New Screening Tool Helps Identify Sleep Apnea in Patients With Epilepsy
Because persons with epilepsy are more likely to have obstructive sleep apnea (OSA), the physiologic effects of which can exacerbate seizures, a team of investigators set out to design and implement an electronic tool to screen for OSA in this population.
Despite that detecting and treating OSA in people with epilepsy might help them maintain seizure control, clinicians do not routinely screen for OSA risk factors in these patients. To address this, the researchers conducted a 3-month retrospective chart review of all adult patients with epilepsy evaluated at the epilepsy clinic at Rutgers University Hospital in Newark, New Jersey. The findings were published in Neurology Clinical Practice.1
Based on the findings of their chart review, the researchers developed a screening tool comprising 12 OSA risk factors and embedded the tool in the patients’ electronic health record (EHR). Over the course of 3 months, patients who had 2 or more OSA risk factors were flagged for referral for polysomnography (PSG).
When they compared the number of patients at risk of OSA who were referred for PSG before and after implementation of the EHR alert, the investigators observed a significant increase in the rate of detection of OSA. Before the intervention, 7.23% of patients with epilepsy were referred for PSG, and of those referred, 56% received an OSA diagnosis. After the intervention, 33.1% of patients with epilepsy were referred for PSG, 87% of whom received an OSA diagnosis.
“Placing this mandatory alert for providers to screen for OSA in the EHR markedly increased the detection of at-risk epilepsy patients who should be referred for a sleep study,” said coauthor Xue Ming, a professor of neurology at Rutgers New Jersey Medical School, in a press release.2 “Such screening can lead to early detection and treatment, which will improve the quality of life of patients with epilepsy and OSA,” she said.
—Michael Gerchufsky
References:
1. Mulvey MA, Veerapandiyan A, Marks DA, Ming X. Electronic health record cue identifies epilepsy patients at risk for obstructive sleep apnea [published August 23, 2018]. Neurol Clin Pract. doi:10.1212/CPJ.0000000000000502. http://cp.neurology.org/content/early/2018/08/23/CPJ.0000000000000502. Accessed September 27, 2018.
2. New screening tool can improve the quality of life for epilepsy patients with sleep apnea [press release]. New Brunswick, NJ: Rutgers, the State University of New Jersey; September 27, 2018. https://news.rutgers.edu/research-news/new-screening-tool-can-improve-quality-life-epilepsy-patients-sleep-apnea/20180926. Accessed September 27, 2018.