Improving Obstructive Sleep Apnea Screening in Patients with Atrial Fibrillation (SLEEP -AF Project)

Abstract Background Obstructive sleep apnea (OSA) contributes to negative cardiac remodeling and worsened atrial fibrillation (AF) outcomes, yet screening remains suboptimal despite guideline recommendations. Objective This quality improvement project aimed to improve screening, diagnosis, and treatment of OSA in AF patients. Methods A pre- and post-intervention design evaluated an OSA screening protocol with home sleep apnea testing (HSAT) and positive airway pressure (PAP) initiation for new AF patients in the electrophysiology (EP) clinic over 3 months. Patients were screened with an OSA questionnaire; those with elevated scores underwent HSAT coordinated by the EP clinic. Patients with moderate to severe OSA were initiated on PAP therapy. Results The sample included 141 patients (pre, n = 81; post, n = 60) with no significant baseline differences. The OSA screening rate increased from 49.3% to 96.7% (p < .001), and the sleep study completion rate increased from 2% to 25% over 3 months (p < .001). Mean time to diagnosis decreased from 151.5 to 22 days. 15 patients were diagnosed with OSA; 3 initiated PAP therapy. Conclusion This protocol with HSAT and PAP delivered by the EP clinic improved OSA detection and treatment. Further study is needed to understand the impact on patient outcomes.