B37-01 Dreaming of Better Sleep: Improving Obstructive Sleep Apnea Screening and Follow-up in Resident-run Clinic

Abstract Rationale Obstructive sleep apnea (OSA) affects an estimated 33.2% of U.S. adults, underscoring its significant public health impact. Given this burden, the American Academy of Sleep Medicine recommends annual OSA screening for high-risk individuals and those with symptoms including excessive daytime sleepiness, loud snoring, witnessed apneas, or nocturnal gasping. The condition is especially prevalent among patients with comorbidities such as hypertension, heart failure, atrial fibrillation, stroke, and type 2 diabetes. Underserved populations have higher rates of these comorbidities, further increasing OSA risk, and at the same time have significant obstacles to management. This quality improvement project sought to identify barriers to OSA diagnosis and treatment at a resident-run primary care clinic serving this population. Methods The project took place at Burgdorf Medical Center in Hartford, Connecticut, a primary care clinic for socioeconomically disadvantaged patients and a continuity clinic for residents of the University of Connecticut Internal Medicine Program. Over an eight-week period, residents completed a pre-test assessing OSA knowledge and appropriate indications for sleep studies. Educational sessions covered OSA recognition, management, and diagnostic evaluation. Standardized clinical tools, including dot phrases, were introduced to support consistent screening and treatment plans. A post-test was administered after eight weeks. More than 250 charts were reviewed to evaluate changes in OSA screening with the STOP-BANG tool, documentation of OSA discussions, and diagnostic or referral interventions. Results Prior to the intervention, only 25% of residents knew how to order home or in-lab sleep studies. Post-intervention, all residents (100%) demonstrated competency and had ordered at least one sleep study for their patients. Screening using the STOP-BANG questionnaire increased by 200%, home sleep test orders by 600%, and referrals to pulmonology or sleep medicine by 185%. Conclusions This intervention improved resident knowledge and OSA screening practices in an underserved, resident-managed clinic. The next phase will assess whether patients completed recommended sleep studies and specialist evaluations. Future efforts will target barriers such as limited health literacy, poor follow-up, and restricted access to treatment. This study is limited by its short duration, single-site design, small resident sample, reliance on documentation accuracy, and lack of patient outcome data, which may affect the generalizability and long-term sustainability of the observed improvements. Long-term goals include training residents to independently manage OSA within primary care, encompassing positive airway pressure (PAP) therapy initiation and maintenance, to reduce dependence on specialty care. This abstract is funded by: None