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Feasibility of electronic sleep disorder screening in healthcare workers of a large healthcare system
Affiliation:1. Sleep Disorders Center, Cleveland Clinic, Cleveland, OH, USA;2. Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA;3. Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA;4. Clinical Integration Employee Health Plan, Cleveland Clinic, Cleveland, OH, USA;5. Office of Professional Staff Affairs, Cleveland Clinic, Cleveland, OH, USA;6. Chief Human Resource Officer, Cleveland Clinic, Cleveland, OH, USA;7. Cerebrovascular Center, Cleveland Clinic, Cleveland, OH, USA
Abstract:Study objectivesMany 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.MethodsAn 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.Results871 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.ConclusionsMany 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  Sleep disorder symptoms  Shift work  Healthcare workers
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