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The Utility of Home Sleep Apnea Testing in the Advanced Heart Failure Populations
Sandra A Carey1, Johanna S van Zyl2, Sarah Williams1
1Center for Advanced Heart and Lung Disease, Baylor University Medical Center, Baylor Scott & White Health, Dallas, Texas.
The American Journal of Cardiology
|January 9, 2023
Summary
Home sleep apnea testing (HSAT) effectively identifies sleep apnea in advanced heart failure patients. This method is crucial for managing co-morbidities like heart disease and hypertension.
Area of Science:
- Cardiology
- Sleep Medicine
- Medical Devices
Background:
- Sleep disorders are linked to serious health risks including heart disease, hypertension, obesity, and diabetes.
- Access to traditional polysomnography is often limited, a challenge exacerbated by the COVID-19 pandemic.
- Home sleep apnea testing (HSAT) presents a practical alternative for diagnosing sleep disorders.
Purpose of the Study:
- To describe and evaluate a home sleep apnea testing (HSAT) protocol for patients with advanced heart failure (HF).
- To assess the feasibility and diagnostic yield of HSAT in this specific patient population.
Main Methods:
- An observational analysis of 135 patients with advanced heart failure (HF) and heart transplant (HT) between 2019-2021.
- Patients completed the STOP-Bang sleep survey and underwent a validated HSAT (WatchPAT, ZOLL-Itamar).
- Statistical analysis included multivariable linear regression to compare apnea-hypopnea index between groups.
Main Results:
- HSAT was successful in 97.6% of patients, with 91.1% testing positive for sleep apnea.
- Obstructive sleep apnea accounted for 91% of cases, with 63% being moderate to severe.
- The apnea hypopnea index was significantly lower in heart transplant patients compared to heart failure patients (p=0.046).
Conclusions:
- Sleep apnea is highly prevalent in patients with advanced heart failure, often accompanied by significant co-morbidities.
- HSAT is a feasible, effective, and valuable tool for screening and diagnosing sleep apnea in this high-risk population.
- The findings highlight the importance of addressing sleep apnea in advanced HF management.
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