Abstract
Purpose: The purpose of this project was to identify potential gaps in primary care related to the identification of obstructive sleep apnea (OSA) in individuals with existing cardiovascular disease.|Background: Research demonstrates that patients with existing heart disease are at elevated risk for OSA. A current lack of screening protocols provides an opportunity to improve OSA recognition. The STOP-Bang questionnaire (SBQ) can provide clinicians an efficient and cost-effective way to enhance OSA recognition in their patient population.|Sample/Setting: 145 patients from a primary care clinic in Omaha, Nebraska were invited to complete the SBQ. The final sample was n=54. Inclusion criteria included an existing diagnosis of atrial fibrillation (A-fib), hypertension (HTN), or heart failure (HF).|Methods: Participants were contacted via phone, clinic instant message service, and e-mail. Patients were requested to respond to the SBQ survey. Items included (S)noring, (T)iredness, (O)bserved apnea, (P)ressure (HTN), and (N)eck size. (B)MI, (A)ge, and (G)ender, were taken from the EMR. SBQ risk scores were calculated from the participating cohort, and categorized as Mild (0-2), Intermediate (3-4), and High (5-8).|Results: 54 patients completed the survey. 24 of these patients (44%) had a previous OSA diagnosis, and 30 patients (56%) were without a prior history of diagnosed OSA. The participants without diagnosed OSA were then scored. Individual scores found 1 individual at Low risk, 11 Intermediate risk, and 18 High risk. The average SBQ score was 4.7, indicating an Intermediate risk average for OSA.|Conclusion: Over half of non-previously screened patients (56%) were positive for elevated OSA risk. The data supports current literature indicating that primary care encounters are not routinely screening for OSA. These missed opportunities may decrease quality patient outcomes. Due to its high sensitivity, the SBQ should be routinely used in primary care for those with cardiac disease. Future recommendations would include a sleep study referral for those with SBQ scores in the intermediate and high risk categories.