Mobile Health for Central Sleep Apnea Screening Among Patients With Stable Heart Failure: Single-Cohort, Open, Prospective Trial

• Published in: JMIR cardio Vol. 3; no. 1; p. e9894
• Main Authors: Treskes, Roderick Willem, Maan, Arie C, Verwey, Harriette Florence, Schot, Robert, Beeres, Saskia Lambertha Maria Anna, Tops, Laurens F, Van Der Velde, Enno Tjeerd, Schalij, Martin Jan, Slats, Annelies Margaretha
• Format: Journal Article
• Language: English
• Published: Toronto JMIR Publications 19.03.2019
• Subjects: Cardiology; Heart failure; Hospitals; Life expectancy; Original Paper; Outpatient care facilities; Patients; Polygraphs; Pulse oximetry; Quality of life; Sensors; Sleep apnea; Sleep disorders; Smartphones; Stroke
• ISSN: 2561-1011; 2561-1011
• DOI: 10.2196/cardio.9894

Background: Polysomnography is the gold standard for detection of central sleep apnea in patients with stable heart failure. However, this procedure is costly, time consuming, and a burden to the patient and therefore unsuitable as a screening method. An electronic health (eHealth) app to measure overnight oximetry may be an acceptable screening alternative, as it can be automatically analyzed and is less burdensome to patients. Objective: This study aimed to assess whether overnight pulse oximetry using a smartphone-compatible oximeter can be used to detect central sleep apnea in a population with stable heart failure. Methods: A total of 26 patients with stable heart failure underwent one night of both a polygraph examination and overnight saturation using a smartphone-compatible oximeter. The primary endpoint was agreement between the oxygen desaturation index (ODI) above or below 15 on the smartphone-compatible oximeter and the diagnosis of the polygraph. Results: The median age of patients was 66.4 (interquartile range, 62-71) years and 92% were men. The median body mass index was 27.1 (interquartile range, 24.4-30.8) kg/m2. Two patients were excluded due to incomplete data, and two other patients were excluded because they could not use a smartphone. Seven patients had central sleep apnea, and 6 patients had obstructive sleep apnea. Of the 7 (of 22, 32%) patients with central sleep apnea that were included in the analysis, 3 (13%) had an ODI≥15. Of all patients without central sleep apnea, 8 (36%) had an ODI<15. The McNemar test yielded a P value of .55. Conclusions: Oxygen desaturation measured by this smartphone-compatible oximeter is a weak predictor of central sleep apnea in patients with stable heart failure.