Implementation of an obstructive sleep apnea screening tool with hypertensive patients in the primary care clinic

Laura Showalter, Catherine O'Keefe

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND PURPOSE: Patients with severe obstructive sleep apnea (OSA) have an almost 4-fold higher odds of resistant hypertension than those with less severe OSA. Obstructive sleep apnea screening practices in primary care are deficient. Additional study is needed regarding the value of OSA screening in hypertensive adults who present to the primary care clinic. METHODS: This was a convenience sample of adults with hypertension from a rural primary care clinic in Iowa. Staff identified patients who met the inclusion criteria for the project. The STOP-Bang Questionnaire was used to screen the patients for OSA. Providers subsequently used discretion as to ordering polysomnography (PSG). CONCLUSIONS: Thirty-two patients were screened over a 3-month time period. All of the men included in the study scored either high or intermediate risk for OSA. Forty percent of the study participants scored high risk for OSA, with 33% of those participants referred for PSG. At project conclusion, three participants had undergone PSG testing, and all were diagnosed with sleep apnea. IMPLICATIONS FOR PRACTICE: To ensure timely diagnosis and treatment of OSA, primary care providers should consider screening all hypertensive adults for OSA. With compulsory screening and subsequent identification and treatment of patients with OSA, nurse practitioner providers can pave the way in reducing mortality and morbidity associated with OSA, as well as resistant hypertension.

Original languageEnglish (US)
Pages (from-to)184-188
Number of pages5
JournalJournal of the American Association of Nurse Practitioners
Volume31
Issue number3
DOIs
StatePublished - Mar 1 2019

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Obstructive Sleep Apnea
Primary Health Care
Polysomnography
Hypertension
Nurse Practitioners
Sleep Apnea Syndromes
Morbidity

All Science Journal Classification (ASJC) codes

  • Nursing(all)

Cite this

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abstract = "BACKGROUND AND PURPOSE: Patients with severe obstructive sleep apnea (OSA) have an almost 4-fold higher odds of resistant hypertension than those with less severe OSA. Obstructive sleep apnea screening practices in primary care are deficient. Additional study is needed regarding the value of OSA screening in hypertensive adults who present to the primary care clinic. METHODS: This was a convenience sample of adults with hypertension from a rural primary care clinic in Iowa. Staff identified patients who met the inclusion criteria for the project. The STOP-Bang Questionnaire was used to screen the patients for OSA. Providers subsequently used discretion as to ordering polysomnography (PSG). CONCLUSIONS: Thirty-two patients were screened over a 3-month time period. All of the men included in the study scored either high or intermediate risk for OSA. Forty percent of the study participants scored high risk for OSA, with 33{\%} of those participants referred for PSG. At project conclusion, three participants had undergone PSG testing, and all were diagnosed with sleep apnea. IMPLICATIONS FOR PRACTICE: To ensure timely diagnosis and treatment of OSA, primary care providers should consider screening all hypertensive adults for OSA. With compulsory screening and subsequent identification and treatment of patients with OSA, nurse practitioner providers can pave the way in reducing mortality and morbidity associated with OSA, as well as resistant hypertension.",
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