Validation and Clinical Utility of a Simple In‐Home Testing Tool for Sleep‐Disordered Breathing and Arrhythmias in Heart Failure: Results of the Sleep Events, Arrhythmias, and Respiratory Analysis in Congestive Heart Failure (SEARCH) Study

Abraham, William T.; Trupp, Robin J.; Phillips, Barbara; Bourge, Robert C.; Bailey, Brian; Harding, Susan M.; Schofield, Peter M.; Pilsworth, Samantha; Shneerson, John M.; Salvo, Thomas Di; Camuso, Janice; Johnson, Douglas C.; King, Martin; Javaheri, Shahrokh

doi:10.1111/j.1527-5299.2006.05693.x

Cited by 23 publications

(28 citation statements)

References 41 publications

(50 reference statements)

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“…Some of these options include the Epworth Sleepiness Scale, 29 the Berlin questionnaire, 30 overnight oximetry, and devices combining limited respiratory assessment, ECG, and oximetry. 31 Specialized analysis of 24-hour ECG recordings also has been proposed as a possible screening tool. 32 The available options have many shortcomings.…”

Section: Definitions Classifications Diagnosis and Pathophysiologymentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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Section: Definitions Classifications Diagnosis and Pathophysiologymentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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“…Sensitivity, specificity and accuracy at AHI ≥ 5 and AHI ≥ 15 cutoffs were 0.92, 0.52, and 0.73 and 0.67, 0.78, and 0.75 respectively. 119 Unfortunately, the performance of the device in distinguishing central from obstructive events was not evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…117,119,120 A study of 50 patients with stable heart failure (Class 2-4; left ventricular ejection fraction < 40%) evaluated the performance of home oximetry against PSG. 117 Home oximetry was considered positive if the 2% ODI ≥ 10, and the PSG was considered positive if AHI ≥ 15 using a hypopnea criteria that did not require oxygen desaturation or arousal.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Kapur

Auckley

Chowdhuri

et al. 2017

Journal of Clinical Sleep Medicine

2,037

1,498

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Introduction: This guideline establishes clinical practice recommendations for the diagnosis of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines on the evaluation and treatment of sleep-disordered breathing in adults. Methods: The AASM commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use. In addition, the task force adopted foundational recommendations from prior guidelines as "good practice statements", that establish the basis for appropriate and effective diagnosis of OSA. The AASM Board of Directors approved the final recommendations. Recommendations:The following recommendations are intended as a guide for clinicians diagnosing OSA in adults. Under GRADE, a STRONG recommendation is one that clinicians should follow under most circumstances. A WEAK recommendation reflects a lower degree of certainty regarding the outcome and appropriateness of the patient-care strategy for all patients. The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources. Good Practice Statements:Diagnostic testing for OSA should be performed in conjunction with a comprehensive sleep evaluation and adequate follow-up. Polysomnography is the standard diagnostic test for the diagnosis of OSA in adult patients in whom there is a concern for OSA based on a comprehensive sleep evaluation. Recommendations:1. We recommend that clinical tools, questionnaires and prediction algorithms not be used to diagnose OSA in adults, in the absence of polysomnography or home sleep apnea testing. (STRONG) 2. We recommend that polysomnography, or home sleep apnea testing with a technically adequate device, be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. (STRONG) 3. We recommend that if a single home sleep apnea test is negative, inconclusive, or technically inadequate, polysomnography be performed for the diagnosis of OSA. (STRONG) 4. We recommend that polysomnography, rather than home sleep apnea testing, be used for the diagnosis of OSA in patients with significant cardiorespiratory disease, potential respiratory muscle weakness due to neuromuscular condition, awake hypoventilation or suspicion of sleep related hypoventilation, chronic opioid medication use, history of stroke or severe insomnia. (STRONG) 5. We suggest that, if clinically appropriate, a split-night diagnostic protocol, rather than a full-night diagnostic protoc...

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“…3 This may in fact have resulted in a referral bias. Since we used a simple and reliable ambulatory mode of monitoring, 7 we believe that our data represent the true magnitude of CSB in severe chronic symptomatic systolic HF patients. Although CSB has been known for many years to be associated with HF, 8,9 its mechanism, prognostic implications, and possible therapies are still controversial.…”

Section: Discussionmentioning

confidence: 92%

Implications of Cheyne‐Stokes Breathing in Advanced Systolic Heart Failure

Amir

Reisfeld²,

Sberro³

et al. 2010

Clinical Cardiology

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Background: Cheyne-Stokes breathing (CSB) has been associated with heart failure (HF) patients for many years; however, its true prevalence and its prognostic implications are still obscure. Hypothesis: The goal of this study was to investigate the prevalence and the possible prognostic implications of nocturnal CSB in advanced heart failure patients. Methods: We performed single night full polysomonography ambulatory sleep studies in 71 HF patients. We analyzed the patients' sleep studies, clinical and laboratory data, and 6 month mortality. Results: A total of 71 chronic systolic HF patients were analyzed, 60 males, 11 females, age 65±13 years. Mean left ventricular ejection fraction was 27%±11%. Short episodes of CSB (at least 3 min duration) were present in all patients,and mean CSB duration was 1 hour. CSB duration was associatedsignificantly with both high serum levels of N-terminal prohormone brain natriuretic peptide (NT-proBNP) as well as with 6 month mortality. Log CSB time had a significant correlation with log NT-proBNP (r = 0.5, P<.0001). Based on median CSB duration, the Kaplan-Meier survival curve analysis showed significant association with 6 month mortality (P = .03). Conclusions: CSB prevalence in advanced HF patients is higher than previously reported and is associated with increased serum levels of NT-proBNP and higher 6 month mortality. IntroductionCheyne-Stokes breathing (CSB) has been associated with heart failure for more than 2 centuries and yet its incidence and clinical implications are still being debated. Therefore, we conducted ambulatory sleep studies in 71 advanced systolic heart failure (HF) patients in order to assess the prevalence and consequences of CSB. To evaluate the possible prognostic implications of CSB in HF, we analyzed sleep study results, clinical data, laboratory parameters, and followed patient mortality for 6 months.

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Validation and Clinical Utility of a Simple In‐Home Testing Tool for Sleep‐Disordered Breathing and Arrhythmias in Heart Failure: Results of the Sleep Events, Arrhythmias, and Respiratory Analysis in Congestive Heart Failure (SEARCH) Study

Cited by 23 publications

References 41 publications

Sleep Apnea and Cardiovascular Disease

Sleep Apnea and Cardiovascular Disease

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Implications of Cheyne‐Stokes Breathing in Advanced Systolic Heart Failure

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