Background / Aims:
Obstructive Sleep Apnoea (OSA) is recognised as an independent risk factor for stroke(1). Patients with severe OSA have approximately double the risk of major cardiovascular events/stroke(2). International clinical guidelines(3,4) recommend routine OSA screening following stroke or transient ischaemic attack (TIA) - Australasian guidelines do not. This service improvement project aimed to increase OSA screening rates, improve detection of patients at risk and facilitate sleep service referrals in a Public Hospital setting.
Methods:
Using a pre-/post- service evaluation, we compared OSA screening over two 2-month periods 1 year apart (November-December 2024/2025). In 2024 patients were screened only on clinical suspicion. In 2025 we aimed to screen ALL sequential acute admissions to our stroke service (ischaemic stroke, intracerebral haemorrhage and TIA). Eligible patients were assessed using validated tools - STOP-Bang and the Epworth Sleepiness Scale (ESS).
Results:
In 2024, 67 eligible patients were identified with 3 (4.5%) completing OSA screening. In 2025, 70 eligible patients were identified, with 57 (81%) screened following implementation of the new approach. Among the patients screened in 2025, 44 (77%) were classified as intermediate risk for OSA (STOP-Bang score >2) and going on to complete ESS screening. 17 patients went on to be referred to the sleep service (38%; 24%) total eligible admitted patients.
Conclusion:
Screening all eligible admissions was feasible. 30% of eligible patients screened were referred on to our local sleep service - however 12 were subsequently declined (below service capacity threshold). 2 have so far completed sleep studies confirming severe OSA.