Please select the eligibility criteria that correspond to the clinical trial below.
Title: Evaluation of a "Fast Track" Respiratory Therapy Clinic for Patients With Suspected Severe Sleep-Disordered Breathing
Brief Summary: Access to medical care for patients with breathing disorders during sleep is a major problem for Canadians. Recently, there has been increasing interest in how health care providers who are not physicians can help to improve access to medical care for these patients, but it is unclear whether patients with severe sleep-disordered breathing who receive care from these non-physician providers have the same response to treatment as patients who receive care from physicians. Since these severe have a high risk of developing cardiac and respiratory complications and of being hospitalized, an initiative to improve access such as the use of non-physician providers could be of great benefit to individual patients and the health care system.

The objectives of this project are:

1. to determine whether patients with severe breathing disorders during sleep have the same response to treatment when cared for by non-physician health care providers (respiratory therapists) as they do when cared for by physicians;
2. to determine the effects of non-physician health care provider treatment to patient access;
3. to determine health care utilization and related costs associated with non-physician health care provider treatment.


Options:
A: Inclusion Criteria:

* Refractory hypertensive patients with moderate-to-severe OSA, aged between 30 to 65 years old.

Exclusion Criteria:

* Aortic, heart and valve diseases
* Renal failure
* Other identifiable causes of hypertension, no adherence, use of cocaine, amphetamines, other illicit drugs, sympathomimetics (decongestants, anorectics), oral contraceptive hormones, nonsteroidal anti-inflammatory drugs.
B: Inclusion Criteria:

* referred to the FMC Sleep Centre for assessment of SDB
* meet one of the three criteria for suspected severe SDB:

  1. Respiratory disturbance index (RDI) \>/= 30 events/hour on an ambulatory sleep test
  2. Mean nocturnal oxygen saturation \</= 85% on an ambulatory sleep test
  3. Suspected hypoventilation, defined by an RDI \>/= 15 events/hour on an ambulatory sleep test and partial pressure of carbon dioxide \>/= 45 mmHg on arterial blood gas
  4. On supplemental oxygen therapy with high suspicion of SDB (as determined by physician review of referral)

Exclusion Criteria:

* Suspected concomitant sleep disorder other than SDB
* A previous diagnosis of OSA treated with PAP or dental appliance
* Primary health insurance provided by a province other than Alberta
* Failure to provide consent to participate in the study
* Under the age of 18
C: Inclusion Criteria:

* self-reported race/ethnic minority
* ages ≥18 years
* accessible by telephone
* consent to participate, which includes permission to release medical record information
* A positive screening for OSA is necessary to be enrolled in the intervention protocol.

Exclusion Criteria:

* are involved in another sleep study.
* are unable to understand and sign this informed consent form.
* know someone who is participating in this study.
* had a heart attack or stroke within the past 12 weeks.
* do not identify yourself as a racial/ethnic minority.
* are pregnant.
* Refuse to use the ARESTM home sleep test device.
* Refuse to use the WatchPATTM home sleep test device.
* are not at risk for sleep apnea.
D: Inclusion Criteria:

* newly diagnosed obstructive sleep apnea syndrome by polysomnography according to standard criteria,
* with moderate to severe sleep apnea,
* no history of previously CPAP therapy and
* with an above-elementary school education.

Exclusion Criteria:

* refusal to participate,
* refusal to CPAP therapy,
* previous CPAP treatment,
* central sleep apnoea syndrome,
* Cheyne-stokes breathing pattern,
* obesity hypoventilation syndrome,
* restrictive ventilator syndromes,
* congestive heart failure,
* history of life-threatening arrhythmias,
* cardiomyopathy,
* long term oxygen therapy,
* family or personal history of mental illness,
* with drug or alcohol abuse,
* severe cognitive impairment,
* concurrent oncologic diseases and
* history of narcolepsy.

Answer: B