Introduction: Obstructive sleep apnea (OSA) is a largely underdiagnosed disorder of upper airway collapse during sleep. Primary care providers do not routinely screen for OSA. This project aims to determine the yield of using the STOP-BANG questionnaire to identify previously undiagnosed OSA in a primary care population.
Methods: This prospective quality improvement pilot project included 181 patients of the Jefferson Department of Family Medicine identified as high-risk for OSA based on 3 EMR-based search criteria taken from STOP-BANG: hypertension, age >50 years, and BMI >35 kg/m2. We attempted contact with patients by mail, followed by up to 3 weekly telephone calls to verbally screen patients with the full STOP-BANG questionnaire. A score of >6 was considered high-risk for OSA. High risk patients were referred for sleep study testing.
Results: From the initial 181 patients, 71 were excluded due to a prior OSA diagnosis; 3 were excluded for various other reasons; and 53 could not be reached. Of those reached, 28 patients refused participation, and 15 patients had a low-risk STOP-BANG score <6. The remaining 11 patients had a high-risk STOP-BANG score >6 and were referred for sleep study testing. While data collection is ongoing, all 3 patients (100%) who completed sleep studies have been newly diagnosed with OSA.
Discussion: Preliminary results confirm utility of the STOP-BANG questionnaire to identify patients at high risk for OSA. The main limitation in our pilot project was difficulty contacting patients. We are adding alternate forms of communication (email, outreach at upcoming patient visits).
Givens, Alyssa; Goldberg, Risa; and Cheng, MD, PhD, Cynthia, "Primary Care Obstructive Sleep Apnea Screening (PCOSA)" (2020). Phase 1. Paper 64.