Sleep apnea can have a dramatic impact on your health. It affects your entire body: heart, lungs, brain, and more. This means that it’s closely linked to many serious health conditions.
This has an upside: if we treat sleep apnea, many of these conditions can improve. But it also has a downside: since most people with sleep apnea don’t know they have it, they experience worse symptoms than they need to.
This is the case for epilepsy. We know that sleep apnea is linked to a worse seizure rate, and that treating sleep apnea can help control seizures. But unfortunately few doctors will send their epilepsy patients for screening. Now, though, thanks to researchers at Rutgers University, we see how easy it can be for doctors to get sleep apnea screening for their epilepsy patients.
Using Health Records to Flag for Sleep Tests
The approach that researchers developed is actually very straightforward. It utilizes patients’ electronic health records (EHR) to identify patients who are at high risk for sleep apnea. They identified risk factors that show up in the EHR and can be used to trigger sleep apnea screening. This includes some basic and some advanced factors, such as:
- Being overweight
- Reports of choking or gasping during sleep
- Waking up frequently at night
- Excessive nighttime urination
- Morning headaches
- Waking with dry mouth, sore throat, or chest pain
- Memory and focus problems
- Large neck circumference
- Daytime sleepiness
- Jaw, mouth, and tongue characteristics that narrow the airway
Patients with two or more of these risk factors received a referral for sleep tests. Most of these factors will likely show up in the EHR naturally. Others require just a question or two to elicit, so they don’t substantially burden treating doctors.
The results of the new screening tool were dramatic. Referrals for sleep tests increased more than four times!
In the three months before the new screening tool, only 25 of 346 epilepsy patients (7%) were referred for a sleep test. In the three months after the tool was introduced, 134 of 405 patients (33%) were sent for a sleep test.
The screening tool was a dramatic success in increasing referrals for sleep tests. In the three months before the tool was introduced, only 25 of 346 epilepsy patients were referred for a sleep test, about 7%. After the tool was introduced 134 of 405 screened patients were referred for a sleep test, about 33%.
Some studies suggest that as much as 60% of people with epilepsy may have sleep apnea, so that means even with this screening tool, many people might be slipping by, but it’s still a huge improvement.
Screening Leads to Treatment, and Treatment Helps
The biggest obstacle to successful treatment of sleep apnea is identifying the condition. With about 80% of people who have the condition undiagnosed, we struggle to deliver effective treatment to all the people who will benefit.
Hopefully, your doctor is already screening you for sleep apnea if you have epilepsy or other linked conditions. However, this is a reminder that if your doctor doesn’t bring it up, you should ask about your risk factors for sleep apnea.