An Underdiagnosed Epidemic: Improving Obstructive Sleep Apnea Detection in Primary Care
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Authors
Rosario, Gabrielle
Issue Date
2023-05-11
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Abstract
Purpose: Obstructive sleep apnea (OSA) is a highly prevalent disease that afflicts one in ten American adults and if untreated, can lead to significant negative health consequences. This quality improvement project implemented a screening process in primary care for adults with OSA risk factors presenting for annual exams. It aimed to determine if the quantity of sleep studies ordered increased compared to when no screening process was used. Background: Diagnosing and treating individuals with OSA is an identified priority in the US’ healthcare agenda as numerous organizations have recognized it as a threat to wellbeing. Still, no screening guidelines have been adopted and 80% of adults live undiagnosed. The use of screening tools can be effective to initially detect disease leading to earlier diagnosis and minimization of health consequences. Evidence demonstrates the STOP-Bang Questionnaire (SBQ) to be the most sensitive in determining OSA risk. Setting: Participants included 81 patients who visited a family medicine clinic. Inclusion criteria comprised patients 18 and older presenting for well exams who had a BMI ≥ 30 and/or a history of hypertension with no previous OSA diagnosis. Methods: Over ten weeks, patients were screened with the SBQ. If they scored ≥ 3, providers recommended/ordered a sleep study if patients agreed. The number of sleep studies ordered was compared to the same timeframe of the previous year when no screening intervention was used. Results: Of 81 patients screened, 49 had increased risk for OSA and were eligible to complete a sleep study. Sixteen patients had one ordered. Retrospective data reviews compared the number of sleep studies ordered over identical ten-week periods in 2022 and 2021. During the intervention period, there was a 59% increase in studies ordered. Conclusion: Using a standardized screening process for at-risk patients presenting for well exams can improve the detection of OSA.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University