Feasibility of electronic sleep disorder screening in healthcare workers of a large healthcare system

Abstract

Study objectives: Many healthcare workers live with sleep disorders and may be unaware of their condition. We aimed to ascertain sleep disorder symptoms including high-risk obstructive sleep apnea (hrOSA), significant insomnia, and excessive daytime sleepiness (EDS) by work shift in a sample of healthcare workers. We aim to inform the development of a mobile application for sleep disorder screening and electronically-delivered follow-up recommendations.

Methods: An initial survey, including the Epworth Sleepiness Scale (ESS) for EDS, Insomnia Severity Scale (ISI) for insomnia, and STOP questionnaire for hrOSA, was completed by healthcare workers at the Cleveland Clinic. A follow-up survey sent ∼3-6 months after screening assessed perceptions of the utility of screening and subsequent actions taken by those with abnormal scores.

Results: 871 of 2851 (30.7%) workers who participated had abnormal ESS scores, with a significantly greater portion of night shift workers with abnormal scores compared to day or evening shift workers (p < 0.001). 27.5% of all workers had moderate to severe insomnia symptoms, with higher percentages of moderate or severe scores in evening and night shift workers (p < 0.001). 36.9% of workers had hrOSA, and of those previously diagnosed with obstructive sleep apnea (OSA) and using positive airway pressure therapy, over 90% reported treatment adherence (≥4 h per night). At follow-up, 92% of 484 respondents believed that sleep screening was valuable, with most taking some action after receiving abnormal results and over a quarter seeking sleep center treatment.

Conclusions: Many healthcare workers, especially shift workers, experience sleep disorder symptoms, and our findings suggest that electronic sleep disorder symptom screening is feasible.

Keywords: Electronic screening; Health screening; Healthcare workers; Shift work; Sleep disorder symptoms.