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Utility of home sleep apnea testing devices in patients with cardiac conditions—critical manual interpretation of the raw data is important

  • Mukesh KapoorEmail author
Sleep Breathing Physiology and Disorders • Letter to the Editors
  • 7 Downloads

A recent study [1] published in this journal utilized the ApneaLink (ResMed) home sleep apnea testing (HSAT) device with a single channel (nasal airflow) to screen adult patients with stable chronic heart failure for sleep apnea. By design, the authors did not aim to distinguish between central sleep apnea (CSA) and obstructive sleep apnea (OSA). The data from the device was autoscored. HSAT using the above device and polysomnography (PSG) was performed simultaneously on the same night. The authors reported a “strong and significant correlation” between the apnea hypopnea index (AHI) determined by ApneaLink and the AHI determined by PSG. Based on the above results, the authors suggest that ApneaLink could be used to identify heart failure patients with sleep apnea and thus in their opinion, relegate the need for a PSG in such patients, which they feel will provide a more cost-effective and timely diagnosis.

The premise and conclusions of this article are noteworthy. However, several...

Notes

Compliance with ethical standards

Off label and investigational use

Not applicable.

Conflict of interest

The author declares no conflict of interest.

Disclosures

None.

References

  1. 1.
    Araujo I, Marques F, Andre S, Araujo M, Marques S, Ferreira R, Moniz P, Proenca M, Borrego P, Fonseca C (2018) Diagnosis of sleep apnea in patients with stable chronic heart failure using a portable sleep test diagnostic device. Sleep Breath 22(3):749–755.  https://doi.org/10.1007/s11325-017-1607-1 CrossRefGoogle Scholar
  2. 2.
    Herrscher TE, Akre H, Overland B, Sandvik L, Westheim AS (2011) High prevalence of sleep apnea in heart failure outpatients: even in patients with preserved systolic function. J Card Fail 17(5):420–425.  https://doi.org/10.1016/j.cardfail.2011.01.013 CrossRefGoogle Scholar
  3. 3.
    Strotmann J, Fox H, Bitter T, Sauzet O, Horstkotte D, Oldenburg O (2018) Characteristics of sleep-disordered breathing in patients with atrial fibrillation and preserved left ventricular ejection fraction. Clin Res Cardiol 107(2):120–129.  https://doi.org/10.1007/s00392-017-1163-5 CrossRefGoogle Scholar
  4. 4.
    Ratz D, Wiitala W, Badr MS, Burns J, Chowdhuri S (2018) Correlates and consequences of central sleep apnea in a national sample of US veterans. Sleep 41(9).  https://doi.org/10.1093/sleep/zsy058
  5. 5.
    Badr MS (2018) Central sleep apnea: Risk factors, clinical presentation, and diagnosis. Chervin RD, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com (Accessed on 10 Dec 2018.)
  6. 6.
    Aurora RN, Patil SP, Punjabi NM (2018) Portable sleep monitoring for diagnosing sleep apnea in hospitalized patients with heart failure. Chest 154(1):91–98.  https://doi.org/10.1016/j.chest.2018.04.008 CrossRefGoogle Scholar
  7. 7.
    Kim RD, Kapur VK, Redline-Bruch J, Rueschman M, Auckley DH, Benca RM, Foldvary-Schafer NR, Iber C, Zee PC, Rosen CL, Redline S, Ramsey SD (2015) An economic evaluation of home versus laboratory-based diagnosis of obstructive sleep apnea. Sleep 38(7):1027–1037.  https://doi.org/10.5665/sleep.4804 CrossRefGoogle Scholar
  8. 8.
    Stewart SA, Skomro R, Reid J, Penz E, Fenton M, Gjevre J, Cotton D (2015) Improvement in obstructive sleep apnea diagnosis and management wait times: a retrospective analysis of home management pathway for obstructive sleep apnea. Can Respir J 22(3):167–170.  https://doi.org/10.1155/2015/516580 CrossRefGoogle Scholar
  9. 9.
    Masa JF, Duran-Cantolla J, Capote F, Cabello M, Abad J, Garcia-Rio F, Ferrer A, Mayos M, Gonzalez-Mangado N, de la Pena M, Aizpuru F, Barbe F, Montserrat JM, Spanish Sleep N, Larrateguy LD, de Castro JR, Garcia-Ledesma E, Utrabo I, Corral J, Martinez-Null C, Egea C, Cancelo L, Garcia-Diaz E, Carmona-Bernal C, Sanchez-Armengol A, Fortuna AM, Miralda RM, Troncoso MF, Monica G, Martinez-Martinez M, Cantalejo O, Pierola J, Vigil L, Embid C, Del Mar Centelles M, Prieto TR, Rojo B, Vanesa L (2014) Effectiveness of home single-channel nasal pressure for sleep apnea diagnosis. Sleep 37(12):1953–1961.  https://doi.org/10.5665/sleep.4248 CrossRefGoogle Scholar
  10. 10.
    Jurado Gamez B, Redel Montero J, Munoz Cabrera L, Fernandez Marin MC, Munoz Gomariz E, Martin Perez MA, Cosano Povedano A (2007) Cost-effectiveness and degree of satisfaction with home sleep monitoring in patients with symptoms of sleep apnea. Arch Bronconeumol 43(11):605–610CrossRefGoogle Scholar
  11. 11.
    Reiter J, Zleik B, Bazalakova M, Mehta P, Thomas RJ (2016) Residual events during use of CPAP: prevalence, predictors, and detection accuracy. J Clin Sleep Med 12(8):1153–1158.  https://doi.org/10.5664/jcsm.6056 CrossRefGoogle Scholar
  12. 12.
    Goldstein CA, Karnib H, Williams K, Virk Z, Shamim-Uzzaman A (2018) The utility of home sleep apnea tests in patients with low versus high pre-test probability for moderate to severe OSA. Sleep Breathing 22(3):641–651.  https://doi.org/10.1007/s11325-017-1594-2 CrossRefGoogle Scholar
  13. 13.
    Bianchi MT, Goparaju B (2017) Potential underestimation of sleep apnea severity by at-home kits: rescoring in-laboratory polysomnography without sleep staging. J Clin Sleep Med 13(4):551–555.  https://doi.org/10.5664/jcsm.6540 CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Sleep Disorders CenterRochester Regional HealthRochesterUSA

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