Master's Theses or Doctor of Nursing Practice

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Department

Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Abstract

Obstructive sleep apnea (OSA) is prevalent in 55% of patients with hypertension; however, the condition is underdiagnosed (Fatureto-Borges et al., 2018). Around 80-90% of people with OSA are undiagnosed, which puts them at an increased risk for cardiovascular disease, hypertension, and all-cause mortality (Chen et al., 2021). The Epworth Sleepiness Scale (ESS) and Stop-Bang questionnaires are sensitive and reliable screening questionnaires for OSA. Evidence-based screening questionnaires were administered at routine follow-up visits for hypertension to increase the diagnosis of OSA. Patients who tested “positive” (a score of eight and above for the ESS or three and above for the Stop-Bang) discussed a sleep study with their provider. A Gantt chart (Appendix A) shows the specific timeline of the project. A strengths, weaknesses, opportunities, and threats (SWOT) analysis helped determine if the project aligned with the clinic's needs. Evidence-based research and the Plan-Do-Study-Act helped develop this project. Over three months, 169 patients with hypertension at a Midwest primary care clinic were screened for OSA; 78% of these patients had a “positive” screening (n=131). Of these 131 patients, 57% (n=75) received a home sleep study order. During the three months, 23 patients completed the sleep study; 83% (n=19) tested positive for OSA (p=0.0039). Screening patients with hypertension for OSA did result in increased rates of OSA. This change in the practice process should remain a standard of care in primary care clinics.

Keywords

Obstructive sleep apnea, hypertension, Epworth Sleepiness Scale, Stop-Bang

Advisor

Dr. Jenny Manry

Date of Award

Spring 2025

Document Type

DNP Project

Rights

© The Author

Additional Files
2025_DNP_Schroer, D poster.pdf (373 kB)
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