Home Sleep Apnoea Testing: Advances, Challenges and Considerations in Heart Failure

Sleep-disordered breathing (SDB), including obstructive and central sleep apnoea, is highly prevalent in heart failure (HF) and contributes to adverse outcomes. In-lab polysomnography is the diagnostic gold standard, but is limited by cost and accessibility. Home sleep apnoea testing (HSAT) offers an accessible alternative, but its accuracy in HF populations remains under evaluation. This review explores HSAT technologies, including peripheral arterial tonometry and respiratory inductance plethysmography, and their ability to detect SDB subtypes. Differentiating obstructive sleep apnoea from central sleep apnoea in HF is complicated by overlapping physiology, comorbidities, and fluid status. With further refinement, HSAT may improve access to timely diagnosis and management of SDB in HF, potentially enhancing outcomes in this high-risk population.