Pornthira Mutirangura, Tamas Alexy, Sophia E Airhart, Jenna E Kay, Antonio C Christophy, Dominic Emerson, David Raymer, Andrew W Shaffer, Anthony W Castleberry, Marshall P Hyden, Karol Mudy, Benjamin Sun, Snigdha Pusalavidyasagar
{"title":"连续流LVAD患者的家庭睡眠呼吸暂停测试：可行吗？","authors":"Pornthira Mutirangura, Tamas Alexy, Sophia E Airhart, Jenna E Kay, Antonio C Christophy, Dominic Emerson, David Raymer, Andrew W Shaffer, Anthony W Castleberry, Marshall P Hyden, Karol Mudy, Benjamin Sun, Snigdha Pusalavidyasagar","doi":"10.5664/jcsm.11606","DOIUrl":null,"url":null,"abstract":"<p><strong>Study objectives: </strong>The incidence of sleep-related breathing disorder (SRBD) remains unclear in patients with a continuous flow left ventricular assist device (LVAD). Polysomnography (PSG) remains the gold standard for diagnosis, but logistical challenges make home sleep apnea testing (HSAT) a more practical alternative. WatchPat has failed to accurately diagnose SRBD in this population. In contrast, the NOX-T3 utilizes more channels to monitor physiological variables potentially offering improved diagnostic accuracy. Therefore, we aimed to validate the NOX-T3 versus PSG in detecting SRBD in patients with a durable LVAD.</p><p><strong>Methods: </strong>This is a single-center, prospective, observational pilot study. Patients with LVAD who screened positive on the STOP-BANG questionnaire were referred to sleep clinic. Patients recommended for PSG by a sleep physician underwent PSG and NOX-T3 simultaneously. Apnea-hypopnea index (AHI) with the PSG and the respiratory event index (REI) using the NOX-T3 were compared as well as time spent with oxygen (O<sub>2</sub>) saturation ≤ 88% using Spearman's correlation. P values less than 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Ten patients (8 males, 2 females) were enrolled. The average age was 54±15 years and 9 were implanted with a HeartMate3 device. There was a strong correlation between the AHI obtained from NOX T3 and PSG (R<sup>2</sup>=0.984) but the time spent with O<sub>2</sub> saturation ≤88% correlated poorly (r=0.168). The tests identified the same 3 patients meeting the diagnostic criteria for obstructive sleep apnea.</p><p><strong>Conclusions: </strong>Our results suggest that the NOX-T3 HSAT device is a useful tool in the comprehensive evaluation of SRBD in patients with LVAD.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Home sleep apnea testing in patients with continuous flow LVAD: is it feasible?\",\"authors\":\"Pornthira Mutirangura, Tamas Alexy, Sophia E Airhart, Jenna E Kay, Antonio C Christophy, Dominic Emerson, David Raymer, Andrew W Shaffer, Anthony W Castleberry, Marshall P Hyden, Karol Mudy, Benjamin Sun, Snigdha Pusalavidyasagar\",\"doi\":\"10.5664/jcsm.11606\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study objectives: </strong>The incidence of sleep-related breathing disorder (SRBD) remains unclear in patients with a continuous flow left ventricular assist device (LVAD). Polysomnography (PSG) remains the gold standard for diagnosis, but logistical challenges make home sleep apnea testing (HSAT) a more practical alternative. WatchPat has failed to accurately diagnose SRBD in this population. In contrast, the NOX-T3 utilizes more channels to monitor physiological variables potentially offering improved diagnostic accuracy. Therefore, we aimed to validate the NOX-T3 versus PSG in detecting SRBD in patients with a durable LVAD.</p><p><strong>Methods: </strong>This is a single-center, prospective, observational pilot study. Patients with LVAD who screened positive on the STOP-BANG questionnaire were referred to sleep clinic. Patients recommended for PSG by a sleep physician underwent PSG and NOX-T3 simultaneously. Apnea-hypopnea index (AHI) with the PSG and the respiratory event index (REI) using the NOX-T3 were compared as well as time spent with oxygen (O<sub>2</sub>) saturation ≤ 88% using Spearman's correlation. P values less than 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Ten patients (8 males, 2 females) were enrolled. The average age was 54±15 years and 9 were implanted with a HeartMate3 device. There was a strong correlation between the AHI obtained from NOX T3 and PSG (R<sup>2</sup>=0.984) but the time spent with O<sub>2</sub> saturation ≤88% correlated poorly (r=0.168). The tests identified the same 3 patients meeting the diagnostic criteria for obstructive sleep apnea.</p><p><strong>Conclusions: </strong>Our results suggest that the NOX-T3 HSAT device is a useful tool in the comprehensive evaluation of SRBD in patients with LVAD.</p>\",\"PeriodicalId\":50233,\"journal\":{\"name\":\"Journal of Clinical Sleep Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-03-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Sleep Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5664/jcsm.11606\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Sleep Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5664/jcsm.11606","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Home sleep apnea testing in patients with continuous flow LVAD: is it feasible?
Study objectives: The incidence of sleep-related breathing disorder (SRBD) remains unclear in patients with a continuous flow left ventricular assist device (LVAD). Polysomnography (PSG) remains the gold standard for diagnosis, but logistical challenges make home sleep apnea testing (HSAT) a more practical alternative. WatchPat has failed to accurately diagnose SRBD in this population. In contrast, the NOX-T3 utilizes more channels to monitor physiological variables potentially offering improved diagnostic accuracy. Therefore, we aimed to validate the NOX-T3 versus PSG in detecting SRBD in patients with a durable LVAD.
Methods: This is a single-center, prospective, observational pilot study. Patients with LVAD who screened positive on the STOP-BANG questionnaire were referred to sleep clinic. Patients recommended for PSG by a sleep physician underwent PSG and NOX-T3 simultaneously. Apnea-hypopnea index (AHI) with the PSG and the respiratory event index (REI) using the NOX-T3 were compared as well as time spent with oxygen (O2) saturation ≤ 88% using Spearman's correlation. P values less than 0.05 were considered statistically significant.
Results: Ten patients (8 males, 2 females) were enrolled. The average age was 54±15 years and 9 were implanted with a HeartMate3 device. There was a strong correlation between the AHI obtained from NOX T3 and PSG (R2=0.984) but the time spent with O2 saturation ≤88% correlated poorly (r=0.168). The tests identified the same 3 patients meeting the diagnostic criteria for obstructive sleep apnea.
Conclusions: Our results suggest that the NOX-T3 HSAT device is a useful tool in the comprehensive evaluation of SRBD in patients with LVAD.
期刊介绍：
Journal of Clinical Sleep Medicine focuses on clinical sleep medicine. Its emphasis is publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the journal will publish proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine.
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