# Diagnosis and Treatment of Sleep Apnea in Women Veterans

> **NIH VA I01** · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · 2022 · —

## Abstract

Sleep disordered breathing (SDB) is associated with significant adverse health consequences including
cardiovascular disease, motor vehicle accidents, daytime functional impairments and mortality risk. Although
SDB is more common among men than women, it still impacts 17% of women in the general population. [Our
preliminary evidence suggests it is even more common among women Veterans who receive VA care.] The
recommended first-line therapy for most patients with SDB is positive airway pressure therapy (PAP).
Published studies show that women have lower PAP adherence than men, particularly in the US, yet we are
not aware of data comparing men and women Veterans. Because women Veterans experience significant
sleep disturbance and other consequences of sleep disorders, adjusting to PAP therapy may be quite difficult.
To date, studies have not tested interventions specifically designed to improve PAP adherence among women,
accounting for important sleep-related and social factors.
 Since 2010 we have been studying sleep disorders among women Veterans, initially focusing on insomnia
disorder. Through this work we discovered that a significant segment of women served by VA also are high risk
for sleep disordered breathing (SDB; also referred to as sleep apnea), particularly if they report poor sleep. In
treating insomnia, we found that the initial discomfort created by traditional cognitive-behavioral therapy for
insomnia (e.g. initial sleep restriction) is difficult for many women Veterans to tolerate. We developed and are
now testing an insomnia intervention based on Acceptance and Commitment Therapy (ACT), called
“Acceptance and the Behavioral Changes to Treat Insomnia” or “ABC-I”. Within ACT, treatment focuses on a
patient's values and reasons for implementing behavioral changes, and teaches the patient strategies for
tolerating temporary discomfort in pursuit of goals consistent with one's values. We now propose to use these
same therapeutic approach, adopted from ACT, to address unique challenges faced by women Veterans in
adjusting to PAP therapy.
 This study is a randomized controlled trial (RCT) to test the efficacy of a program combining patient
education with ACT-based techniques in improving adherence to PAP therapy, called “ABC-SA” or
“Acceptance and the Behavioral Changes to treat Sleep Apnea.” This 6-session intervention will address initial
discomfort, link treatment to the patient’s values and incorporate methods for accepting the changes that are
required to treat SDB. Main study outcomes will be assessed 3 months after PAP initiation, and PAP
adherence will be tracked remotely for 12 months. The 6-session “control” intervention will account for the
contact with a study interventionist and will be modeled after usual care.
 The objectives of this proposal are: (1) to test the efficacy of the ABC-SA program in improving PAP
adherence, compared to a control program modeled after usual care, for women Veterans with SDB; (2) to test
the ...

## Key facts

- **NIH application ID:** 10300577
- **Project number:** 5I01HX002300-04
- **Recipient organization:** VA GREATER LOS ANGELES HEALTHCARE SYSTEM
- **Principal Investigator:** Jennifer L Martin
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-02-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10300577

## Citation

> US National Institutes of Health, RePORTER application 10300577, Diagnosis and Treatment of Sleep Apnea in Women Veterans (5I01HX002300-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10300577. Licensed CC0.

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