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

Roderick Willem Treskes; Arie C Maan; Harriette Florence Verwey; Robert Schot; Saskia Lambertha Maria Anna Beeres; Laurens F Tops; Enno Tjeerd Van Der Velde; Martin Jan Schalij; Annelies Margaretha Slats

doi:10.2196/cardio.9894

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

JMIR Cardio. 2019 Mar 19;3(1):e9894. doi: 10.2196/cardio.9894.

Authors

Roderick Willem Treskes¹, Arie C Maan¹, Harriette Florence Verwey¹, Robert Schot², Saskia Lambertha Maria Anna Beeres¹, Laurens F Tops¹, Enno Tjeerd Van Der Velde¹, Martin Jan Schalij¹, Annelies Margaretha Slats²

Affiliations

¹ Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
² Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands.

Abstract

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.

Keywords: central sleep apnea; heart failure; mobile health; mobile phone; prevention; screening.

©Roderick Willem Treskes, Arie C Maan, Harriette Florence Verwey, Robert Schot, Saskia Lambertha Maria Anna Beeres, Laurens F Tops, Enno Tjeerd Van Der Velde, Martin Jan Schalij, Annelies Margaretha Slats. Originally published in JMIR Cardio (http://cardio.jmir.org), 19.03.2019.