0941 Sleep Apnea Testing in Hospitalized Patients: Are Patients Following Up?

Abstract

Abstract Introduction Obstructive sleep apnea (OSA) can often be recognized in an inpatient setting where patients are continuously monitored. Although an unattended portable sleep study can successfully diagnose OSA in many inpatients, allowing for earlier intervention, a loss to follow up can compromise effective treatment. This study aims to determine the rate of hospital follow-up in patients who are diagnosed with OSA on a portable inpatient sleep study. Methods We included adult inpatients who underwent portable sleep studies from 2013 to 2022. This is a retrospective study design. Individual charts were reviewed to determine demographics including age, gender, and race. Co-morbidities and length of stay were recorded. Sleep study data analyzed included total recording time, total estimated sleep time, overall apnea-hypopnea index (AHI) and nadir oxygen saturation. Primary outcome was percentage of patients with AHI 5/h with scheduled follow up visit. Secondary outcome was percentage of patients with AHI 5/h completed outpatient follow-up visit. Results 104 patients were included for analysis. Majority were middle aged (55.2 SD15.9 years-old), black (n=71, 68.2%) and male gender (n=64, 62%). A minority identified as Hispanic (n=7, 6.7%). The total number of sleep studies with AHI 5/h was 95 (91.3%) and the mean AHI was in the severe range (42.8 SD31.4/h) with significant associated oxygen desaturations (mean nadir oxygen saturation 77.1 SD10.6%). Primary outcome: the number of patients with a positive sleep study for OSA (AHI 5/h) who had scheduled for follow-up at discharge was 57 (60%). Secondary outcome: 54.4% of patients with positive sleep study and scheduled follow-up completed the outpatient visit. Conclusion The percentage of patients lost to follow-up is high despite diagnosing OSA successfully with an inpatient portable sleep study. Close to half of the patients had no scheduled follow-up, and the “no show” rate remained high (close to 50%) in those who had a sleep medicine appointment. Future studies should explore effective interventions to improve the follow-up rate and overall adherence to treatment. Support (if any)