Does the presence of arrhythmias detected by home sleep apnea testing correlate with obstructive sleep apnea severity in cardiology patients?
In a cardiology-based screening program, patients with arrhythmias detected on home sleep apnea testing had a significantly higher burden of moderate to severe obstructive sleep apnea.
Abstract Introduction An estimated 80% of patients with obstructive sleep apnea (OSA) remain undiagnosed. Our previous work established a high prevalence of OSA within our OSA screening program based in cardiology practices using the WatchPAT device. We describe updated outcomes from this program, specifically evaluating WatchPAT’s arrhythmia detection feature, which can identify atrial fibrillation (AF) and premature beats to flag at-risk patients. Methods We conducted a retrospective analysis of 858 cardiology patients who underwent OSA screening with the Watchpat home sleep apnea test from 1/2024-1/2025. 846 patients were included for analysis. Results were analyzed for the overall cohort and stratified by WatchPAT arrythmia detection (AD) status (+AD and –AD). Comorbidity prevalence was analyzed with a rank sum test, and apnea-hypopnea index (AHI) differences were analyzed with a t-test. Results OSA was detected in 74.62% of patients screened, with 39.89% diagnosed as moderate or severe. +AD average age was 64 years and BMI was 32 kg/m2. –AD average age was 58 years and BMI was 32 kg/m2. Comorbidities in each group were as follows: hypertension (+AD 69%, -AD 64.95%), AF (+AD 56.07%, -AD 17.59%, p 0.0001), other arrhythmias (+AD 16.82%, -AD 12.58%), stroke (+AD 5.61%, -AD 2.98%), myocardial infarction (+AD 0.93%, -AD 2.44%), heart failure (+AD 7.48%, -AD 5.55%), PCI/CABG (+AD 14.02%, -AD 5.55%), and coronary artery disease (+AD 19.63%, -AD 15.70%). The OSA severity distribution in +AD was normal (18.1%), mild (28.71%), moderate (26.73%), and severe (25.74%) and in -AD was normal (26.30%), mild (35.69%), moderate (23.70%), and severe (14.31%). +AD mean AHI was 24.36 and –AD mean AHI was 14.79 (p 0.0001). Notably, +AD had a higher prevalence of cardiac comorbidities and a higher degree of OSA (moderate to severe OSA incidence of 52.47% +AD, 38.00% in –AD) (p 0.0018). Conclusion These results reinforce the high prevalence of OSA, particularly moderate to severe OSA, in this cardiology-based OSA screening program. The higher prevalence of moderate to severe OSA in +AD patients suggests a possible association between arrhythmias and higher OSA disease burden. WatchPAT’s arrhythmia detection flagged undiagnosed arrhythmias in 43.93% of +AD patients, highlighting its potential to identify the need for further cardiac evaluation. Support (if any)
Basist et al. (Fri,) studied this question.