Efficacy of portable sleep monitoring device in diagnosing central sleep apnea in patients with congestive heart failure

Pi-Hung Tung; Meng-Jer Hsieh; Li-Pang Chuang; Shih-Wei Lin; Kuo-Chun Hung; Cheng-Hui Lu; Wen-Chen Lee; Han-Chung Hu; Ming-Shien Wen; Ning-Hung Chen

doi:10.3389/fneur.2022.1043413

Efficacy of portable sleep monitoring device in diagnosing central sleep apnea in patients with congestive heart failure

Front Neurol. 2022 Dec 21:13:1043413. doi: 10.3389/fneur.2022.1043413. eCollection 2022.

Authors

Pi-Hung Tung¹, Meng-Jer Hsieh^{1

2}, Li-Pang Chuang^{1

2

3}, Shih-Wei Lin^{1

2}, Kuo-Chun Hung⁴, Cheng-Hui Lu⁴, Wen-Chen Lee⁴, Han-Chung Hu^{1

2}, Ming-Shien Wen^{3

4}, Ning-Hung Chen^{1

2

5}

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Sleep Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
² Department of Respiratory Therapy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
³ School of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁴ Division of Cardiology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
⁵ School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan.

Abstract

Introduction: Central sleep apnea (CSA) is a common and serious comorbidity mainly occurring in patients with heart failure (HF), which tends to be underdiagnosed and has not been widely studied. Overnight polysomnography (PSG) is the gold standard for diagnosing CSA; however, the time and expense of the procedure limit its applicability. Portable monitoring (PM) devices are convenient and easy to use; however, they have not been widely studied as to their effectiveness in detecting CSA in patients with HF. In the current study, we examined the diagnostic value of PM as a screening tool to identify instances of CSA among patients with HF.

Methods: A total of 22 patients under stable heart failure conditions with an ejection fraction of <50% were enrolled. All patients underwent PM and overnight PSG within a narrow time frame. The measurements of the apnea-hypopnea index (AHI), hypopnea index (HI), central apnea index (CAI), and obstructive apnea index (OAI) obtained from PSG, automatic scoring, and manual scoring of PM were recorded. The results obtained from PSG and those from PM (automatic and manual scoring) were compared to assess the accuracy of PM.

Results: Among the patients, CSA in 11 patients was found by PSG. The AHI measurements performed using manual scoring of PM showed a significant correlation with those performed using PSG (r = 0.69; P = 0.01). Nonetheless, mean AHI measurements showed statistically significant differences between PSG and automatic scoring of PM (40.0 vs. 23.7 events/hour, respectively; P < 0.001), as well as between automatic and manual scoring of PM (23.7 vs. 29.5 events/hour; P < 0.001). Central sleep apnea was detected by PM; however, the results were easily misread as obstructive apnea, particularly in automatic scoring.

Conclusion: PM devices could be used to identify instances of central sleep apnea among patients with HF. The results from PM were well-correlated with standard PSG results, and manual scoring was preferable to automated scoring.

Keywords: central sleep apnea; heart failure; polysomnography; portable monitor device; sleep apnea.