Live Recordings (Sleep Medicine Trends 2026)-03 Don’t Sleep on It

Video Transcription

Video Summary

The speaker presents new AASM/ASM guidelines on managing obstructive sleep apnea (OSA) in hospitalized patients and how to implement a hospital sleep medicine program. OSA is common but underdiagnosed (about 80% undetected), and in hospitals its effects may worsen due to acute illness and high cardiovascular risk. The talk links OSA to autonomic instability (“dive reflex”), proposing this contributes to nighttime rapid response events; inpatient PAP therapy reduced such events.<br /><br />Evidence shows high prevalence of sleep-disordered breathing among inpatients (often 70–80%). A structured inpatient screening/referral program dramatically increased post-discharge sleep testing and found most cases were moderate–severe. Studies cited suggest PAP adherence after inpatient identification reduces readmissions and ED visits for heart failure and COPD, and observational data suggest possible mortality benefit.<br /><br />The guideline recommendations include: screen high-risk inpatients, initiate inpatient PAP rather than no treatment, ensure sleep-medicine consultation access, and create an active discharge plan to secure timely diagnosis/follow-up. A “good practice” statement urges continuing PAP for patients already diagnosed.<br /><br />Implementation tips include partnering with respiratory therapy, securing executive leadership support, automated two-tier screening (e.g., BMI flag + STOP-Bang followed by oximetry/HST), targeting severe cases for inpatient treatment, and improving follow-up (e.g., navigators, telemedicine, home sleep studies for nursing-home patients).

Keywords

obstructive sleep apnea (OSA)

AASM/ASM inpatient guidelines

hospital sleep medicine program

inpatient screening and referral (STOP-Bang)

positive airway pressure (PAP) therapy

sleep-disordered breathing prevalence in hospitalized patients

readmission reduction (heart failure/COPD)

discharge planning and post-discharge sleep testing