Lyons M Melanie, Auckley Dennis H, Mokhlesi Babak, Charchaflieh Jean G, Myers John V, Yilmaz Meltem, Williams Lisa M, Khan Meena S, Card Elizabeth B, Gelfand Brian J, Pilla Michael A, Loftsgard Theodore O, Sawyer Amy M, Matura Lea Ann, Carlucci Melissa A, Sahni Ashima S, Glaser Kathleen M, Al Ghussain Dana E, Brock Guy N, Bhatt Nitin Y, Magalang Ulysses J, Rosen Ilene M, Gali Bhargavi
Division of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine, Wexner Medical Center, The Ohio State University, Columbus, Ohio.
Division of Pulmonary, Critical Care and Sleep Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
J Clin Sleep Med. 2025 May 1;21(5):765-773. doi: 10.5664/jcsm.11528.
Physicians-in-training (residents, fellows) and advanced practice providers (APPs) receive limited education on sleep disorders, including obstructive sleep apnea (OSA). They often assess patients first. We aimed to understand their views on OSA and screening for OSA in the perioperative period.
Electronic-mail surveys were sent to physicians-in-training and APPs, in 5 categories of practice (anesthesiology, internal medicine, family medicine, obstetrics/gynecology/gynecologic oncology, and surgery) at 9 major institutions. Cochran-Mantel-Haenszel tests evaluated associations between participant characteristics (clinical role, physician years of training, APP years of practice, categories of practice) and survey responses (perception of OSA, perioperative risk factor, screening/managing of perioperative OSA) stratified by institution. False discovery rate (FDR) adjustment accounted for multiple comparisons (FDR-adjusted- values) of associations between multiple characteristics and a given response. Breslow-Day tests evaluated the homogeneity of odds ratios from Cochran-Mantel-Haenszel tests.
We received 2,236/6,724 (33.3%) responses. Almost all (97%) agreed OSA represents a risk factor for perioperative complications. Many (37.9%) were unaware which screening tool was used at their institution, with differences by clinical role (FDR-adjusted- < .001), with APPs reporting not knowing more than residents and fellows, and across category of practice (FDR-adjusted- < .001). While 66.5% routinely asked perioperative patients about signs/symptoms of OSA, 33.5% did not. There were differences by clinical role (FDR-adjusted- < .001), as APPs reported asking about OSA more frequently than residents/fellows; and, by category of practice (FDR-adjusted- < .001) as anesthesia and medical specialties reported asking about OSA more than surgical services. Importantly, approximately half of the respondents in surgery (48%) and obstetrics/gynecology/gynecologic oncology (46%) reported not routinely asking. Differences also existed by physician postgraduate year clinical training (FDR-adjusted- = .005) with those with higher postgraduate year reporting they asked about OSA more often.
Significant differences exist in screening by clinical roles and categories of care. This highlights the importance of improving provider education on the role of OSA in perioperative risk assessment and patient care.
Lyons MM, Auckley DH, Mokhlesi B, et al. Physicians-in-training and advanced practice providers perceptions in managing perioperative obstructive sleep apnea: a multi-institutional survey. . 2025;21(5):765-773.
住院医师和专科培训医师以及高级执业医疗人员接受的睡眠障碍相关教育有限，其中包括阻塞性睡眠呼吸暂停（OSA）。他们通常首先对患者进行评估。我们旨在了解他们对OSA以及围手术期OSA筛查的看法。
向9家主要机构中5类执业领域（麻醉学、内科、家庭医学、妇产科/妇科肿瘤学和外科）的住院医师和专科培训医师以及高级执业医疗人员发送电子邮件调查问卷。 Cochr an - Mantel - Haenszel检验评估了参与者特征（临床角色、医师培训年限、高级执业医疗人员执业年限、执业领域类别）与按机构分层的调查回复（对OSA的认知、围手术期风险因素、围手术期OSA的筛查/管理）之间的关联。错误发现率（FDR）调整用于处理多个特征与给定回复之间关联的多重比较（FDR调整值）。Breslow - Day检验评估了 Cochr an - Mantel - Haenszel检验中优势比的同质性。
我们收到了2236份回复，占6724份问卷的33.3%。几乎所有受访者（97%）都认为OSA是围手术期并发症的一个风险因素。许多人（37.9%）不知道他们所在机构使用的是哪种筛查工具，这在临床角色方面存在差异（FDR调整后P <.001），高级执业医疗人员表示不知道的情况比住院医师和专科培训医师更多，并且在执业领域类别方面也存在差异（FDR调整后P <.001）。虽然66.5%的人会常规询问围手术期患者OSA的体征/症状，但33.5%的人不会。这在临床角色方面存在差异（FDR调整后P <.001），因为高级执业医疗人员报告比住院医师/专科培训医师更频繁地询问OSA；并且在执业领域类别方面也存在差异（FDR调整后P <.001），麻醉和医学专科报告比外科服务更频繁地询问OSA。重要的是，外科（48%）和妇产科/妇科肿瘤学（46%）中约一半的受访者报告不会常规询问。医师研究生临床培训年份也存在差异（FDR调整后P =.005），研究生年级较高的人报告他们更频繁地询问OSA。
在筛查方面，临床角色和护理类别存在显著差异。这凸显了改善医疗人员关于OSA在围手术期风险评估和患者护理中作用的教育的重要性。
Lyons MM, Auckley DH, Mokhlesi B等。住院医师和高级执业医疗人员对围手术期阻塞性睡眠呼吸暂停管理的看法：一项多机构调查。. 2025;21(5):765 - 773。
