for people ages 18 years and up (full criteria)
at San Francisco, California and other locations
study started
estimated completion



The primary objective of this project is to compare a health care delivery model, Direct Referral for Apnea Monitoring (DREAM), with initial in-person (Traditional) clinic appointments for Veterans at risk for obstructive sleep apnea (OSA). A secondary objective is to determine the negative predictive value (NPV) of home sleep apnea testing (HSAT).

Official Title

Improving Access to Sleep Apnea Care: A Pragmatic Study of New Consultation Models


Patients referred to one of 3 participating VA sleep medicine clinics (San Francisco VA, VA Portland or VA Pittsburgh) for OSA will be assigned either to the Traditional clinical pathway (which might include an initial encounter with a sleep care provider through in-person visits, telephone clinics, or video conferencing) or the DREAM pathway which will omit the initial encounter with a care provider. After a clinician conducts a chart review of medical records, patients in the DREAM pathway will be referred for sleep testing. All patients will be tracked from the time of referral until 90-days past the initiation of treatment. To determine the NPV of HSAT, results of sleep tests will be compared for patients who undergo both HSAT and polysomnographic (PSG) procedures.


Obstructive Sleep Apnea (OSA), Apnea, Sleep Apnea Syndromes, Sleep Apnea, Obstructive, Negative predictive value of HSAT


You can join if…

Open to people ages 18 years and up

Age ≥ 18 years Agrees to be seen by a VA sleep program Reason for referral to sleep clinic: New OSA Evaluation

You CAN'T join if...

Age < 18 years Declines to be seen by a VA sleep program Reason for referral to sleep clinic: anything other than a new OSA evaluation


  • San Francisco VAMC accepting new patients
    San Francisco California 94121 United States
  • VA Portland Health Care System accepting new patients
    Portland Oregon 97239 United States


accepting new patients
Start Date
Completion Date
VA Office of Research and Development
Study Type
Expecting 832 study participants
Last Updated