Identifying patients at risk for obstructive sleep apnea in a primary care practice

Michael Grover, Martina Mookadam, Danielle Armas, Ciara Bozarth, Tarah Castleberry, Meghan Gannon, Denise Webb, Amylou Dueck

    Research output: Contribution to journalArticlepeer-review

    32 Scopus citations


    Purpose: The purpose of this study was to determine (1) whether our review of systems (ROS) form facilitates identification of sleep complaints; (2) how frequently department physicians investigate these sleep complaints; (3) the prevalence of our family practice patients at increased risk for obstructive sleep apnea (OSA); and (4) how well ROS responses function as diagnostic tests to identify OSA risk. Methods: We used a prospectively collected sample of consecutive adult patients undergoing preventive examinations at 2 family medicine clinics. Patients completed ROS forms and the Berlin Questionnaire to determine OSA risk level. Physicians at only one site used ROS forms during care. Results: Two hundred forty-nine of 382 eligible patients (65%) completed forms and underwent examinations. Thirty-seven percent responded positively to sleep-related ROS questions. Physicians documented 24% of those complaints. ROS form use affected documentation (31% with use vs 5% without; P = .03). Thirty-three percent of all patients had increased OSA risk. Fifty-seven percent of high-risk patients responded affirmatively to an ROS question as opposed to 27% for those at lower risk (P < .001). ROS responses were 57% sensitive and 73% specific for increased OSA risk. Conclusions: Sleep symptoms were common and were recognized significantly more often when our physicians used a ROS form. However, few complaints were investigated. Our current ROS sleep questions are not sufficiently sensitive to identify increased OSA risk. Physicians should prioritize evaluation of sleep dysfunction because of the association with OSA. (J Am Board Fam Med 2011;24:152-160.).

    Original languageEnglish (US)
    Pages (from-to)152-160
    Number of pages9
    JournalJournal of the American Board of Family Medicine
    Issue number2
    StatePublished - Mar 2011


    • Family medicine research
    • Obstructive sleep apnea
    • Prevention
    • Screening
    • Sleep disorders

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health
    • Family Practice


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