Two Stage Screening For Obstructive Sleep Apnea In A Primary Practice Setting

Andrej Pangerc, Marija Petek Šter, Leja Dolenc Grošelj

Keywords: Family medicine, Obstructive sleep apnea, Primary practice setting, STOP-BANG questionnaire, Ambulatory polygraphy, Two-stage screening

Background:

Obstructive Sleep Apnea (OSA), a common sleep-related respiratory disorder, is an independent risk factor for hypertension, stroke, depression, diabetes , motor vehicle accidents. Often overlooked and underdiagnosed, its detection is hindered by limited accessibility to sleep studies, typically located remotely and requiring time consuming manual interpretation, restricting diagnostic capacity and accessibility.

Research questions:

The aim of our study was to evaluate the effectiveness of a two-stage screening process for OSA in family medicine, integrating the STOP-BANG questionnaire with automated-scoring home sleep apnea testing (HSAT). This evaluation sought to determine the feasibility and efficiency of this approach for OSA detection, and to assess the accuracy and reliability of automated interpretation in sleep study analysis.

Method:

The study was conducted in four Slovenian family practices using a cross-sectional approach, between august 2018 and august 2022. 153 randomly selected patients that came for consultation for any reason aged between 18 and 70 were included. All patients completed the STOP-BANG questionnaire and underwent same night HSAT with type III polygraphy. The recordings were scored automatically and by experienced and accredited somnologist.

Results:

Preliminary results show excellent correlation between manual and automated interpretation of HSAT and are also promising for the two-stage model of OSA screening in a primary practice.

Conclusions:

The two-stage screening for OSA in a primary care setting with automated home sleep apnea testing shows promise and might represent a viable and efficient method for early OSA detection in primary care.

Points for discussion:

Is it time for OSA diagnosis and thepray move in to primary practice?

How to scale this study and finance it?

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