STOP-Bang Questionnaire Screening for Sleep Apnea Treatment In An Outpatient Surgical Center
Date
2017
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Abstract
Background: Sleep apnea is often undiagnosed, increasing in prevalence and contributes to anesthetic risk. Sleep apnea is associated with hypertension resistant to treatment, cardiac arrhythmias and stroke. It is critical for anesthesia providers to use the STOP-Bang Questionnaire to screen patients for sleep apnea risk factors and severity and to develop a care plan which will lead to a safe anesthetic outcome.
Purpose: This study used the STOP-Bang Questionnaire pre-operatively to screen, identify and educate patients about their sleep apnea risk factors. The objectives of this study were to examine the effect of sleep apnea screening on patients’ decisions regarding further evaluation of sleep apnea with PCPs and Sleep Medicine Practitioners, as well as identify facilitators and barriers to further evaluation.
Methods: Patients at an outpatient surgical center were screened by an anesthesia provider with the STOP-Bang Questionnaire. Patients with STOP-Bang scores equal to or greater than 3 were educated and instructed to follow-up with their Primary Care Provider. Each patient received a copy of their completed questionnaire and information from www.stopbang.ca describing the long-term health effects of untreated sleep apnea. Patients consented to have the anesthesia provider notify their PCPs regarding their sleep apnea risk factors. The researcher followed up with patients in three months to determine whether patients sought further evaluation and treatment for sleep apnea.
Results: Thirty two patients with scores > 3 agreed to participate. Fifteen patients discussed sleep apnea risk with their PCPs within 3 months, among whom, 9 patients consulted Sleep Medicine Practitioners and completed sleep studies. Of these 15, four patients PCPs did not think their patient needed to have a sleep study. The remaining 2 patients who visited the PCP did not want to follow thru with the sleep study even though the PCP recommended that they do. Eight patients from the original sample of 32 intended to discuss sleep apnea during their next scheduled visit with their PCPs. The remaining 9 patients gave various reasons for lack of follow- up with their PCPs.
Conclusion: Sleep apnea is widely undiagnosed and few providers screen patients for sleep apnea. STOP-Bang screening and education at the outpatient surgical center can help identify sleep apnea risk factors and encourage patients’ further evaluation and treatment of sleep apnea.
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