Research Projects
A Smart Sleep Apnea Self-management Support Programme (4S) to improve apnea severity and cardiovascular health – A pragmatic randomized controlled trial

Programme(s) to which this project applies:

☑ MPhil/PhD ☒ MRes[Med] ☑ URIS

Obstructive sleep apnea OSA affects around 12% and 24% of adults in Hong Kong and China Mainland, respectively. Chronic intermittent hypoxia and sleep fragmentation of OSA leads to cardiometabolic and neurocognitive sequelae (e.g. hypertension, diabetes, daytime sleepiness and depression). Long-term, multidisciplinary management involving patients in the decision-making of treatment strategies, shifting from positive airway pressure (PAP) device-focused to the patient-centred chronic care model has been suggested. We designed A Smart Sleep Apnoea Self-management Support Programme (4S) to examine the effectiveness of 4S on improving apnoea severity, cardiovascular health and quality of life in subjects with obstructive sleep apnea (OSA).


To examine the effectiveness of a 4S to improve sleep apnea and cardiovascular health in subjects with (OSA).
To identify patients’ facilitators and barriers of 4S.
To explore the mechanisms of the impacts of 4S on improvements in self-management.


A 2-group randomized controlled trial on overweight and physically inactive subjects with moderate to severe OSA will be conducted with process and outcome evaluation at 4-month and 12-month follow-up. The mixed-effects model analysis will be conducted to compare the difference in changes of outcomes between two groups, by intention-to-treat and complete case analyses. Causal mediation effects, dose-response effect, programme acceptability (patient engagement and program satisfaction), intervention credibility, healthcare utilization will be examined.


The 4S can improve patients’ self-efficacy and responsibility in managing their health and reduce the health service burden from OSA and its related diseases.

Dr YKA Lai, School of Nursing

Dr Agnes Lai is an Assistant Professor at the School of Nursing of the University of Hong Kong. Dr Lai received her BN, DN, and PhD from The University of Hong Kong and MSc (Epidemiology and Biostatistics) from the Chinese University of Hong Kong. She is a registered nurse in HK and the USA, a fellow of the Hong Kong Academy of Nursing, a registered polysomnographic technologist, a cancer exercise specialist, and a certified zentangle trainer. She also is a council member of the Hong Kong Respiratory Nursing Association and a committee member of the CNE/CPD Education Committee at the Hong Kong Thoracic Society.

Her research interest areas are two-fold, including clinical and preventive medicine. She has broad experience in conducting trials on various chronic diseases (sleep apnea, lung cancer, diabetes, cardiovascular diseases, and insomnia), self-management education programs, mental health and quality of life. She also conducted various capacity-building train-the-trainer workshops for teachers, social workers, and lay health promoters, empowering them to implement a series of large-scale community-based projects to integrate physical activity and healthy eating habits into daily life. She has conducted various epidemiology studies to update lung function and grip strength reference values for adults and large-scale health promotion activities in Hong Kong.

Dr Lai also received various funding from major funding bodies and international and local awards and scholarships. Her achievement is recognized by the Excellence Research Award from Food and Health Bureau, HKSAR, Hong Kong.

Scholars Hub

For more information or to express interest for this project, please email the supervisor or the specified contact point in the project description.  Interested candidates are advised to enclose with your email:

  1. your CV,
  2. a brief description of your research interest and experience, and
  3. two reference letters (not required for HKUMed UG students seeking MRes[Med]/URIS projects).

Information on the research programme, funding support and admission documentations could be referenced online at the Research Postgraduate Admissions website. General admission enquiries should be directed to

HKUMed MBBS students interested in the Master of Research in Medicine (MRes[Med]) programme may visit the programme website for more information.  

HKUMed UG students interested in the Undergraduate Research Internship Scheme (URIS) may visit the scheme’s website for more information.