LAUSR

Obstructive sleep apnea (OSA) is a common sleep disorder with obesity being a significant risk factor. Undiagnosed OSA increases the risk of complications at the time of surgery and those with severe OSA at increased risk of post-operative MI, stroke, arrhythmias, and death as well as readmission and acuity of post-operative care. Because of this, our Bariatric program screens all patients pre-operatively with a STOP-BANG questionnaire. Those with severe OSA (AHI or REI > 29) require pre-treatment with PAP therapy until compliance is reached before the patient is eligible for surgery. This study examines those that screened at high risk for OSA with a STOP-BANG score > 2 to see if there was a specific cutoff that predicts those having severe OSA in order to better expedite sleep testing as recent supply chain issues have greatly impacted the timeliness of care for these patients. During the months of January to June 2022, demographic, clinical and sleep data was collected on all new patients being evaluated by the Bariatric Sleep clinic for use in quality assessment. Bariatric patients with BMI < 50 and no significant cardiac or pulmonary disease were tested using HSAT, whereas those who met one or more of the above comorbidities underwent PSG. There were 143 bariatrics patients who screened as “high risk” for OSA with a STOP-BANG score > 2 during these 6 months and 112 (78%) of them completed sleep testing. There were 25 patients (22%) with severe OSA. The average STOP-BANG score for those with severe OSA was 4.3. Women averaged 4.0 (range 3-6), while men averaged higher at 4.8 (range 4-6) likely reflecting that male gender garners an extra point with the STOP-BANG. STOP-BANG scores increased with age: 20s x=3, 30s x=4.1, 40s x=4.4, 50s x=4.6, 60s x=6. There was no specific cutoff for the STOP-BANG score that predicted severe OSA in our bariatric patients to help our program triage those most at surgical risk in order to place them in an expedited sleep testing and PAP therapy pathway. Overall, STOP-BANG scores were impacted by gender and age.