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Awareness for OSA diagnosis in a tertiary cardiology center: a temporal survey.
Despite the advancements on the evidence pointing the high frequency and
potential cardiovascular (CV) impact of Obstructive Sleep Apnea (OSA), the sub diagnosis
and overall acceptance of OSA among cardiologists may vary. This scenario may be
exacerbated by the poor accuracy of sleep questionnaires in the Cardiology setting and the
neutral CV results of OSA treatment from recent randomized controlled trials (RCTs) in
patients with high CV risk.
the awareness and relevance of OSA as a CV risk factor decreased overtime.
We applied a survey for staff physicians and physicians in training
(residents) from the Cardiology Division at the Heart Institute (InCor). This survey was
applied twice for the medical staff and once for each residence team that rotated in 2014
and 2019 in our Institution and comprised questions addressing the availability of sleep
medicine classes during medical graduation, importance of OSA as a CV risk factor, number
of consultations per month vs number of diagnostic suspicious of OSA as well as knowledge
and clinical applicability of OSA screening methods (Berlin Questionnaire).
We applied the survey twice for 77 physicians. Of them 32.5% were staff
physicians and 67.5% were residents. On average, the Cardiologists reported a mean
number of consultations in the last month of 153±89 and 176±118 patients per month but
only a mean number of suspected diagnoses of OSA of 6±9 and 6±8 in 2014 and 2019,
respectively. Interestingly, the vast majority of them considered OSA a CV risk factor and
the percentages did not significantly change overtime (from 97.4% in 2014 to 94.7% in
2019, P=0.44). Regarding the questions about sleep, we found that 14.3% of them asked
about snore in 2014 vs 76.3% of them in 2019 (p< 0.001). In contrast, we observed a
significant decrease in using OSA screening questionnaires (from 80.5% in 2014 to 23.7% in
2019, P< 0.001). We did not find any difference through the years regarding their self evaluation about knowledge of sleep medicine
the vast majority of the Cardiologists consider
OSA as a CV risk factor but the sleep medicine field still remains largely unknown among
them. We observed a significant decrease in the use of sleep questionnaires in the last five
years (probably reflecting evidence showing low accuracy of these tolls in screening OSA in
the Cardiology setting).
Obstructive sleep apnea, cardiology, risk factors
Sofia Fontanello Furlan, Lucas E Costa, Viktor Sinkunas, Rosana S C Alves, Maria Carolina Pintão, Bianca A Campos, Geraldo Lorenzi-Filho, Luciano Fereira Drager