Slota, Katarzyna A.

Abstract Introduction Obstructive sleep apnea(OSA) is a common diagnosis associated with immediate and long-term health consequences. Due to increasing awareness, the demand for treatment with CPAP is increasing. However, CPAP compliance remains a problem, and may be improved by initial patient education targeted at common CPAP problems Methods A 10 min video depicting common CPAP related problems was created in the Mayo Clinic Florida Simulation Center using standardized patients. Newly diagnosed patients with OSA requiring CPAP were randomized into two arms: (i) the intervention arm was shown the video and received standard of care; or (ii) in the “placebo” or standard of care alone. Our standard of care includes a review of the sleep study, discussion of diagnosis and recommendation for CPAP therapy along with Mayo OSA information packet, followed by compliance visit at 3 months. Compliance is defined as >4 hours of CPAP use per night gathered from machine’s SD card. The two groups were compared for statistically significant difference in compliance at 3 months. Results 47 patients diagnosed between 10/2018-5/2019 were included in the study(21:intervention, 26:placebo). 7 (33%) and 7 (26%) patients in the intervention and the placebo came back for follow up visit (p=0.63). Among them, median CPAP usage was 362.5 min (236.0, 480.0) in intervention arm vs 351.0 min (125.0, 466.0) in placebo group and the difference was not significant. Average nightly use of >than 4 hours was 12(57.1%) in the intervention group and 17(65.4%) in placebo group. Conclusion In this group addition of an educational video to standard of care did not show benefit in CPAP compliance. There was a tendency toward greater median nightly usage. Patients receiving the video had a higher likelihood of making their follow up appointment which is pivotal, as it provides an opportunity for further intervention and enhancement of adherence. Support Mayo Clinic Jacksonville

Abstract Introduction Evidence of the relationship between periodic limb movements during sleep (PLMS) and cerebral small vessel disease (cSVD) is limited and inconsistent. Here, we aimed to assess the independent association between PLMS and the different neuroimaging signatures of cSVD. Methods Community dwelling adults aged ≥60 years enrolled in the Atahualpa Project undergoing PSG and MRI with time intervals ≤6 months were included. MRI readings focused on white matter hyperintensities (WMH) of presumed vascular origin, deep cerebral microbleeds (CMB), silent lacunar infarcts (LI), and >10 enlarged basal ganglia-perivascular spaces (BG-PVS). Data from single-night polysomnograms were interpreted according to recommendations of the American Academy of Sleep Medicine. Associations between the PLMS index and neuroimaging signatures of cSVD (as dependent variables) were assessed by means of logistic regression models, adjusted for relevant confounders. Results A total of 146 individuals (mean age: 71.4 ± 7.5 years; 64% women) were included. A PLMS index ≥15/hour were noted in 48 (33%) participants. Moderate-to-severe WMH were present in 33 individuals (23%), deep CMB in 9 (6%), silent LI in 16 (11%), and >10 BG-PVS in 44 (30%). In univariate analyses, silent LI (p=0.035) and the presence of >10 enlarged BG-PVS (p=0.034) were significantly higher among participants with a PLMS index ≥15/hour. However, fully-adjusted multivariate models showed no significant association between PLMS index ≥15/hour and any of the neuroimaging signatures of cSVD. Conclusion This study shows no independent association between the PLMS index and neuroimaging signatures of cSVD in stroke-free community-dwelling older adults. Support This study was supported by Universidad Espíritu Santo - Ecuador.