Recognition of sleep disorders in a community-based setting following an educational intervention

To determine the recognition of sleep disorders in a community-based outpatient health setting following an educational intervention for health care professionals. Previously we have reported very low rates of recognition of sleep disorders in minority and medically indigent populations in a community-based setting. This omission is significant, since there is evidence of an increased number of sleep disorders among minority populations.

In-service training on sleep and sleep disorders was conducted over a 4-year period. Patients screened at the health center with suspected sleep disorders were referred to a hospital-based sleep laboratory. Rates of recognition and referral for sleep-related disorders were compared over the 4-year period using the sleep lab and health center databases and patient chart review at the health center.

The intervention program was highly rated and well attended by staff. Rates of referral for sleep testing significantly increased from pre-intervention (0.06%) to the last year post-intervention (0.21%). Overall prevalence rate for sleep diagnoses increased similarly (0.11 vs. 0.26%).

The educational intervention was effective in increasing rates of recognition and diagnosis, although the rate remains low compared to the estimated prevalence of sleep disorders in the general population. Despite broad coverage of sleep disorders during the training program, OSA was the primary diagnosis. Further examination of factors leading to the lack of recognition of other primary sleep disorders needs to be addressed in this patient group.