A WVU sleep doctor recommends clinicians identify and screen hospitalized patients who are at-risk of sleep disorders, especially rural patients who lack healthcare access.
RT’s Three Key Takeaways:
- High Rates of Undiagnosed Sleep Apnea: Despite its strong links to cardiovascular disease, 50–77% of hospitalized patients with sleep apnea remain undiagnosed, according to WVU sleep expert Dr. Sunil Sharma.
- In-Hospital Screening Opportunity: Hospitalization offers a critical chance to identify and treat sleep apnea, especially in high-risk patients with conditions like heart failure, stroke, or obesity, and in populations with limited access to outpatient care.
- Improved Outcomes with Early Detection: Screening and initiating PAP therapy during hospitalization can lead to better survival, stroke recovery, cardiovascular health, and lower readmission rates, while reducing overall healthcare costs.
Despite growing evidence that sleep apnea contributes to cardiovascular disease and can even make it worse, about 50% to 77% of hospitalized patients remain undiagnosed, according to a West Virginia University expert on sleep disorders.
Working with colleagues in the American Academy of Sleep Medicine, Dr. Sunil Sharma, N. Leroy Lapp Professor and chief of the Division of Pulmonary Critical Care and Sleep Medicine in the WVU School of Medicine, developed guidelines that can reduce deaths and improve quality of life for those with sleep apnea. He will present those guidelines in his role as chair of the 2026 symposium of the American College of Chest Physicians.
“There are two high-risk groups that warrant screening and evaluation for sleep apnea during hospitalization,” said Dr. Sunil Sharma, N. Leroy Lapp Professor and chief of the Division of Pulmonary Critical Care and Sleep Medicine, WVU School of Medicine. “The first is patients with comorbidities strongly associated with sleep-disordered breathing, such as heart failure, atrial fibrillation, chronic obstructive pulmonary disease, stroke and pulmonary hypertension.
“The second is patients who screen positive for classic signs and symptoms of disordered sleep — obesity, snoring, hypertension, excessive daytime sleepiness and fatigue,” he added.
The practice may help reduce healthcare disparities. According to Sunil, patients in rural Appalachia often face significant barriers to accessing care, with hospitalization serving as their first and sometimes only point of contact with the medical system. He says its the ideal time to screen for sleep disorders.
“Identifying sleep-disordered breathing, providing education and initiating treatment during hospitalization is a chance to offer therapy they would not otherwise receive,” Sunil says.
He recommends clinicians assess at-risk patients using a validated sleep apnea questionnaire, which could potentially be followed by a comprehensive assessment and objective screening by the hospital sleep medicine service, and may include overnight high-resolution pulse oximetry or a Type 3 home sleep apnea testing.
“Randomized trials show improved survival in patients who are identified during hospitalization and start positive airway pressure therapy, or PAP therapy. Other positive patient outcomes from the screenings include better stroke recovery, reduced cardiovascular complications, fewer hospital readmissions and significant improvement in excessive daytime sleepiness — even decreased cost of care for the healthcare system.”
Source: WVU/WVU School of Medicine
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