What is the clinical evidence from this study?

Study design: Observational. Population: Obstructive Sleep Apnea (n=200). Intervention: STOP questionnaire. Primary outcome: Detection of high risk for OSA (STOP score ≥ 2).

What question did this study set out to answer?

This study aims to enhance the detection of obstructive sleep apnea (OSA) among veterans undergoing pulmonary function testing.

May 10, 2026

0531 Screening for Obstructive Sleep Apnea in the Pulmonary Function Lab: A Quality Improvement Initiative

Key Result

Screening veterans for obstructive sleep apnea in the pulmonary function lab using the STOP questionnaire identified 62.5% (50/80) of screened patients as high risk.

Key Points

This study aims to enhance the detection of obstructive sleep apnea (OSA) among veterans undergoing pulmonary function testing.
Prospective study administered the STOP questionnaire to veterans in the PFT lab, starting 10/2024.
Data collected included demographics and STOP scores from 200 consecutive veterans from 10/08-11/20/2024.
The respiratory therapist recorded questionnaire results in the PFT report.
178 (89%) of the veterans were male; 50 (62.5%) of the screened veterans were high risk for OSA (score ≥ 2).
13 (26%) of high-risk veterans were referred to sleep medicine, with 5 diagnosed with OSA and started on CPAP.
Screening is indicated as an effective strategy to identify veterans at high risk for OSA, emphasizing the need for expanded efforts.

Study Design

Type

Observational (n=200)

Multicenter

Structured PICO

Does administering the STOP questionnaire improve the detection of obstructive sleep apnea in veterans presenting for pulmonary function testing?

Population

200 consecutive veterans presenting for pulmonary function testing (PFT), mean age 70 years, 89% male, 82% white.

Intervention

Administration of the STOP questionnaire by a respiratory therapist to screen for obstructive sleep apnea.

Outcome

Detection of high-risk obstructive sleep apnea and sleep medicine referral outcomes.

Implementing the STOP questionnaire in the pulmonary function lab is an effective strategy to identify veterans at high risk for obstructive sleep apnea.

Abstract

Abstract Introduction Obstructive sleep apnea (OSA) is a chronic sleep disorder affecting nearly 1 billion adults aged 30-69 years globally. Veterans are at particularly high risk given OSA is twice as prevalent in this population. OSA increases risk for hypertension, diabetes, cardiovascular disease, stroke, and dementia among others. Despite its prevalence and health consequences, OSA remains widely underdiagnosed, underscoring the urgent need to increase screening within the VA Health Administration and beyond. This study aims to improve detection of OSA by administering the STOP questionnaire to all veterans presenting for pulmonary function testing (PFT). Methods This prospective study was determined to be exempt by the Portland VA IRB. Beginning 10/2024, the respiratory therapist (RT) in the PFT lab administered the STOP questionnaire to all veterans unless they declined, have OSA, or have been previously referred to sleep clinic. The RT recorded the results in the PFT report and we subsequently collected and analyzed the following data for 200 consecutive veterans from 10/08-11/20/2024: age, sex, race, BMI, smoking history, OSA history, sleep medicine referral history, STOP scores, and sleep medicine referral outcomes. Results The mean age of veterans was 70 years. 178 (89%) were male and 163 (82%) were white with a mean BMI of 30.71 kg/m2. The mean pack-year smoking history was 33 years. The STOP questionnaire was not administered to 120 (60%) veterans; 100 had known OSA, 9 were previously referred to sleep clinic, and 11 declined. 80 veterans were screened for OSA; 50 (62.5%) were high risk (score ≥ 2). 13 (26%) high-risk veterans were referred to sleep medicine. 5 (~40%) were diagnosed with OSA and started on CPAP, 5 had not completed a sleep study at the time of data review, 2 were started on non-invasive ventilation due to known chronic respiratory failure, and 1 was referred for CBT-I. Conclusion Implementing OSA screening in the PFT lab is an effective strategy to detect veterans at high risk for OSA. Given the adverse impact of OSA among veterans with comorbid conditions, efforts to expand screening are greatly needed. Further research is required to improve diagnostic testing for veterans at high risk for OSA. Support (if any)

Bookmark