title: The STOP-BANG questionnaire improves the detection of epilepsy patients at risk for obstructive sleep apnea.
abstract: Patients with epilepsy and obstructive sleep apnea (OSA) are at risk for worsened seizure control and quality of life. We performed a quality improvement project, evaluating for improvements in the screening of OSA in epilepsy patients using the STOP-BANG questionnaire. The electronic medical records of patients seen in our epilepsy clinic were screened for 4 months prior to the intervention. We subsequently implemented the STOP-BANG questionnaire for 3 months. Only 22/664 patients (3.3%) had their sleeping habits explored during the pre-intervention period; 11 (1.7%) were referred to sleep medicine. Following implementation of the STOP-BANG questionnaire, the percentage of patients screened for OSA increased to 41.6% (269/647, Chi-square Fisher's Exact test 2-sided p<0.001). Of the 269 patients screened, 84 (31.2%) met criteria for elevated OSA risk. Forty-one patients were referred to sleep medicine during the subsequent 3 month period, including 33 who met STOP-BANG criteria for OSA. This represented 6.3% and 5.1% (respectively) of all 647 patients, a significant improvement over the percentage referred prior to the intervention (Chi-square Fisher's Exact test 2-sided p<0.001). Twelve of the 33 patients referred based on the STOP-BANG questionnaire saw sleep medicine; 11 (91.7%) were referred for polysomnography (PSG). Of the 10 patients who underwent PSG, 9 (90%) were diagnosed with OSA and offered treatment with continuous positive airway pressure (CPAP).
authors.affiliation: Department of Neurology, George Washington University, 2150 Pennsylvania Avenue, 9th Floor, Room 9-400, Washington, DC 20037, USA. Electronic address: anusharma@mfa.gwu.edu.
authors.forename: Anumeha
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, 260 Stetson Street, Suite 2300, Cincinnati, OH 45267-0525 USA. Electronic address: molanoje@UCMAIL.UC.EDU.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Molano
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, 260 Stetson Street, Suite 2300, Cincinnati, OH 45267-0525 USA. Electronic address: briandmoseley@gmail.com.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Moseley
mesh_terms: D004827:Epilepsy / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D012017:Referral and Consultation; D012306:Risk; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: Epilepsy; OSA; Obstructive sleep apnea; STOP-BANG; Seizures