Patient response to sleep apnea screening in a dental practice

This study investigated patient response to a recommendation for physician evaluation following screening for obstructive sleep apnea (OSA) in a dental practice.

In a community-based dental practice in Raleigh, North Carolina, 119 patients were recruited by nonprobability purposive sampling and administered both a validated subjective (STOP questionnaire) and objective (pulse oximeter) screening instrument for OSA. Patients who screened high-risk for OSA on either instrument were recommended to consult their physician within three months. All patients were contacted via telephone after three months to determine if they had consulted a physician regarding their screening results. Multivariate log-binomial models estimated prevalence ratios (PR) and 95 percent confidence limits (95% CL) for physician consultation according to OSA risk, adjusting for potential confounders.

Overall, 18.5 percent of patients screened high-risk on the STOP questionnaire alone, 26.1 percent on pulse oximetry alone, and 31.9 percent on both instruments. Follow-up of 111 subjects (93.3%) found that 40 (47.1%) of those high-risk for OSA on one or both instruments sought physician evaluation. Patients who screened high-risk on pulse oximetry were 2.55 times as likely to seek physician evaluation compared with those who screened low-risk on both instruments (PR = 2.55, 95% CL: 1.02, 6.37). Screening high-risk on the STOP questionnaire did not significantly increase the likelihood of physician evaluation.

Nearly, half of dental patients who screen high-risk for OSA may be responsive to a recommendation to seek physician evaluation.