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Published on: December 6, 2016
Improving obstructive sleep apnea screening in patients with atrial fibrillation (SLEEP-AF project)
T Jennifer Walker1, Tracy Vernon Platt2, Suja Davis2
1University of North Carolina Health, Chapel Hill, North Carolina.
Background:
Obstructive sleep apnea (OSA) contributes to negative cardiac remodeling and worsened atrial fibrillation (AF) outcomes, yet screening remains suboptimal despite guideline recommendations.
Objective:
This quality improvement project aimed to improve screening, diagnosis, and treatment of OSA in patients with AF.
Methods:
A pre- and postintervention design evaluated an OSA screening protocol with home sleep apnea testing (HSAT) and positive airway pressure (PAP) initiation for new patients with AF in the electrophysiology (EP) clinic over 3 months. Patients were screened with an OSA questionnaire; those with elevated scores underwent HSAT coordinated by the EP clinic. Patients with moderate to severe OSA were initiated on PAP therapy.
Results:
The sample included 141 patients (pre, n = 81; post, n = 60) with no significant baseline differences. The OSA screening rate increased from 49.3% to 96.7% (P < .001), and the sleep study completion rate increased from 2% to 25% over 3 months (P < .001). The mean time to diagnosis decreased from 151.5 to 22 days. 15 patients were diagnosed as having OSA; 3 initiated PAP therapy.
Conclusion:
This protocol with HSAT and PAP delivered by the EP clinic improved OSA detection and treatment. Further study is needed to understand the impact on patient outcomes.
