People who check into the hospital with undiagnosed sleep apnea are at very serious risk. Sleep apnea increases the risk of serious complications from anesthesia, can slow healing and recovery, and can even reduce the effectiveness of treatments for heart failure. Doctors need to know when their patients have sleep apnea so that they know how to work to avoid the risks.
To help with this, researchers at Thomas Jefferson University and Hospitals developed an economical screening program to help identify sleep apnea sufferers as they were admitted to the hospital. The screening program not only helped identify more sleep apnea sufferers, but it increased awareness and led to more sleep apnea referrals.
A Vetted Questionnaire
The screening program was a simple, inexpensive approach. It directed all patients with a body mass index (BMI) over 30 in a number of departments, such as cardiology, internal medicine, and family medicine, to a screening program.
The screening program started with the common STOP questionnaire. In this questionnaire, doctors ask patients four questions:
- Do you Snore?
- Do you feel Tired during the day?
- Has anyone Observed your breathing stop during sleep?
- Do you have elevated blood Pressure?
If patients showed a sleep apnea risk on the basis of the STOP questionnaire, they were observed overnight using a pulse oximeter, the simple monitor that is worn on the finger, and all of us are probably familiar with from our own or relatives’ visits to the hospital.
If the pulse oximeter test showed drops in oxygen saturation, a formal sleep study was recommended.
The technique was so effective at channeling appropriate candidates for polysomnography that 87% of those tested actually had sleep apnea.
Increased Awareness Helps, Too
A side benefit that was unanticipated by the researchers was that awareness of sleep apnea and its risks increased in the hospital as a whole, even among doctors not participating in the study. This meant that more people were being referred for sleep tests by their doctors who noticed risk factors for sleep apnea.
This is a good reminder that, despite the concerted efforts at spreading awareness of sleep apnea, there remains much work to be done. Doctors need to be reminded of the condition and its risks. If your doctor isn’t bringing it up, you need to.
Treatment Needs to Change
As we encourage more people to get tested for sleep apnea, we will see significant results in the health of the hospital population and reduced complications. But our progress will be limited as long as we continue to rely primarily on CPAP for treatment. CPAP is very effective, when it is used, but many sleep apnea sufferers don’t use their CPAP as they should. Consider that in this study, no heart failure patients who used CPAP had to go back to the hospital, but less than a quarter did so. Sleep apnea treatment must be used to be effective, and in order to be used, it has to be comfortable and convenient. Like oral appliance therapy.
If you know that you have sleep apnea and you want to avoid the health effects, but just can’t use your CPAP, we can help. Please call for an appointment with a Denver sleep dentist at the TMJ Therapy & Sleep Center of Colorado.