Background: Obstructive sleep apnea (OSA) is a disorder characterized by obstructive apneas and hypopneas due to repetitive collapse of the upper airway during sleep. OSA is the most common sleep-related breathing disorder. The estimated prevalence is 20 to 30 percent in males and 10 to 15 percent in females. Patients with OSA, are at increased risk for a broad range of cardiovascular morbidities. STOP BANG questionnaire is the most validated tool for screening. The study was interested in screening hospitalized patients at risk for OSA. Patients were screened using STOP BANG.
Methods: A member of the hospital quality team, screened patients on select floors in the hospital. The patients were given the option to be screened or not. Screening was completed using STOP BANG. Patients who scored intermediate or high risk, were informed of their score. These patients were given a brochure on obstructive sleep apnea, education by a respiratory therapy, and instruction to follow up with their physician outpatient for further evaluation.
Results: Each patient was scored using the STOP BANG survey. Patients who scored 0 to 2 were low risk. Patients who scored 3 to 4 were intermediate risk and patients who scored greater than 5 were high risk. The total number of patients who scored low risk, intermediate risk and high risk was then totaled. Percentages were calculated for each of the three groups. The study found (92/276) 33% scored low risk; (102/276) 37% scored intermediate risk; (82/276) 67% scored high risk. Therefore, (184/276) 67% of the patients scored intermediate to high risk for underlying sleep apnea.
Conclusions: A majority of hospitalized patients, 67%, screened within intermediate/high risk using STOP BANG. In particular, these patients are at an increased risk for cardiovascular events including, cardiac arrhythmias, congestive heart failure, hypertension, and cardiomyopathy. Other consequences of untreated OSA include diabetes, depression, chronic fatigue, hypersomnia, memory loss, sexual dysfunction and stroke. These results will lead to a hospital wide intervention to screen all hospitalized patients in an effort to begin treating these individuals.