for people ages 18 years and up (full criteria)
at San Francisco, California and other locations
study started
completion around
Principal Investigator
by Kathleen Fumiko Sarmiento, MD MPH
Headshot of Kathleen Fumiko Sarmiento
Kathleen Fumiko Sarmiento



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. Concurrent PSG and HSAT studies will be done at Portland, Pittsburgh, and San Francisco.


Obstructive Sleep Apnea (OSA), sleep apnea syndromes, polysomnography, home sleep apnea testing, Apnea, Obstructive Sleep Apnea, 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 VA Medical Center, San Francisco, CA accepting new patients
    San Francisco California 94121-1563 United States
  • VA Portland Health Care System, Portland, OR accepting new patients
    Portland Oregon 97207-2964 United States
  • VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA accepting new patients
    Pittsburgh Pennsylvania 15240 United States

Lead Scientist at UCSF

  • Kathleen Fumiko Sarmiento, MD MPH
    Kathleen Sarmiento is an Associate Professor of Medicine, Director of the Sleep Program at the VA San Francisco Health Care System, VISN 21 Specialty Care Sleep Clinical Resource Hub Director, and National Lead for VHA TeleSleep.


accepting new patients
Start Date
Completion Date
VA Office of Research and Development
Study Type
Expecting 2413 study participants
Last Updated