Carl Stepnowsky

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BACKGROUND Obstructive sleep apnea is a prevalent condition with potentially serious medical and psychosocial consequences. Nasal continuous positive airway pressure (CPAP) is the treatment-of-choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture and decrease daytime sleepiness. Patient compliance with(More)
BACKGROUND/OBJECTIVE Few studies have examined whether chronic heart failure (HF) outcomes can be improved by increasing patient engagement (known as activation) in care and capabilities for self-care management. The objective was to determine the efficacy of a patient activation intervention compared with usual care on activation, self-care management,(More)
Although sleep-disordered breathing (SDB) has been shown to be very prevalent in the elderly, little has been done to examine differences between the elderly of different racial groups. It has been well documented that SDB often results in hypertension and that hypertension is more common in African-Americans than in Caucasians. Therefore, one might suspect(More)
STUDY OBJECTIVES To explore the relationship between psychologic variables measured prior to continuous positive airway pressure (CPAP) treatment and subsequent CPAP compliance. DESIGN Participants were assigned to a CPAP treatment group. Psychologic questionnaires administered prior to the start of treatment assessed depression, anxiety, stress, anger or(More)
STUDY OBJECTIVES To determine the relative predictive utility of measures of behavior-change principles on treatment adherence in individuals with obstructive sleep apnea. METHODS Ninety-eight participants with moderate to severe obstructive sleep apnea were recruited into this prospective longitudinal study. Participants were recruited from an academic(More)
Obstructive sleep apnea (OSA) is a condition with serious medical and psychosocial consequences. Low patient adherence to nasal continuous positive airway pressure (CPAP) limits the effectiveness of treatment. Intervention studies based on intensive support protocols have shown modest improvement in CPAP adherence; however, this approach would require(More)
BACKGROUND Obstructive sleep apnea is a prevalent condition with serious medical and psychosocial consequences. Nasal continuous positive airway pressure (CPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness. However, little is known about the(More)
Mobile health (mHealth) refers to the use of mobile technology (e.g., smartphones) and software (i.e., applications) to facilitate or enhance health care. Several mHealth programs act as either stand-alone aids for Veterans with post-traumatic stress disorder (PTSD) or adjuncts to conventional psychotherapy approaches. Veterans enrolled in a Veterans(More)
OBJECTIVES Sleep disordered breathing (SDB) is very common in older people and is known to be associated with complaints of impaired daily functioning, including excessive daytime sleepiness and cognitive impairments. As part of a larger study on SDB and aging, it became possible to examine the relationship between SDB and cognition in older men and women.(More)
OBJECTIVE Older adults with chronic kidney disease have a high rate of uncontrolled hypertension. Home monitoring of blood pressure (BP) is an integral part of management, but requires that patients bring records to clinic visits. Telemonitoring interventions, however, have not targeted older, less technologically-skilled populations. METHODS Veterans(More)