Recommended assessment and management of sleep disordered breathing in patients with atrial fibrillation, hypertension and heart failure: Taiwan Society of Cardiology/Taiwan Society of sleep Medicine/Taiwan Society of pulmonary and Critical Care Medicine joint consensus statement

Pei-Lin Lee; Yen-Wen Wu; Hao-Min Cheng; Cheng-Yi Wang; Li-Pang Chuang; Chou-Han Lin; Liang-Wen Hang; Chih-Chieh Yu; Chung-Lieh Hung; Ching-Lung Liu; Kun-Ta Chou; Mao-Chang Su; Kai-Hung Cheng; Chun-Yao Huang; Charles Jia-Yin Hou; Kuo-Liang Chiu

doi:10.1016/j.jfma.2023.08.024

Recommended assessment and management of sleep disordered breathing in patients with atrial fibrillation, hypertension and heart failure: Taiwan Society of Cardiology/Taiwan Society of sleep Medicine/Taiwan Society of pulmonary and Critical Care Medicine joint consensus statement

J Formos Med Assoc. 2024 Feb;123(2):159-178. doi: 10.1016/j.jfma.2023.08.024. Epub 2023 Sep 14.

Authors

Pei-Lin Lee¹, Yen-Wen Wu², Hao-Min Cheng³, Cheng-Yi Wang⁴, Li-Pang Chuang⁵, Chou-Han Lin⁶, Liang-Wen Hang⁷, Chih-Chieh Yu⁸, Chung-Lieh Hung⁹, Ching-Lung Liu¹⁰, Kun-Ta Chou¹¹, Mao-Chang Su¹², Kai-Hung Cheng¹³, Chun-Yao Huang¹⁴, Charles Jia-Yin Hou¹⁵, Kuo-Liang Chiu¹⁶

Affiliations

¹ Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
² Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
³ Division of Faculty Development, Taipei Veterans General Hospital, Taipei, Taiwan; PhD Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan.
⁴ Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
⁵ Sleep Center, Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Tauyan, Taiwan.
⁶ Division of Respirology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
⁷ School of Nursing & Graduate Institute of Nursing, China Medical University, Taichung, Taiwan; Sleep Medicine Center, China Medical University Hospital, Taichung, Taiwan.
⁸ School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁹ Cardiovascular Center, MacKay Memorial Hospital, Taipei, Taiwan; Institute of Biomedical Sciences, Mackay Medical College, Taipei, Taiwan.
¹⁰ Division of Chest, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Medical College, New Taipei City, Taiwan.
¹¹ School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Clinical Respiratory Physiology, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
¹² Sleep Center, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan.
¹³ Kao-Ho Hospital, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
¹⁴ Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
¹⁵ Cardiovascular Center, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Medical College, New Taipei City, Taiwan. Electronic address: jiayinhou@gmail.com.
¹⁶ Division of Chest Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan. Electronic address: kuoliang.chiu@gmail.com.

PMID: 37714768
DOI: 10.1016/j.jfma.2023.08.024

Abstract

Sleep disordered breathing (SDB) is highly prevalent and may be linked to cardiovascular disease in a bidirectional manner. The Taiwan Society of Cardiology, Taiwan Society of Sleep Medicine and Taiwan Society of Pulmonary and Critical Care Medicine established a task force of experts to evaluate the evidence regarding the assessment and management of SDB in patients with atrial fibrillation (AF), hypertension and heart failure with reduced ejection fraction (HFrEF). The GRADE process was used to assess the evidence associated with 15 formulated questions. The task force developed recommendations and determined strength (Strong, Weak) and direction (For, Against) based on the quality of evidence, balance of benefits and harms, patient values and preferences, and resource use. The resulting 11 recommendations are intended to guide clinicians in determining which the specific patient-care strategy should be utilized by clinicians based on the needs of individual patients.

Keywords: Atrial fibrillation; Continuous positive airway pressure; Heart failure; Hypertension; Sleep disordered breathing.

Publication types

Practice Guideline

MeSH terms

Atrial Fibrillation* / complications
Atrial Fibrillation* / diagnosis
Atrial Fibrillation* / therapy
Cardiology*
Critical Care
Heart Failure* / complications
Heart Failure* / therapy
Humans
Hypertension* / complications
Hypertension* / diagnosis
Sleep
Sleep Apnea Syndromes* / diagnosis
Sleep Apnea Syndromes* / therapy
Stroke Volume
Taiwan