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

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)