https://orcid.org/0000-0001-6429-8115
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Abstract
Background
Early diagnosis and treatment of sleep apnea in patients with atrial fibrillation (AF) is critical. The WatchPAT (WP) device was shown to be accurate for the diagnosis of sleep apnea; however, studies using the WatchPAT device have thus far excluded patients with arrhythmias due to the potential effect of arrhythmias on the peripheral arterial tonometry (PAT) amplitude and pulse rate changes.
Purpose
To examine the accuracy of the WP in detecting sleep apnea in patients with AF.
Patients and Methods
Patients with AF underwent simultaneous WP and PSG studies in 11 sleep centers. PSG scoring was blinded to the automatically analyzed WP data.
Results
A total of 101 patients with AF (70 males) were recruited. Forty-six had AF episodes during the overnight sleep study. A significant correlation was found between the PSG-derived AHI and the WP- derived AHI (r=0.80, p<0.0001). There was a good agreement between PSG-derived AHI and WP-derived AHI (mean difference of AHI: -0.02±13.2). Using a threshold of AHI ≥15 per hour of sleep, the sensitivity and specificity of the WP were 0.88 and 0.63, respectively. The overall accuracy in sleep staging between WP and PSG was 62% with Kappa agreement of 0.42.
Conclusion
WP can detect sleep apnea events in patients with AF. AF should not be an exclusion criterion for using the device. This finding may be of even greater importance in the era of the COVID19 epidemic, when sleep labs were closed and most studies were home based.
Disclosure
Thomas Penzel reports grants from Itamar, Cidelec, and Resmed and grants and personal fees from Philips, and Löwenstein Medical, during the conduct of the study; and is a shareholder of Advanced Sleep Research, Somnico, and The Siestagroup, outside the submitted work. Giora Pillar reports grants from Itamar Medical, during the conduct of the study. The authors report no other potential conflicts of interest in this work.