Original Investigation

Quality Improvement Intervention to Increase Sleep Apnea Diagnostic Testing After Stroke and Transient Ischemic Attack

JAMA Network Open 10.1001/jamanetworkopen.2025.43385

November 14, 2025 at 11:00 AM EST

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Can a quality improvement intervention improve sleep apnea diagnostic testing among patients who are hospitalized for acute ischemic stroke or transient ischemic attack?In this stepped-wedge cluster randomized trial with 1747 patients at 6 intervention sites and 7454 patients at 30 usual care sites, the 30-day diagnostic testing rate increased from 2.1% (baseline) to 29.1% (21-month active implementation), whereas usual care sites maintained a low rate.These results suggest that sites seeking to implement acute care sleep services can use quality improvement strategies to provide sleep apnea diagnostic testing to patients with acute cerebrovascular disease.

Corresponding Author: Dawn M. Bravata, MD, Richard L. Roudebush VA Medical Center, HSRdawn.bravata2@va.gov).

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