Rude Awakening

A hospitalist-turned-sleep specialist at Beth Israel Deaconess Medical Center (BIDMC) in Boston wants hospitalists to be aware of a recent report that showed 80.5% of hospitalized patients were at high risk for obstructive sleep apnea (OSA)—but she doesn’t want you to lose any sleep over it.

Suzie Bertisch, MD, MPH, a physician in the Division of Pulmonary, Critical Care, and Sleep Medicine at BIDMC, says hospitalists should stay current with OSA research because of its growing prevalence. However, because there is little evidence-based data on just how much of a complicating factor the condition is, she doesn’t suggest hospitalists be too concerned.

"It’s the reality that we’ve all seen a patient who has sleep apnea," says Dr. Bertisch, an instructor at Harvard Medical School who helped lead a session on OSA at HM10. "It’s important to keep an eye on it because it could become a bigger deal. We’re not sure now what it is."

The study, the results of which were announced in November by Loyola University Health System in Maywood, Ill., was based on a one-day survey of 195 patients who were given an eight-question OSA screening questionnaire known as STOP-BANG. Patients who answered “yes” to three of the questions were considered high-risk.

Dr. Bertisch notes that since the general prevalence of OSA usually is cited at about 2% to 4% of the population (about 12 million Americans, according to the National Institutes of Health), the low threshold for determining risk via the STOP-BANG test likely contributed to the outsized percentage of those considered high-risk.

The researchers suggested the results could prod hospitals, and by extension hospitalists, to administer the STOP-BANG test to gauge risk.

Dr. Bertisch, who gave up hospitalist duties in recent months to focus on sleep research, says she expects more research to be conducted in order to help answer questions about how sleep apnea affects other health conditions. “It’s an emerging field,” she says.

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