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Academic cardiac electrophysiologists’ perspectives on sleep apnea care

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Obstructive sleep apnea syndrome (OSAS) is an important, modifiable risk factor in the pathophysiology of arrhythmias including atrial fibrillation (AF). The purpose of the study was to evaluate cardiac electrophysiologists’ (EPs) perception of OSAS.

Methods

We designed a 27-item online Likert scale–based survey instrument entailing several domains: (1) relevance of OSAS in EP practice, (2) OSAS screening and diagnosis, (3) perception on treatments for OSAS, (4) opinion on the OSAS care model. The survey was distributed to 89 academic EP programs in the USA and Canada. While the survey instrument questions refer to the term sleep apnea (SA), our discussion of the diagnosis, management, and research on the sleep disorder is more accurately described with the term OSAS.

Results

A total of 105 cardiac electrophysiologists from 49 institutions responded over a 9-month period. The majority of respondents agreed that sleep apnea (SA) is a major concern in their practice (94%). However, 42% reported insufficient education on SA during training. Many (58%) agreed that they would be comfortable managing SA themselves with proper training and education and 66% agreed cardiac electrophysiologists should become more involved in management. Half of EPs (53%) were not satisfied with the sleep specialist referral process. Additionally, a majority (86%) agreed that trained advanced practice providers should be able to assess and manage SA. Time constraints, lack of knowledge, and the referral process are identified as major barriers to EPs becoming more involved in SA care.

Conclusions

We found that OSAS is widely recognized as a major concern for EP. However, incorporation of OSAS care in training and routine practice lags. Barriers to increased involvement include time constraints and education. This study can serve as an impetus for innovation in the cardiology OSAS care model.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank the Center for Survey Research at the University of Virginia for their assistance with the survey construction. We acknowledge Dr. Robert Bache, University of Minnesota Professor Emeritus, and Dr. John DiMarco, University of Virginia Professor Emeritus, for their advice on the study.

Funding

This research was supported by ResMed Foundation Public Awareness program and NIH R21HL140432 and R21HL150502.

Author information

Authors and Affiliations

  1. Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA

    Michael Dong

  2. Department of Medicine, University of Washington, Seattle, WA, USA

    Linda Liu

  3. Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, USA

    Kenneth C. Bilchick

  4. Department of Cardiovascular Medicine, William Beaumont Oakland University School of Medicine, Rochester, MI, USA

    Nishaki K. Mehta

  5. Division of Cardiology, Chung-Ang University, Seoul, South Korea

    Yoon-Sik Cho

  6. Aultman Deuble Heart and Vascular Hospital, Canton, OH, USA

    Ryan J. Koene

  7. Division of Cardiology, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA

    Selcuk Adabag

  8. Division of Cardiology, Department of Medicine, Queen’s University, Kingston, ON, Canada

    Adrian Baranchuk

  9. Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA

    Neal A. Chatterjee & Younghoon Kwon

  10. Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA

    T. Jared Bunch

  11. Division of Cardiology, Department of Medicine, Columbia University, New York City, NY, USA

    Hirad Yarmohammadi

  12. Harborview Medical Center, Division of Cardiology, University of Washington, 325 9th Avenue, Box 359748, Seattle, WA, 98104-2499, USA

    Younghoon Kwon

Authors
  1. Michael Dong
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  2. Linda Liu
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  3. Kenneth C. Bilchick
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  4. Nishaki K. Mehta
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  5. Yoon-Sik Cho
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  6. Ryan J. Koene
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  7. Selcuk Adabag
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  8. Adrian Baranchuk
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  9. Neal A. Chatterjee
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  10. T. Jared Bunch
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  11. Hirad Yarmohammadi
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  12. Younghoon Kwon
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Corresponding author

Correspondence to Younghoon Kwon.

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Ethics approval

The manuscript does not contain clinical studies or patient data. This is a survey study. The University of Virginia Research Ethics Committee has confirmed that no ethical approval is required.

Conflict of interest

The authors declare they have no conflict of interest. Dr. Neal Chatterjee: disclosures include speakers board for Abbott and Sanofi. Dr. Jared Bunch: disclosures include research grants for Altathera, Boehringer Ingelheim, and Boston Scientific. There are no personal compensation or honorarium received from these companies.

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Dong, M., Liu, L., Bilchick, K.C. et al. Academic cardiac electrophysiologists’ perspectives on sleep apnea care. Sleep Breath 27, 561–568 (2023). https://doi.org/10.1007/s11325-022-02636-9

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  • DOI: https://doi.org/10.1007/s11325-022-02636-9

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