Home respiratory polygraphy for diagnosis of sleep-disordered breathing in heart failure

Abstract

The present study assessed the usefulness of home cardiorespiratory polygraphy as an alternative to overnight polysomnography for the diagnosis of sleepdisordered breathing in heart failure.A total of 75 patients with chronic stable heart failure due to systolic dysfunction (left ventricular ejection fraction f45%) underwent polysomnography at the Virgen del Rocio Hospital and cardiorespiratory polygraphy at home. The two studies were performed in random order and within 30 days. The accuracy of polygraphical findings was determined by sensitivity and specificity obtained by area under the receiver operating characteristics (ROC) curves for apnoea-hypopnoea index (AHI) thresholds of o5, o10 and o15 in the polysomnography.The area under the ROC curve for AHI o5, o10 and o15 was 0.896, 0.907 and 0.862, respectively. The diagnostic accuracy of polygraphy compared with polysomnography ranged 78.6-84%, with sensitivities of 68.4-82.5%, and specificities of 88.6-97.8% for the different AHI thresholds. Altogether, 29 patients had an AHI o10 (central pattern 24, obstructive pattern 5). Sensitivity and specificity of home polygraphy for identifying the sleep-disordered breathing pattern was 100%.These data show that home cardiorespiratory polygraphy has a high sensitivity and specificity for the diagnosis of sleep-disordered breathing associated with heart failure.

Impact of obstructive sleep apnoea on diastolic function

“…However, different studies investigating the ability of polygraphy to detect sleep-disordered breathing showed a high diagnostic accuracy of the portable recording devices [42][43][44]. It is unlikely that the additional information on sleep stages given by polysomnography would profoundly modify the results.…”

Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis

“…[46][47][48]52,55,81,88,89,98,104 In addition, 7 of 14 inlaboratory studies showed a decline in sensitivity and an increase in specificity, and 2 studies showed an increase in area under the ROC curve. 47,48,51,52,58,[61][62][63][65][66][67][69][70][71] We found no significant difference in baseline characteristics between the 2 groups of patients in all 8 studies that reported disease management after the diagnosis by either test.…”

Development and validation of a novel non‐contact monitor of nocturnal respiration for identifying sleep‐disordered breathing in patients with heart failure

“…The performance of SM in detecting and screening SDB in this HF cohort was comparable to other forms of portable/home contact screening devices 14, 15, 16, 17, 18, 19. However, most of these studies only included patients without HF.…”

“…PMs are usually used as an initial diagnostic or screening tool and in selected patients, if the test results are positive, can be used to recommend treatment, while ruling out additional testing if results were negative 16. PMs can be used on an unattended basis, and several studies have reported a high diagnostic accuracy of up to 90% in detecting SDB 17, 18, 19, 20, 21. High study failure rates because of their complex unattended design can, however, result in the need for repeated studies 16.…”