.), 2020-05, Vol.43 (Supplement_1), p.A386-A387</ispartof><rights>Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com. 2020</rights><rights>Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1583,27923,27924</link.rule.ids></links><search><creatorcontrib>Fung, C H</creatorcontrib><creatorcontrib>Martin, J L</creatorcontrib><creatorcontrib>Dzierzewski, J M</creatorcontrib><creatorcontrib>Fiorentino, L</creatorcontrib><creatorcontrib>Stepnowsky, C</creatorcontrib><creatorcontrib>Song, Y</creatorcontrib><creatorcontrib>Zeidler, M</creatorcontrib><creatorcontrib>Mitchell, M</creatorcontrib><creatorcontrib>Vaughan, E C</creatorcontrib><creatorcontrib>Huang, A</creatorcontrib><creatorcontrib>Markland, A</creatorcontrib><creatorcontrib>Josephson, K</creatorcontrib><creatorcontrib>Alessi, C</creatorcontrib><title>1017 An Integrated Behavioral Therapy for Positive Airway Pressure Adherence and Insomnia Reduces Nocturia Frequency</title><title>Sleep (New York, N.Y.)</title><description>Abstract
Introduction
Nocturia is common among patients with both insomnia disorder and obstructive sleep apnea (OSA) and adversely affects quality of life. Within a randomized controlled trial testing an integrated behavioral therapy for positive airway pressure (PAP) adherence and insomnia for patients with coexisting OSA and insomnia disorder, we examined the impact of the integrated therapy on nocturia frequency.
Methods
Patients aged > 50 years with untreated OSA (apnea hypopnea index > 15) and chronic insomnia disorder were recruited from a VA medical center and randomized to 5 weekly individual integrated behavioral treatment sessions versus control (general sleep education). Nocturia frequency (self-reported average number of nocturia events per night) was assessed at baseline, 3 months, and 6 months. Linear regression models were used to examine relationships between objective PAP adherence (# nights used > 4hrs over the last 30 days) and Insomnia Severity Index (ISI) score (0 [none] - 28 [severe]) and nocturia frequency (0 - 5+/night), and change in nocturia frequency associated with integrated therapy.
Results
Nocturia data were available for 112 participants (treatment=56, control=56; mean age 63 [SD 7], 95% male). Mean nocturia frequency (episodes/night) was 2.1 (SD 1.3; baseline), 1.6 (SD 1.1; 3 months), and 1.7 (SD 1.2; 6 months). Overall, higher PAP adherence (B=.029, p=.008) and ISI score improvement (B=0.05, p=.004) were associated with decreased nocturia frequency at 3-month follow-up. No differences were observed in nocturia frequency between treatment and control participants at baseline (p=.429). Integrated therapy reduced nocturia frequency at 3 months (B=-0.56, p=.020) but not at 6 months follow-up (B=-0.4, p=.081) compared to control.
Conclusion
Nocturia frequency improved with integrated behavioral therapy for PAP adherence and insomnia in veterans (primarily male) with co-existing OSA and insomnia. Additional studies are needed to examine the mechanisms underlying the relationship between the behavioral therapy for PAP adherence and insomnia and nocturia.
Support
VA HSR NIA; VA GRECC</description><subject>Behavior modification</subject><subject>Insomnia</subject><subject>Nocturia</subject><subject>Sleep apnea</subject><issn>0161-8105</issn><issn>1550-9109</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkMtOwzAQRS0EEqXwA6wssQ71o3aTZal4VKqgQmVt-TGhqdo42ElR-Hpc2g9gNZo7Z-6VLkK3lNxTUvBR3AI0o5-oNREySZSfoQEVgmRFup-jAaGSZjkl4hJdxbghaR8XfIDaxE7wtMbzuoXPoFtw-AHWel_5oLd4tYagmx6XPuClj1Vb7QFPq_Cte7wMEGMX0u4SBbUFrGuXjKLf1ZXG7-A6CxG_ett2IQlPAb66xPXX6KLU2wg3pzlEH0-Pq9lLtnh7ns-mi8xSwXk2MZOSOyaAlc44mVNjhRGc5jInpgCRjyUjOWFgNLW5AcskLQVoCsKMgTs-RHdH3yb4lBxbtfFdqFOkYoKwgkhJWKLYkbLBxxigVE2odjr0ihJ1aFf9tatO7apDu-kpOz75rvkP_wvMHn_J</recordid><startdate>20200527</startdate><enddate>20200527</enddate><creator>Fung, C H</creator><creator>Martin, J L</creator><creator>Dzierzewski, J M</creator><creator>Fiorentino, L</creator><creator>Stepnowsky, C</creator><creator>Song, Y</creator><creator>Zeidler, M</creator><creator>Mitchell, M</creator><creator>Vaughan, E C</creator><creator>Huang, A</creator><creator>Markland, A</creator><creator>Josephson, K</creator><creator>Alessi, C</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope></search><sort><creationdate>20200527</creationdate><title>1017 An Integrated Behavioral Therapy for Positive Airway Pressure Adherence and Insomnia Reduces Nocturia Frequency</title><author>Fung, C H ; Martin, J L ; Dzierzewski, J M ; Fiorentino, L ; Stepnowsky, C ; Song, Y ; Zeidler, M ; Mitchell, M ; Vaughan, E C ; Huang, A ; Markland, A ; Josephson, K ; Alessi, C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1533-7b7f3d25e2fdbd681bc5b5318680b9e584620802eba1c8bec261f5ea1e5b4e3d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Behavior modification</topic><topic>Insomnia</topic><topic>Nocturia</topic><topic>Sleep apnea</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fung, C H</creatorcontrib><creatorcontrib>Martin, J L</creatorcontrib><creatorcontrib>Dzierzewski, J M</creatorcontrib><creatorcontrib>Fiorentino, L</creatorcontrib><creatorcontrib>Stepnowsky, C</creatorcontrib><creatorcontrib>Song, Y</creatorcontrib><creatorcontrib>Zeidler, M</creatorcontrib><creatorcontrib>Mitchell, M</creatorcontrib><creatorcontrib>Vaughan, E C</creatorcontrib><creatorcontrib>Huang, A</creatorcontrib><creatorcontrib>Markland, A</creatorcontrib><creatorcontrib>Josephson, K</creatorcontrib><creatorcontrib>Alessi, C</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><jtitle>Sleep (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fung, C H</au><au>Martin, J L</au><au>Dzierzewski, J M</au><au>Fiorentino, L</au><au>Stepnowsky, C</au><au>Song, Y</au><au>Zeidler, M</au><au>Mitchell, M</au><au>Vaughan, E C</au><au>Huang, A</au><au>Markland, A</au><au>Josephson, K</au><au>Alessi, C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>1017 An Integrated Behavioral Therapy for Positive Airway Pressure Adherence and Insomnia Reduces Nocturia Frequency</atitle><jtitle>Sleep (New York, N.Y.)</jtitle><date>2020-05-27</date><risdate>2020</risdate><volume>43</volume><issue>Supplement_1</issue><spage>A386</spage><epage>A387</epage><pages>A386-A387</pages><issn>0161-8105</issn><eissn>1550-9109</eissn><abstract>Abstract
Introduction
Nocturia is common among patients with both insomnia disorder and obstructive sleep apnea (OSA) and adversely affects quality of life. Within a randomized controlled trial testing an integrated behavioral therapy for positive airway pressure (PAP) adherence and insomnia for patients with coexisting OSA and insomnia disorder, we examined the impact of the integrated therapy on nocturia frequency.
Methods
Patients aged > 50 years with untreated OSA (apnea hypopnea index > 15) and chronic insomnia disorder were recruited from a VA medical center and randomized to 5 weekly individual integrated behavioral treatment sessions versus control (general sleep education). Nocturia frequency (self-reported average number of nocturia events per night) was assessed at baseline, 3 months, and 6 months. Linear regression models were used to examine relationships between objective PAP adherence (# nights used > 4hrs over the last 30 days) and Insomnia Severity Index (ISI) score (0 [none] - 28 [severe]) and nocturia frequency (0 - 5+/night), and change in nocturia frequency associated with integrated therapy.
Results
Nocturia data were available for 112 participants (treatment=56, control=56; mean age 63 [SD 7], 95% male). Mean nocturia frequency (episodes/night) was 2.1 (SD 1.3; baseline), 1.6 (SD 1.1; 3 months), and 1.7 (SD 1.2; 6 months). Overall, higher PAP adherence (B=.029, p=.008) and ISI score improvement (B=0.05, p=.004) were associated with decreased nocturia frequency at 3-month follow-up. No differences were observed in nocturia frequency between treatment and control participants at baseline (p=.429). Integrated therapy reduced nocturia frequency at 3 months (B=-0.56, p=.020) but not at 6 months follow-up (B=-0.4, p=.081) compared to control.
Conclusion
Nocturia frequency improved with integrated behavioral therapy for PAP adherence and insomnia in veterans (primarily male) with co-existing OSA and insomnia. Additional studies are needed to examine the mechanisms underlying the relationship between the behavioral therapy for PAP adherence and insomnia and nocturia.
Support
VA HSR NIA; VA GRECC</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/sleep/zsaa056.1013</doi><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Behavior modification Insomnia Nocturia Sleep apnea |
| title | 1017 An Integrated Behavioral Therapy for Positive Airway Pressure Adherence and Insomnia Reduces Nocturia Frequency |
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