Identifying Obstructive Sleep Apnea Risk Using the STOP-BANG Questionnaire in a Cardiology Clinic

Untreated obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality, warranting enhanced awareness, screening, and action among healthcare providers to optimize patient outcomes. Attempting to address the potential under detection of OSA, this quality improvement project implemented the STOP-Bang Sleep Apnea Questionnaire at a cardiology clinic, with the goals to stratify risk for OSA in 100% of patients and increase provider referral of high risk patients for sleep studies. The setting was an outpatient cardiology clinic in Pensacola, Florida. The sample included new and existing patients 18 years or older who had one or more of the following diagnoses: hypertension, heart failure, coronary artery disease, atrial fibrillation, or arrhythmia. Methods involved collecting and comparing preintervention sleep study referral rate data with 6-week STOP-Bang questionnaire implementation data. Results demonstrated a 65% (279 of 428 patients seen) screening implementation rate and a modest but statistically significant increase in the overall referral rate from 2.6% preintervention to 5.1% postintervention ( p = .040). Overall, standard use of the STOP-Bang questionnaire may enable higher detection and referral of OSA.