The use of portable sleep monitoring may be an accurate way to diagnose sleep apnea in hospitalized patients with heart failure (HF) and may help promote early initiation of treatment, according to the results of a study published in Chest.
The researchers sought to examine whether portable sleep monitoring with respiratory polygraphy could diagnose sleep apnea accurately in patients who are hospitalized with decompensated HF. Hospitalized patients with HF underwent concurrent respiratory polygraphy and unattended polysomnography. Using standard criteria, the results of both recordings were scored for obstructive and central disordered breathing events in a blinded fashion and the apnea-hypopnea index (AHI) was ascertained.
A total of 53 patients comprised the study sample, 47% of whom were women. The mean age of the participants was 59 years. Sleep apnea severity was evaluated based on the following commonly used cut-points: none (<5 events per hour), mild (5.0 to 14.9 events per hour), moderate (15.0 to 29.9 events per hour), and severe (≥30.0 events per hour).
The correlation coefficient for the overall-AHI across the 2 diagnostic methods was 0.94 (95% CI, 0.89-0.96). The average difference in the AHI between the 2 methods for assessing sleep apnea was 3.6 events per hour (95% CI, –6.0 to –1.2). When central and obstructive AHI values were compared, a strong concordance was demonstrated between the 2 methods, with correlation coefficients of 0.98 (95% CI, 0.96-0.99) and 0.91 (95% CI, 0.84-0.95), respectively, reported.
The investigators concluded that the determination of specific therapy for sleep apnea once a diagnosis has been made should be based on the totality of clinical data and may require an in-laboratory assessment to establish the most ideal means of treatment. These study results could potentially improve the designs of healthcare paradigms and care management plans for patients with sleep apnea hospitalized with HF.
Aurora RN, Patil SP, Punjabi NM. Portable sleep monitoring for diagnosing sleep apnea in hospitalized patients with heart failure [published online April 20, 2018]. Chest. doi:10.1016/j.chest.2018.04.008