Nursing assessment of obstructive sleep apnea in hospitalised adults: A review of risk factors and screening tools

Screening for Obstructive Sleep Apnea in Veterans Seeking Treatment of Posttraumatic Stress Disorder

“…Because of the unique challenges with adherence to CPAP in veterans with OSA and PTSD, VA nurses and other clinicians with expertise in sleep medicine and PTSD treatment have the opportunity to collaborate to develop specialized training for these patients to properly use CPAP therapy, provide mechanisms to cope with anticipated barriers to proper use, and monitor treatment adherence. 44 In addition, nurses at all levels of practice are particularly well suited to serve in this role, as nursing care focuses on the promotion of health and well-being, prevention of illness, optimization of health outcomes in the context of medical comorbidities, and on advocating for patients while they are in the care of health care professionals as well as when they are in their community.…”

“…Improved detection and treatment of OSA among veterans with PTSD may improve sleep quality and reduce negative health outcomes associated with OSA, and research indicates that nurses are positioned to play a critical role in those processes. 44 Research is warranted to investigate the relationship between OSA and PTSD symptom severity in samples with greater variation in PTSD symptoms. Most importantly, clinical practice and research should be targeted at conducting confirmatory PSG on patients determined to be at risk for OSA, creating interventions for treatment with CPAP that are tailored to the needs of this population, monitoring adherence to CPAP therapy, and measuring physical and mental health outcomes with CPAP treatment.…”

Implications and Interventions Related to Obstructive Sleep Apnea

“…40 One study validated the STOPBang tool and found it to have a sensitivity of 91.7% and a specificity of 63.4% in identifying subjects at high risk for postoperative complications. 43 Another study found that a score of three on the STOP-Bang questionnaire had a sensitivity of 90% and Table 2 Symptoms and complications or comorbidities of OSA Symptoms Excessive daytime sleepiness 14,29 Excessive or disruptive snoring 14,29 Gasping for air, snorting breath, waking up to breathe 30 Periods of apnea during sleep (reported by bed partners) 29 Morning headaches 29,31 Irritability, personality changes, depression 8,29 Difficulty or poor concentration 8,29 Complications or Comorbidities Pathophysiology or Prevalence Neurocognitive Related to sleep fragmentation or neural damage due to intermittent hypoxia 38 Decreased cognitive function in areas of attention, learning, memory 38,39 Major factor in motor vehicle crashes 39 a high positive predictive value of 85% to identify OSA in obese surgical subjects. 44 Chung and colleagues did another study looking at the predictive probabilities of the STOP-Bang questionnaire based on different scores and concluded that a score less than three rules out the risk for OSA.…”