Obstructive sleep apnea occurs when an individual’s airway collapses during sleep, often leading to reduced oxygen in the body and placing stress to the heart and brain. In July 2015, Centegra launched one of the first programs nationwide designed to identify patients with this sleep disorder and schedule them for a sleep study prior to leaving the hospital.
Since inception, this intervention lowers readmission rates and also shortens length of stay.
“Undiagnosed obstructive sleep apnea can make certain existing health conditions worse,” said Andrea Ramberg, BA, RPSGT, CCSH, Centegra Sleep Health Navigator who helped launch the program and continues to oversee it. “The good news is, it can be prevented in almost every case.”
Sleep Apnea Linked to Serious Conditions, Billions in Spending
Obstructive sleep apnea or OSA has been linked to many diseases and conditions, such as:
- Congestive heart failure: An estimated 40 to 50 percent of patients with congestive heart failure have sleep-disordered breathing
- Hypertension: An estimated 30 to 50 percent of patients with hypertension have OSA
- Type 2 diabetes: The direct and indirect cost attributable to diabetes in recent years was $174 billion.
- Stroke: Patients presenting with stroke or transient ischemic attack are three to four times more likely to have OSA.
It is estimated that increased healthcare spending to treat undiagnosed obstructive sleep apnea is between $1,950 and $3,899, per patient, per year. Nationwide, these combined costs add up to billions of dollars annually.
The STOP BANG Questionnaire
Ramberg screens patients at the Huntley and McHenry Centegra hospital locations, where she triages patients identified during an admission assessment — called the STOP BANG Questionnaire. The questionnaire asks patients the following:
- Do you SNORE loudly?
- Do you feel TIRED during the daytime?
- Has anyone OBSERVED you stop breathing during your sleep?
- Do you have or are you being treated for high blood PRESSURE?
- Is your BMI more than 35kg/m2?
- AGE over 50 years old?
- NECK circumference > 16 inches?
- GENDER: Male?
Once high-risk patients are identified, Ramberg consults with physicians to help develop a care plan for them. Often a continuous positive airway pressure or CPAP machine is prescribed if the patient tests positive for sleep apnea. CPAP is a device with a mask and hose that a patient wears when sleeping to help keep the airway open and provides a continuous flow of air.
“The program is not only helping patients get better and avoid having to return to the hospital, it is supporting value-based healthcare. By treating a patient’s sleep disorder, we are improving the efficiency of our care by improving the patient’s quality of life,” Ramberg said.