Study Shows the Benefits of Proper Diagnosis and Therapy with Positive Airway Pressure Devices.
The growing recognition of the influence of sleep-disordered breathing (SDB), especially obstructive sleep apnea (OSA), on cardiovascular disease is reﬂected in new guidelines for the management of atrial fibrillation (AF), which recommend screening for SDB.
Although several clinical symptom-based questionnaires have been proposed to help identify patients for formal assessment for SDB, these tools have proven to be disappointing. They include self-reported daytime sleepiness in detection of SDB in patients with AF and the Epworth Sleepiness Scale (ESS).
An enlightening editorial by P. Timothy Pollak and Marcus Povitz titled “Asleep at the Switch? Are We Failing to Recognize Obstructive Sleep Apnea in Patients with Atrial Fibrillation and Heart Failure?” was published in the November 2019 issue of the Canadian Journal of Cardiology.
The article discusses how the failure to diagnose mild SDB increases its chances of progressing to more severe forms. The article also notes that when properly diagnosed, many patients can improve their arrhythmia outcomes by starting therapy with nocturnal positive airway pressure devices (PAP).
For these reasons, more AF patients should be referred for diagnostic sleep testing. In addition, the study authors recommend that further research be conducted to examine the benefit of CPAP therapy in patients with difficult-to-control AF who have SDB.
To read the full journal article, click here.
Pollak PT, Povitz M. Asleep at the switch? are we failing to recognize obstructive sleep apnea in patients with atrial fibrillation and heart failure? Canadian Journal of Cardiology. 2019;35(11):1426-1429. doi:10.1016/j.cjca.2019.09.005
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