With no prior policy in place about the impact of obstructive sleep apnea on overall health, an Austin sleep specialist took steps to ideate, research, write, and secure support for a resolution the Texas Medical Association’s House of Delegates enshrined into policy at the most recent TexMed.
A first-time resolution author, Vani Vallabhaneni, MD, initially shared her thoughts on sleep health’s impact on maternal health at the Women Physicians Section meeting during 2024’s TexMed. Existing American Medical Association policy encourages research and education on the condition but stops short of recommending screening.
Dr. Vallabhaneni thus made her first foray into policymaking, authoring a resolution encouraging screening for obstructive sleep apnea and advocating for associated physician payment. Fellow section members helped refine and strengthen the policy.
Along the resolution’s path to policy, it garnered support from Dr. Vallabhaneni’s home Travis County Medical Society, for which she serves as alternate delegate to the House of Delegates.
“Sleep plays a big role in our overall health,” she said. “Untreated sleep apnea and poor sleep quality can have a great impact on physical, emotional, and mental health. It is closely related to cardiovascular risk [and] can increase the risk for high blood pressure, stroke, heart disease, and poor control of diabetes and dementia.”
As a modifiable risk factor, Dr. Vallabhaneni says treatment for obstructive sleep apnea can “reduce the risk of maternal mortality and morbidity, improve outcomes for both mother and the fetus, and reduce hospitalization and overall cost.”
As the TMA policy “supports obstructive sleep apnea screening to reduce negative outcomes,” Dr. Vallabhaneni recommends physicians in any specialty consider implementing the General Practice Sleep Scale (GPSS) for its sensitivity and specificity.
The scale assigns a score of low, moderate, or high risk of obstructive sleep apnea based on a patient’s responses across nine dimensions. Dr. Vallabhaneni calls GPSS “a game changer,” and suggests including the screening questionnaire with a patient’s medical history or intake.
Dr. Vallabhaneni lauds the policy’s inclusive approach to screening, irrespective of pregnancy status, as well as the workings of TMA that allow physicians to “put their heads together, work together, and pass these policies and also look at old policies.”
Eschewing “practicing medicine the way it was probably written 20, 30 years ago ... Change comes only when we educate other physicians and implement it,” Dr. Vallabhaneni said.
“Grassroots advocacy, I think, is the heart of medicine.”
Jessica Ridge
Reporter, Division of Communications and Marketing
(512) 370-1395