Photoplethysmographic Signal to Screen Sleep-Disordered Breathing in Hospitalized Heart Failure Patients

Sharma, Sunil; Mather, Paul; Efird, Jimmy T.; Kahn, Daron; Cheema, Mohammed; Rubin, Sharon; Reeves, Gordon R.; Bonita, Raphael; Malloy, Raymond; Whellan, David J.

doi:10.1016/j.jchf.2015.04.015

Cited by 26 publications

(18 citation statements)

References 28 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Introductionmentioning

confidence: 90%

“…Furthermore, a low-cost screening protocol was effectively able to detect underlying SDB. 8 We showed that the oxygen desaturation index (ODI) as determined by high-resolution photoplethysmography can reliably detect SDB; there was a high concordance with the outpatient apnea-hypopnea index (AHI) as determined by polysomnography.8 Recent data also suggest that early detection and initiation of therapy for SDB in hospitalized patients may reduce readmissions in patients with congestive heart failure (CHF). patients with SDB on positive airway pressure therapy (PAP) in the outpatient setting ranges from 29% to 84%.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Adherence to Positive Airway Pressure Therapy in Hospitalized Patients with Decompensated Heart Failure and Sleep-Disordered Breathing

Sharma

Chakraborty

Chowdhury

et al. 2016

Journal of Clinical Sleep Medicine

Self Cite

View full text Add to dashboard Cite

Study Objectives: Sleep-disordered breathing (SDB) has been implicated as a risk factor for the development of several adverse cardiovascular outcomes, but can be mitigated with positive airway pressure therapy (PAP). The nonadherence of patients with SDB on PAP in the outpatient setting ranges from 29% to 84%. However, adherence of PAP in patients with congestive heart failure (CHF) admitted for decompensated CHF and in whom SDB has been diagnosed in the hospital setting is not known. We hypothesized that despite a diagnosis in the hospital, the compliance of these patients with PAP therapy would not be different from the well-established adherence in patients with a diagnosis and treatment in the outpatient setting. Methods: The study was a retrospective analysis of patients admitted to an academic tertiary care hospital between March 2013 and February 2014. Patients presenting with decompensated CHF were screened and high-risk patients were started on PAP empirically and advised to undergo a postdischarge polysomnogram. Compliance of the patients with PAP was tracked for over 12 mo. Data from a similar outpatient group who underwent polysomnography during the study period were also reviewed. Results: Ninety-one patients underwent polysomnograhy postdischarge. Of the 91 patients, 81 patients agreed to PAP therapy. One patient was excluded as data were missing. The adherence at 3, 6, and 12 mo was 52%, 37%, and 27%, which was not significantly different than an outpatient control group. There was a trend for those with CHF plus SDB and compliant with PAP to have a higher probability of survival compared to those who were noncompliant (p = 0.07). Conclusions: Adherence of patients to PAP therapy in whom a SDB diagnosis is made during acute hospitalization for heart failure is comparable to patients in the ambulatory setting. Adherence in first 3 mo is a predictive marker for improved survival trend. Keywords: sleep-disordered breathing, congestive heart failure, hospitalized patients, adherence to therapy, outcome Citation: Sharma S, Chakraborty A, Chowdhury A, Mukhtar U, Willes L, Quan SF. Adherence to positive airway pressure therapy in hospitalized patients with decompensated heart failure and sleep-disordered breathing. J Clin Sleep Med 2016;12(12):1615-1621. I NTRO DUCTI O NSleep-disordered breathing (SDB) is a common condition with a prevalence reported to be as high as 24%.1 It has been implicated as a risk factor for the development of several adverse cardiovascular outcomes.2-5 Despite this association and recent data on sudden deaths, 6 the practice of sleep medicine remains largely confined to the outpatient setting. Patients admitted to the hospital are rarely screened for SDB despite significant co-morbid conditions. Our recent data on obese hospitalized patients showed a high prevalence of undetected SDB in patients hospitalized on the medical service. Furthermore, a low-cost screening protocol was effectively able to detect underlying SDB. 8 We showed that the oxygen desaturation index (ODI) as de...

show abstract

Section: Introductionmentioning

confidence: 90%

mentioning

confidence: 99%

Adherence to Positive Airway Pressure Therapy in Hospitalized Patients with Decompensated Heart Failure and Sleep-Disordered Breathing

Sharma

Chakraborty

Chowdhury

et al. 2016

Journal of Clinical Sleep Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…Of 5062 patients included in the final database, 1161 patients have been included in prior publications. 9,11,12,16,17 The Thomas Jefferson University Institutional Review Board approved the study.…”

Section: Methodsmentioning

confidence: 99%

Recognition and Treatment of Sleep-Disordered Breathing in Obese Hospitalized Patients May Improve Survival. The HoSMed Database

Sharma

Mukhtar

Kelly

et al. 2017

The American Journal of Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…As noted in the figure, the ratio of direct consults as opposed to screen prompted consults significantly improved over time. The highresolution Plethysmography (HRPO) however, may be a game changer in implementing a cost effective strategy for effective screening of SDB in CHF patients [12].…”

Section: Editorialmentioning

confidence: 99%

Detection of Sleep Disordered Breathing in Patients Hospitalized with Congestive Heart Failure

Sharma¹,

Mather²

2015

J Sleep Disord Ther

Self Cite

View full text Add to dashboard Cite

Photoplethysmographic Signal to Screen Sleep-Disordered Breathing in Hospitalized Heart Failure Patients

Abstract: Screening hospitalized patients with heart failure using targeted inpatient ODI identifies a cohort of patients with a high prevalence of SDB. Our screening strategy provides a potentially cost-effective method for early detection and treatment of SDB.

Cited by 26 publications

References 28 publications

Adherence to Positive Airway Pressure Therapy in Hospitalized Patients with Decompensated Heart Failure and Sleep-Disordered Breathing

Adherence to Positive Airway Pressure Therapy in Hospitalized Patients with Decompensated Heart Failure and Sleep-Disordered Breathing

Recognition and Treatment of Sleep-Disordered Breathing in Obese Hospitalized Patients May Improve Survival. The HoSMed Database

Detection of Sleep Disordered Breathing in Patients Hospitalized with Congestive Heart Failure

Contact Info

Product

Resources

About