Student examines patient success with multiple attempts at using a PAP device to treat sleep apnea

by Philadelphia College of Osteopathic Medicine

Neeti Shirke

Neeti Shirke (DO ’26), a student physician at PCOM South Georgia, conducted research investigating the factors associated with patients who attempted positive airway pressure (PAP) therapy after having an unsuccessful first attempt or multiple unsuccessful attempts.

 MOULTRIE, GANeeti Shirke (DO ’26), a student physician at PCOM South Georgia, is interested in how compliant people are when their doctors prescribe positive airway pressure (PAP) treatment to help with sleep apnea. Her research focuses on how successful patients are when they attempt using a PAP device after an unsuccessful previous attempt.

“Sleep apnea in itself can be very disruptive to people’s day-to-day quality of life,” Shirke said. “The number one treatment for sleep apnea is PAP therapy, which rests upon patient adherence to therapy. This is why we’re hoping that this project will help physicians better understand how they can tailor their recommendations for patients’ treatment going forward.”

For those patients who do not succeed with their first attempt at using a CPAP (continuous positive air pressure), APAP (auto-adjusting positive airway pressure) or another positive airway pressure therapy machine, subsequent attempts may be necessary.

“My project was titled ‘Adherence of Repeat Positive Airway Pressure Treatment Attempts,’” Shirke said. “In this project, we aimed to investigate factors associated with patients that re-attempted PAP therapy because there’s less known about patients who were successful once they decided to give PAP another chance. This was a retrospective cohort analysis with subjects from a large ACO (accountable care organization).”

According to the National Institute of Neurological Disorders and Stroke’s website, sleep apnea is considered a common sleep disorder consisting of interruptions in breathing of 10 seconds more while sleeping. These interruptions occur throughout a person’s sleep cycle. While the person will partially awaken as they try to take a breath, they will not remember the episodes when they wake up. Without treatment, sleep apnea can be life-threatening due to extreme daytime sleepiness or the heart disease risks that are associated with sleep apnea.

Originally from Alpharetta, Georgia, Shirke earned a bachelor’s degree in biology and a minor in health policy and management from the University of Georgia. Then she graduated with a master’s degree in biomedical and health informatics from Case Western Reserve University. Shirke began this research project while at CWRU and continued after she started medical school at PCOM South Georgia. Her partner in the research is her mentor, Anna May, MD, a clinical instructor with University Hospitals Cleveland Medical Center.

Earlier this fall, Shirke attended the conference of American College of CHEST Physicians in Hawaii to present a poster about her research. She received a travel award from PCOM Alumni to help cover expenses of that trip.

“Working on this project has been incredibly useful to me in so many ways,” Shirke said. “For one thing, having the opportunity to get to present at this conference was incredibly exciting. I met a lot of different professionals in their fields, and I also enjoyed working with my mentor. She’s given me the chance to discuss what I’m interested in, and I’m furthering my interest in research. I know what that might look like – incorporating research into my future career.”

The research experience also gave Shirke an idea of how complex sleep research can be.

“This has been a really great project, and it’s given me exposure to a lot of different fields and sub specialties in medicine,” she said. “Through this sleep apnea and sleep medicine project, I’ve gotten exposure to internal medicine, critical care and pulmonary critical care. I think it’s really helped me get a better idea of what specialty I’ll be interested in going into the future.”

However, Shirke is quick to mention that this research is not finished.

“For our future studies, we’re also going to look into what machine type the patients were using,” she said. “We’re hoping that will give us a better analysis as to what role machine type plays in contributing to patient adherence.”

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