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Global OSA Institute UAE: Module 3 Applying OSA Screening Tools & HSAT Supported Diagnostic Pathways

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Description

This activity is supported by an independent education grant from Lilly. This online education program has been designed for healthcare professionals globally, excluding the UK.

The content for this enduring activity has been designed to be specific to the UAE.

Join leading experts Dr Jessica Schwartz Pumar and Dr. Reena Mehra for this accredited virtual session on implementing simplified diagnostic algorithms and integrated care pathways for Obstructive Sleep Apnea (OSA). This expert-led presentation equips primary care and sleep specialists with actionable, evidence-based strategies to overcome diagnostic bottlenecks, address significant underdiagnosis in high-risk populations, and confidently initiate integrated cardiometabolic-OSA management.

Participants will gain practical insights into navigating delayed in-lab testing by effectively utilizing Home Sleep Apnea Testing (HSAT), fostering multidisciplinary collaboration, and applying proactive protocols to seamlessly integrate positive airway pressure (PAP) therapy with lifestyle interventions for optimized long-term patient outcomes.

This is Module Three of Three. Modules One and Two can be found here.

Session Highlights

Targeted Screening in High-Risk Populations: Learn to actively identify and screen patients at elevated risk for OSA—particularly in underrepresented and minority groups facing disproportionate rates of underdiagnosis—using validated instruments directly within the primary care setting.
Overcoming Diagnostic Bottlenecks with HSAT: Explore simplified algorithms that leverage Home Sleep Apnea Testing (HSAT) for uncomplicated patients, effectively bypassing lengthy wait times for in-lab polysomnography (PSG) to safely and rapidly accelerate treatment initiation.
Multimodal Treatment Initiation and Adherence: Master evidence-based protocols for promptly initiating Positive Airway Pressure (PAP) therapy while proactively building in early adherence support, telemonitoring, and tailored behavioral interventions to prevent premature treatment discontinuation.
Integrated Cardiometabolic-OSA Care Pathways: Gain tactical insights into applying a multidisciplinary, chronic-disease model that seamlessly aligns OSA management with ongoing cardiometabolic care, incorporating targeted weight loss, exercise, and blood pressure control strategies.

Who Should Watch

This program is designed for healthcare professionals globally involved in the frontline screening, diagnosis, and long-term clinical management of obstructive sleep apnea (OSA) including:

Primary Care Physicians (General Practitioners)
Sleep Specialists

Visual Learner? See our Infographic Here.

Faculty

Dr Reena Mehra, MD, MS is an Associate Professor of Medicine at Case Western Reserve University School of Medicine and a staff physician at the Cleveland Clinic, where she serves as the Director of Sleep Disorders Research within the Neurological Institute's Sleep Center. Her extensive research portfolio focuses on the intersection of sleep and cardiovascular health, specifically investigating the relationship between sleep-disordered breathing and abnormal cardiac electrophysiology. Through both epidemiological analyses and clinical trials, she explores how various sleep disorders contribute to cardiovascular disease, establishing her as a key contributor to the understanding of the hemodynamic and mechanistic links between sleep apnea and cardiac outcomes.

Dr Jessica Schwarts Pumar is a Specialist ENT and Sleep Surgeon at American Hospital Dubai and a highly regarded authority in advanced sleep medicine and surgical interventions. A Diplomate in Sleep Medicine and a board member of the Ibero-American Society of Sleep Surgery (SIBECS), Dr Pumar specializes in the comprehensive management of snoring and obstructive sleep apnea (OSA). She is recognized as a pioneer in the region, being one of only three physicians—and the first female specialist—in the UAE to perform hypoglossal nerve stimulation (HNS) therapy, an innovative upper airway implant procedure for patients with complex sleep apnea. Bringing a unique blend of surgical precision and cutting-edge clinical expertise to this online teaching session, Dr Pumar provides healthcare providers with practical, evidence-based insights into the latest diagnostic criteria and transformative therapeutic pathways for moderate-to-severe obstructive sleep apnea.

Disclosures

Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All relevant financial relationships are mitigated according to Partners policies.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.

Dr Reena Meehra has the following relevant financial relationships: Consultant, Advisory Board, Educational Media - Amgen, Apnimed, Centessa, Eli Lilly, Haymarket Media, and Mineralys.

Dr Jessica Schwartz Pumar has no relevant financial relationships to disclose.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and MedAll. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Education

Partners designates this enduring activity for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Continuing Professional Development

The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 0.25 ANCC contact hours.

PA Continuing Medical Education

Partners has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.25 AAPA Category 1 CME credits. Approval is valid until July 27th 2027. PAs should only claim credit commensurate with the extent of their participation.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Fee Information

There is no fee for this educational activity.

This continuing education activity is active starting September 9th 2026, and will expire on July 27th 2027.

Estimated time to complete this activity: 15 Minutes

Learning objectives

Integrate OSA diagnosis into cardiometabolic risk assessment and management through screening of high-risk patients and coordinated cardiometabolic care.

Implement evidence-based, multimodal OSA treatment plans that integrate PAP therapy, cardiometabolic management, and emerging pharmacotherapy, applying a multidisciplinary, chronic-disease model.

Develop multidisciplinary OSA management plans that systematically address obesity co-management, PAP alternatives, and cardiometabolic comorbidities within specialist-led and hospital-centric care environments.

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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

Now we will shift to the 3rd objective of our program. So this is really implementing simplified diagnostic algorithms and integrated cardio metabolic obstructive sleep apnea care pathways. So we're pulling question 5. In your setting, what usually happens when a high-risk patient is suspected of moderate to severe obstructive sleep apnea, but in laboratory polysomnography access is delayed. A. The patient waits for in laboratory polysomnography. B. The patient is referred to a sleep specialist. C. Home sleep apnea testing is arranged. D, cardio metabolic care is continued without obstructive sleep apnea testing. E. The next steps vary by sight, hair, or availability. So I'll give you some time to answer. So we'll move on to our third patient case. So we have a 50-year-old male with obesity resistant hypertension and diabetes, body mass index of 37, BP elevated at 156/94, hemoglobin A1C elevated at 8.2. He has loud snoring, witness apneas, morning headaches, and daytime sleepiness. Upwards sleepiness scale score is 14, and there's a high suspicion for moderate to severe obstructive sleep apnea. The in laboratory polysomnogram wait time, however, several months, and there's no home sleep apnea testing pathway or sleep specialist triage um that's initiated. So we have obesity and the cardiovascular disease risk and suspected sleep apnea that are being managed separately in this case. So sleep apnea remains underdiagnosed, we reviewed that, but in particular, it remains underdiagnosed in high risk populations in the United States. So the high rates of elevated OSA risk and there's low rates of diagnosis in the US, uh, in middle-aged adults. So in a recent survey, a US based survey on sleep apnea that included Approximately 1000 adults that were representative of the US population, 81% of respondents had never been tested or diagnosed, and of those 11% suspected that they had sleep apnea, which is equivalent to 29 million United States adults. So when assessing for sleep apnea risk, 26% overall were categorized as intermediate and 12% as high risk. And we know that they're underrepresented minorities, um, African Americans have a higher prevalence of sleep apnea and more severe sleep apnea versus non-Hispanic whites. There are some data to to show that. Risk factors may also be different across race and ethnicity, um, in terms of differences in body fat distribution and higher prevalence of comorbidities. And in terms of the higher rates of sleep apnea, and yet This underdiagnosis in African Americans, um, prevalence is estimated to be about 24%, uh, with a moderate to severe degree of sleep apnea, and 95% of those with moderate to severe sleep apnea are undiagnosed. So overall there's an underdiagnosis, but in particular, This is a problem in our underrepresented minorities, and the risk factors in African Americans, um, include age, male sex, body mass index, hypertension, neck circumference, and habitual snoring, uh, more so than some of those other listed risk factors. So the guidance really supports targeted primary care physician initiated obstructive sleep apnea screening in high risk adults. In the US, you know, primary care physicians have a lot on their plate when they're doing the intake for patients, and sometimes just don't have the bandwidth to screen for. obstructive sleep apnea or it's not built into their um their care path. So the American Academy of Sleep Medicine Quality Measures task force really highlighted the importance of primary care physicians taking an active role in screening for sleep apnea, recommending that the initial evaluation for sleep apnea begin in the office of the primary care physician and They can be patients can be screened with validated obstructive sleep apnea instruments and recommended an evidence-based action plan which may include referral to a specialist. Starting with the primary care physician identifying adults at high risk for sleep apnea. Um, in terms of symptoms related to sleep apnea, cardio metabolic risk factors, and then documenting the screening for sleep apnea, uh, using validated tools as we've reviewed, and then developing an action plan as we talked about lifestyle modification, a referral for diagnostic testing, or referral to a sleep medicine specialist. So. This kind of comprises of a pathway for a faster and more efficient diagnosis and treatment for sleep apnea. The home sleep apnea testing first pathways can really simplify the route to diagnosis in those patients who are uncomplicated. Um, so when there's clinical suspicion for sleep apnea, There's high pretest probability for sleep apnea based on signs and symptoms and increased risk based upon screening, um, and There's factors that allow for home sleep apnea testing acquisition and interpretation, then, you know, don't coincide with any issues in terms of home sleep apnea testing in terms of comorbidities or um mobility issues or such as that, then you can proceed. Home sleep apnea testing that's administered by a sleep center, supervised by a sleep physician, so that we can really ensure, given the limitations of home sleep apnea testing, that the results are being interpreted appropriately given the clinical context. And um then that making the diagnosis of obstructive sleep apnea. Now, if there's excess of comorbidities such as um cardiopulmonary disease that's severe, severe Heart failure, um, neuromuscular disease can common in sleep disorders such as insomnia, uh, suspected hyperventilation, stroke history, or other, you know, other sleep disorders that we feel that the home sleep apnea test would not suffice, then, uh, proceeding to polysomnography, um, supervised by a sleep physician, and then, um, leading to the sleep apnea diagnosis. So this is kind of a, um, The pathway by which we can consider uh the routes to diagnosis in in our patients. Although the primary care physician sleep specialist collaboration has challenges, um, really having a good collaboration can reduce delays in the sleep apnea care path. So, Um, collaboration across primary care physicians and sleep specialists is recommended, um, and sleep apnea guidance, um, advocating really advocates for a multidisciplinary team here. Um, however, both primary care physicians and sleep specialists report barriers to achieving this coordination of the care of sleep disorders in terms of lack of role clarity, lack of coordination. So those, those kind of be the primary drivers of what's standing in the way. And despite these challenges, um, we know that this effective collaboration can reduce delays in the sleep apnea care path. Um, within a study of 100 patients with sleep apnea who had home sleep apnea testing ordered, initially managed by primary care physician or sleep medicine specialist, um, the primary care. Physician managed patients waited just one additional day after whom sleep apnea testing interpretation to be offered treatment. Um, in sleep medicine specialist managed pathways, they spent 113 days in the sleep apnea care path. Um, in primary care physician managed, uh, patients spent 28 days in the sleep apnea care path. And um in sleep medicine specialists managed patients, they had about a one hour longer use of nightly positive airway pressure. So, Overall, we can surmise that primary care physicians can aid timely sleep apnea diagnosis testing and allow patients to bypass the lengthy specialty care wait times. However, enhanced education and support is really needed to address the variation in patient outcomes. The sleep apnea diagnosis should also trigger treatment initiation and early adherence support. So building in that early adherence as we know, optimal early adherence uh will affect.