Reducing sleep health disparities was recognized as a priority area for intervention by the
National Institutes of Health. Sleep apnea, which disproportionately affects minorities, is
an important preventable and treatable disease that should be targeted as it is associated
with increased cardiovascular risk and disease outcomes, including obesity, diabetes,
hypertension, stroke, cardiac arrhythmia, and chronic heart failure. Evidence from previous
research suggests that most minorities are unaware of general sleep problems, such as sleep
apnea symptoms and the negative effects on cardiovascular disease. Only 26% of minorities
participating in the investigators prior research followed up on recommended sleep apnea
screening, although 39% were at high risk for sleep apnea. While few followed the
physician's recommendations, 90% of those assessed received a sleep apnea diagnosis. The
investigators research will assess the effectiveness of peer-based sleep health education
and social support in increasing sleep apnea screening and treatment rates among minorities
with sleep apnea risk. Participants will receive quality-controlled and culturally tailored
peer education using a sleep health education manual. They will each receive up to 4
sessions promoting sleep apnea screening during a 6-month period. Those with a diagnosis
will receive 2 additional sessions promoting sleep apnea treatment adherence, in conjunction
with telephone interventions. The investigators research will also assess the rate of sleep
apnea among minorities using home recordings. The long-term goal of the investigators study
is to apply this intervention in community-based settings (barbershops, beauty salons,
churches, and health centers), thereby linking community health promotion to the healthcare
Primary Aim: To ascertain effectiveness of tailored, peer-based sleep health education and
social support in increasing adherence rates to recommended OSA evaluation and treatment
among blacks at risk for OSA.
Secondary Aim: To ascertain the rate of OSA among black men and women at the community level
using home-based sleep recordings in accordance with criteria from the American Academy of
Hypotheses: Among blacks at risk for OSA, those randomized to receive peer-based sleep
health education and social support, compared with those randomized to the attention-control
group, will have:
- Greater adherence to physician-recommended OSA evaluation using home sleep recordings.
- Greater adherence to OSA treatment using telemetry (CPAP use [>4 hrs. a night for 70%
of the nights]).
- Individual-level factors (OSA knowledge, OSA self-efficacy, and past evaluation
behavior) and contextual level factors (i.e., trust/rapport with peer educators, family
network, and socioeconomic position) will mediate effects of peer education on
adherence to OSA evaluation and recommended treatment.
- self-reported race/ethnicity as black
- ages ≥18 years
- accessible by telephone
- no plans to move away from the region within the year following enrollment
- consent to participate, which includes permission to release medical record
- A positive screening for OSA is necessary to be enrolled in the intervention
- are involved in another sleep study.
- are unable to understand and sign this informed consent form.
- know someone who is participating in this study.
- plan to move away in the next two years.
- had a heart attack or stroke within the past 12 weeks.
- do not identify yourself as Black or African American.
- are pregnant.
- are not at risk for sleep apnea.
- refuse to use the Apnea Risk Evaluation System (ARES) home sleep test device.