What is Sleep Apnea? Causes, Symptoms, and Treatment
Sleep apnea is a common and serious sleep disorder that causes a sleeping person to experience short interruptions in breathing, or shallow breathing for extended stretches of time. People suffering from sleep apnea experience lapses in breathing for several seconds up to a few minutes at a time, over and over again during the sleep cycle. The result is significant disruption to daily life and even serious physical and mental problems.
Sleep apnea affects approximately 20 million Americans—nearly one out of every 16 people—and estimates show that sleep disorders affect over 40 million people in the United States alone. Sufferers are unable to achieve restful sleep, no matter how long they spend in bed. As a result, people with sleep apnea suffer from many negative health effects and conditions as a result of the strain on their body and mind. When left untreated, sleep apnea can significantly reduce a person’s health and quality of life.
It isn’t all bad news! Sleep apnea is easy to diagnose and treat. Once you take the first step to determine whether you suffer from this common disorder, your sleep doctor will provide you with several options to address the underlying causes of your sleep disruption, helping you breathe easier and sleep better.
Wondering if your symptoms are warning signs that you have sleep apnea? Take this short quiz to learn more!
We’ve created this guide to sleep apnea to help you understand more about sleep apnea, the causes, symptoms, risk factors and treatment options. Keep reading to discover:
- What is Sleep Apnea?
- What Physically Happens During Sleep Apnea?
- What are the Health Effects of Sleep Apnea?
- What are the Consequences of Leaving Sleep Apnea Untreated?
- Sleep Apnea Symptoms: How Can I Tell If I Have Sleep Apnea?
- Am I in Danger of Developing Sleep Apnea? Common Risk Factors
- How Do I Get a Sleep Apnea Diagnosis?
- Treatment Options: Will I Have Sleep Apnea From Now On?
What is Sleep Apnea?
Sleep apnea is defined as the cessation of breath during sleep, which means that breathing stops and starts again multiple times during the night. This irregular breathing pattern leads to reduced oxygen flow and poor sleep quality, causing dozens of other short and long term issues.
Why is Sleep Apnea So Disruptive?
We’ve all heard that we should get 8 hours of sleep a night—but what kind of sleep, and why is it so important? There are two kinds of sleep: Non Rapid Eye Movement (NREM) and Rapid Eye Movement (REM). Humans need both light (NREM) and deep (REM) sleep to feel rested, and for sleep to truly be restorative. Normal, high quality sleep includes several cycles of NREM and REM during the night. When one kind of sleep in interrupted, or not achieved at all—such as in the case of someone suffering sleep apnea—it is impossible to experience the effects of a good night’s sleep.
Non Rapid Eye Movement (NREM)
In NREM sleep, which makes up around 70%-75% of our sleeping time, there are three main stages. With each stage, brain function decreases.
- Stage 1: In this stage, sleep is lighter during the transition from being awake to being asleep. If you do wake up during this stage, you might believe that you weren’t ever asleep.
- Stage 2: During this stage, sleep deepens and there are short bursts of brain activity. It is very rare to dream during this stage.
- Stage 3: Sleep is deepest during this stage. Stage 3 is also called “slow-wave sleep” because our brain activity becomes more consistent and moves in waves. It can be hard to wake someone when they are in Stage 3. Dreaming is possible, but it is not as common as in REM sleep, when dreams are more exciting.
REM (Rapid Eye Movement)
REM sleep is a unique form of sleep, which we require for about 25%-30% of our total sleep. Without enough REM sleep, people are less likely to be creative and are more likely to be anxious or irritable, have a hard time concentrating, and experience an increased appetite. Brain scans during REM sleep show a lot of activity—almost as much as someone during waking brain activity. Dreams occur during this sleep stage, your heart rate increases, your muscles become paralyzed, and your eyes twitch in various directions (hence the name).
Why Do Consistent Oxygen Levels Matter?
In normal sleep, a person’s breathing will slow and become consistent, delivering a regular supply of oxygen to the blood. For people with sleep apnea, the frequent dips in oxygen level signal to the brain that there’s something wrong and that they need to partially wake up. As a result, the person’s sleep is disturbed, making it impossible to sink into the deep, restorative sleep stages. People with severe sleep apnea can go through this process of partially waking up hundreds of times each night. Often, people do not remember this happening, and think that they have slept normally even though they were likely snoring, choking, and tossing and turning. They wake up feeling exhausted, groggy, and unrested.
What are the Results of Sleep Deprivation?
The results of sleep deprivation include more than just irritability or sleepiness during the day. Sleep deprivation can contribute to milder symptoms like fatigue or drowsiness, puffy eyes or hand tremors, as well as more serious physical symptoms like clumsiness, trouble coordinating movements, headaches or sore muscles, obesity, and even seizures. Sleep deprivation impacts mental health as well causing confusion, memory lapses or loss, or depression.
People suffering from sleep apnea deal with not only the negative effects of sleep deprivation as we’ve just highlighted, but also the strain of trying to cope with oxygen deprivation at night. This puts serious strain on the brain, the heart, and the rest of the body during both sleeping and waking hours.
Think you might have sleep apnea? Take this two minute quiz to find out.
What Physically Happens During Sleep Apnea?
During sleep apnea, regular breathing is disrupted. This prevents the sufferer from getting enough oxygen, and makes it impossible to get good quality sleep. There are three types of sleep apnea: Obstructive Sleep Apnea, Central Sleep Apnea, and Mixed Sleep Apnea.
Obstructive Sleep Apnea
Obstructive Sleep Apnea (OSA) is the most common form of sleep apnea, affecting about 18 million Americans and accounting for about 80% of sleep apnea cases. It is caused by a physical obstruction of the airway during sleep when the tissue in the back of the throat collapses. This makes it difficult or impossible for the sleeper to breathe, which in turn causes a partial awakening and disrupted sleep. This leads sufferers to snore loudly or make choking noises during sleep. In other words, people with OSA have a “mechanical” problem with the tissue in their mouth and throat blocking the passage of air.
Central Sleep Apnea
Central Sleep Apnea (CSA) occurs when the brain fails to signal the body to breathe. CSA is a neurological problem. Patients with this condition are physically able to breathe, except their brain is not telling them to do so. This causes carbon dioxide to build up in the body and oxygen levels to dip. Often (but not always), CSA is associated with other serious medical conditions such as congestive heart failure, kidney failure, or neurological diseases like Parkinson’s disease.
Mixed Sleep Apnea
“Mixed” or “complex” sleep apnea is a combination of obstructive sleep apnea (anatomical) and central sleep apnea (neurological). It can be explained as a central event that turns into an obstructive event.
What Are the Health Effects of Sleep Apnea?
The effects of sleep apnea are not limited to your body or mind. The result of consistently not achieving high quality sleep can impact job performance, and even personal relationships.
How Sleep Apnea Impacts the Body
The oxygen deprivation that occurs during an apnea puts serious strain on your body. The heart struggles to pump enough blood around the body, which can contribute to heart disease and high blood pressure. Other conditions like diabetes, liver damage, low fertility and sexual dysfunction have also been connected to sleep apnea.
How Sleep Apnea Impacts the Brain
Oxygen deprivation and lack of sleep take a toll on your brain. Research has shown that sleep apnea actually decreases the amount of white and gray matter in the brain  , meaning that sufferers experience decreased cognitive function and decreased memory and putting them at greater risk of developing dementia.
How Sleep Apnea Impacts the Mind
Sleep apnea can cause mental and emotional damage. Sleep deprivation causes stress, moodiness, and irritability, making a sufferer miserable. During prolonged periods of sleep deprivation, it can be challenging to sustain relationships—even with partners or family. Unsurprisingly, sleep apnea has been linked to depression.
How Sleep Apnea Impacts Relationships
The effects of sleep apnea aren’t limited to the person suffering from this disorder. As the symptoms like irritability and reduced sex drive become more pronounced, they can impact the partner, family, friends, and even colleagues of the person suffering. In extreme cases, the snoring, tossing and turning, and decreased intimacy or fertility can alienate a partner, leading to breakdowns in relationships.
Wondering if you’re suffering from sleep apnea? Get started today with a consultation with one of our sleep specialists.
What are the Consequences of Leaving Sleep Apnea Untreated?
Seeking treatment might be uncomfortable, but it is important—the consequences of leaving this sleep disorder are very real. In fact, an 18-year study found that people with sleep apnea were three times more likely to die from any cause  during the study than healthy people. That’s right: sleep apnea patients die at three times the rate of normal sleepers. Here are just some of the health risks associated with sleep apnea.
Sleep apnea poses a real threat for people suffering from heart disease or other cardiac issues. Did you know:
- People with sleep apnea are more likely to have high blood pressure, heart arrhythmias, strokes, and heart failure.
- 50% or more of cardiovascular patients have sleep apnea, compared to less than 5% in the overall population  
- In patients with heart failure, those with sleep apnea died at twice the rate of the healthy sleepers 
High Blood Pressure
Sleep apnea has an impact on blood pressure, making existing symptoms even worse:
- Severity of sleep apnea is directly correlated to increasing blood pressure, regardless of sex, age, and other factors  
- 37% of people with high blood pressure and 83% of people with drug-resistant hypertension have sleep apnea  
- People with moderate to severe sleep apnea are three times as likely to have high blood pressure as their healthy counterparts 
Strokes and sleep apnea are often related, and can impact on chances for a normal recovery:
- 65% of stroke patients have sleep apnea 
- As many as 50% of strokes occur at night or within one hour of waking up—right when sleep apnea is putting the greatest strain on the body 
- Stroke patients with sleep apnea have higher mortality rates and function more poorly than normal sleepers 
Diabetes and sleep apnea have a close connection:
- Half of people with type two diabetes have sleep apnea 
- People with moderate to severe sleep apnea are over twice as likely to be diagnosed with diabetes 
- Sleep apnea is associated with increased glucose intolerance and insulin resistance 
As noted above, there’s a proven link between sleep apnea and cognitive function:
- People with sleep apnea experience irritability, lack of concentration, impaired memory formation, and forgetfulness
- Studies have shown that grey matter concentration and the size of parts of the brain important to memory formation are decreased in patients with sleep apnea  
- People with sleep apnea experience the onset of dementia over 10 years earlier than normal sleepers (at 77 versus 90 years old) 
- Sleep apnea can impact on your love life and reproductive health:
- Men with erectile dysfunction are more than twice as likely to have sleep apnea 
- Sleep deprivation decreases sexual desire in women  and impacts fertility, making it harder to conceive 
- Couples in which one or both partners suffer from a sleep disorder may have trouble conceiving
Increased Risk of Accidents
Sleep apnea puts you at risk for serious accidents:
- People with sleep apnea are 2-3 times more likely to be in a car crash 
- Driving while sleep-deprived is just as dangerous as driving drunk—both double the risk of being in an accident 
Are you concerned about the negative effects of sleep apnea? Thankfully, sleep apnea treatment can effectively prevent or even reverse some of these negative health effects. Start with a sleep study to test for sleep apnea:
Sleep Apnea Symptoms: How Can I Tell If I Have Sleep Apnea?
The vast majority of people with sleep apnea do not know they have the sleep disorder—80% of cases go undiagnosed! In fact, it’s possible that up to 93% of women and 82% of men with moderate-to-severe sleep apnea are unaware they have a sleep disorder.
Many people brush off the effects of sleep apnea as aging, stress, or just being tired. Or, they might not realize why they feel the way they do. That’s why it is so important to review the signs and symptoms to see if you do suffer from sleep apnea, so you can begin treatment and start benefitting from a normal night’s sleep.
Are You Suffering From These Symptoms of Sleep Apnea?
As we discussed above, there are many warning signs that you might have sleep apnea, including:
- Excessive sleepiness during the day: People with sleep apnea are incapable of getting restful sleep, which means they are chronically sleep-deprived, no matter how long they spend in bed. If you are constantly exhausted, sleep apnea could be the cause.
- Decrease in attention, lack of concentration, lack of energy, irritability: Many of the mood and concentration issues that are associated with not getting enough sleep are constant hallmarks of sleep apnea.
- Decrease in memory: Poor sleep quality decreases your recall ability. Plus, prolonged oxygen deprivation can damage your brain.
- Poor sleep at night: If you have trouble sleeping at night, or frequently have to get up to use the bathroom, this points to the poor sleep quality caused by sleep apnea.
- Snoring: People who snore are more likely to suffer from sleep apnea.
- Choking sounds or periods of not breathing at night: During an apnea, a person stops breathing and may begin gasping, choking or snorting. If you notice this in a bed partner, or if you wake up at night gasping, this is a serious warning sign.
- Waking up with a dry mouth, sore throat, or headache: These are all aftereffects of a strenuous night of sleep.
- Other health conditions: Sleep apnea is strongly correlated with several other health problems, most notably heart disease and high blood pressure. If you have these conditions, sleep apnea could make them worse.
If any of those symptoms are familiar or if you have any other conditions that might put you at increased risk of sleep apnea, don’t wait any longer to talk to your sleep doctor about being tested—request a sleep study today!
Am I in Danger of Developing Sleep Apnea? Common Risk Factors
Obstructive Sleep Apnea (OSA)—the most common type of sleep apnea—occurs when the tissue at the back of the throat sags into the airway, blocking your breath. Certain behaviors and physical attributes can make it more likely that you will experience this kind of blockage, putting you at risk for this disorder.
Who Gets Sleep Apnea?
Sleep apnea is more common in men, and risk tends to increase once someone has reached middle age. However, sleep apnea can be found in virtually anyone—people of any age, women, and children can all develop this disorder.
What are the Physical Risk Factors?
You may be at risk of sleep apnea if you match these criteria:
- Being overweight: Being overweight or obese is one of the most significant risk factors. About 50% of people with obstructive sleep apnea are overweight. When fat accumulates around the upper airway, it can change the shape of the airway or the extra weight can make it more likely that the throat tissue will collapse during sleep
- A large neck: This is another very important physical indicator, often used by doctors to measure the likelihood that someone has sleep apnea. People with a neck circumference greater than 17 inches for men and 15 inches for women are considered at heightened risk for OSA.
- A small jaw: People with small jaws have tongues that are seated farther back in the mouth, increasing the probability of it falling into the airway.
- Large tonsils or adenoids: This is particularly problematic in children. If the tonsils are large enough, they can actually obstruct the throat and cause sleep apnea.
- High blood pressure and diabetes: Sleep apnea is correlated to these other health conditions and your family health history can also play a role.
- Nasal congestion: Trouble breathing through the nose—because of allergies or a deviated septum, for example—can make sleep apnea more likely.
Will Certain Actions Increase the Risk of Developing Sleep Apnea?
Yes—there are certain actions can exacerbate or increase the likelihood of an apnea occurring, including:
- Smoking: The inflammation and lung damage caused by smoking means that smokers are significantly more likely to have the disorder.
- Drinking alcohol: Alcohol can cause the throat muscles to relax more than usual.
- Sleeping on your back: During back sleeping, gravity pulls the tongue back into the throat, reducing airflow. If you have sleep apnea, sleeping on your stomach is a good option.
How Do I Reduce My Chances of Developing Sleep Apnea?
In general, getting sufficient exercise, maintaining a healthy weight, eating a balanced diet and taking care of your body decreases your risk for developing sleep apnea.
Have Any Concerns? Talk to Us!
It is normal to feel apprehensive about the possibility of having sleep apnea, but our experienced team and comfortable facilities will make diagnosing and addressing your sleep disorder easy and straightforward, helping you to start feeling like yourself again. Request a consultation with one of our sleep doctors if you think you may be at risk or believe you are suffering from sleep apnea.
How Do I Get a Sleep Apnea Diagnosis?
Sleep apnea is diagnosed through a simple test that records metrics like your pulse, how hard it is for you to breathe, movement, brainwaves and how much oxygen is in your body. This can happen in two ways: either by visiting a sleep center, or by taking the test at home. During your test, if you experience five or more periods where you stop breathing, it is likely that you’ll be diagnosed with sleep apnea.
In-Home Sleep Test vs. an In-Center Sleep Study: Which is Right For You?
If you need to be tested for a sleep disorder, there are two main types of tests available: Home Sleep Testing (HST), or a traditional overnight stay in a sleep center, which is like a hotel and has all the amenities you need for a good night’s sleep.
In-Center Sleep Test (Polysomnogram)
A traditional sleep study occurs at a sleep center. You will sleep overnight in a private, comfortable room that has everything you’d expect to have in your bedroom at home, including your own restroom and shower facilities. In-center testing permits detailed monitoring of the your brainwaves, oxygen saturation, leg motion, and other critical benchmarks for diagnosing a variety of sleep disorders. A technician oversees your test throughout the night to ensure the most detailed results possible.
Home Sleep Testing (HST)
A Home Sleep Test takes place in the comfort and convenience of your home. Prior to the test, you will be instructed by a technician on how to use the home testing machine. You then go home, turn on the machine, and sleep in your own bed while the machine records metrics like your pulse and the effort required to breathe. It is a simple, comfortable way to assess if you are suffering from a sleep disorder.
Which Type of Test Should I Have?
There are benefits to both types of tests. Below, we’ve highlighted why you and your sleep doctor might consider choosing one over the other.
3 Reasons to Have an In-Center Sleep Study
- Detail: The thoroughness of the sensors that are used during an overnight test can detect a variety of sleep disorders, from sleep apnea to restless legs syndrome.
- Accuracy: The presence of a technician and the detailed sensors ensure that the test goes according to plan and you get the data you need.
- Comprehensiveness: In-center studies can detect all types of sleep disorders and can monitor all types of patients, including children.
3 Reasons to Have a Home Sleep Test
- Comfort: Taking the test in your own home allows you to sleep in a familiar, comfortable environment.
- Accessibility: HST is convenient because you do not have to spend the night in a sleep center. This makes it accessible to those who are homebound, such as the elderly, or those with illnesses or mobility issues.
- Cost: Home testing can be less expensive. If you have any concerns about what your insurance will cover, speak to us—we’re contracted and in-network with hundreds of insurance companies, keeping your costs as low as possible.
Get started today—request a sleep study and our sleep doctors will help you decide which sleep test will be the most comfortable and convenient for you.
Treatment Options: Will I Have Sleep Apnea From Now On?
The good news is that sleep apnea is entirely treatable! There are a variety of treatment options for patients who have been diagnosed with sleep apnea. Discover some of the most common treatments below:
CPAP (Continuous Positive Airway Pressure) Therapy
Continuous Positive Airway Pressure devices (also known as PAP or CPAP) deliver pressurized ambient air through the throat, keeping the airway open and eliminating the “apnea events” that make it hard to sleep. The pressurized air is delivered via a tube and a mask worn over the face. You’ll simply need to put the mask on when you’re ready to fall asleep and breath normally. CPAP is the most effective treatment for sleep apnea and can potentially improve the patient’s sleep overnight, dramatically increasing the quality of life for individuals affected by sleep apnea.
CPAP Advantages and Considerations
- Advantages: PAP is the most effective, tried-and-true sleep apnea treatment. CPAP treatment is nearly 100% effective at eliminating the negative effects of sleep apnea, and is your best bet for curing your sleep apnea.
- Considerations: A CPAP device must be used every night to be effective. New developments mean they are smaller, quieter, and more comfortable and technologically advanced than ever.
Sleep Apnea Surgery
Sleep apnea surgery is less effective than PAP treatment. It is more invasive and can entail complications and a recuperation period. However, it can be effective in certain circumstances and may be required if PAP treatment does not work for an individual.
There are many different types of surgeries that attempt to cure sleep apnea. Here are some of the more common ones:
- Removing throat tissue: Some types of surgery physically remove some of the tissue that falls back into the throat during an apnea. Removed tissue can include the uvula, part of the roof of the mouth, the tonsils, and even part of the tongue.
- Removing the tonsils and adenoids in children: This type of surgery is remarkably successful, with a 75%-100% success rate in children with oversized tonsils.
- Bimaxillary advancement surgery: This involves moving forward both the upper and lower jaw to expand the airway.
- Upper Airway Stimulation: This type of surgery involves placing a pulse generator inside the body that sends electrical pulses to the tongue, causing it to move forward and open the airway.
Sleep Apnea Surgery Advantages and Considerations
- Advantages: Surgery can be effective in certain situations, and it eliminates the issue of PAP compliance.
- Considerations: Surgery is much less effective than CPAP treatment. Also, it is invasive and can involve risk.
Dental Devices for Sleep Apnea
Dental devices work by trying to keep throat tissue from sagging into the windpipe. There are two main types:
- Mandibular Advancement Device (MAD): This pushes the lower jaw forward and downward, which helps prevent blockage in the airway.
- Tongue Retraining Device (TRD): This is a splint that holds the tongue in a forward position, preventing it from falling backward during sleep and obstructing the airway.
- Dental devices are also not as effective as PAP treatment, but can be an option for people who cannot commit to PAP compliance.
Advantages and Considerations for Sleep Apnea Dental Devices
- Advantages: They are a convenient way of treating sleep apnea and can be more comfortable than PAP. They can be an effective treatment for people with mild sleep apnea.
- Considerations: They can be pricey or cause altering of the teeth position in the long run. They are not as effective as PAP therapy.
Sleep apnea impacts sufferers in many ways. Beyond causing regular drowsiness, it can lead to serious disease, mental health issues, and place unnecessary stress on relationships.
Diagnosis and treating sleep apnea is straightforward, and doesn’t have to be uncomfortable or inconvenient. Take the first steps to getting your energy back, improving your relationships, and feeling like yourself again—schedule a consultation now!
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