A Comparison of Two Nights of Ambulatory Sleep Testing in Arrhythmia Patients

Abstract

Introduction Obstructive sleep apnea (OSA) is common and usually underdetected in patients with cardiac arrhythmia. Ambulatory sleep testing may provide an alternative method for detection of OSA under realistic conditions compared to in-laboratory polysomnography. We aimed to (1) determine the sleep architecture in arrhythmia patients; (2) detect differences in sleep parameters between patients with and without OSA; and (3) compare the results of two consecutive nights of unattended ambulatory sleep testing. Methods Consecutive patients with unknown OSA status were recruited from arrhythmia clinics. Patients underwent two consecutive nights of self-applied in-home sleep testing replete with electroencephalogram (EEG) recording. Results One hundred patients were recruited. The mean age was 64 ± 13 years (70% males). OSA (AHI ≥ 5/h) was detected in 85% of patients. In the total sample, the sleep efficiency was reduced, and sleep onset latency was longer compared to a reference population of the same age. In patients with OSA, the sleep efficiency and the percentage of slow wave sleep were reduced; however, the arousal and periodic limb movement indices were increased compared to patients without OSA. The two nights of the ambulatory sleep testing showed consistent results with an excellent test-retest reliability for the AHI (ICC = 0.813). REM latency was shorter during the second night of sleep recording (p = 0.02). There were no other significant differences in the sleep architecture, respiratory indices, and other sleep parameters between the first and the second night of the ambulatory sleep recording. Conclusions There is no significant difference in the respiratory parameters obtained during two consecutive nights of ambulatory sleep testing. Ambulatory studies incorporating EEG may provide a reliable, convenient, and economically efficient method for sleep assessment and there appears to be no significant night-to-night variability.

Night-to-Night Variability of Polysomnography-Derived Physiologic Endotypic Traits in Patients With Moderate to Severe OSA

“… 27 , 28 , 29 , 30 Moreover, our estimate for reliability of the AHI (ICC, 0.82) is in line with previous analyses (ICC, 0.75-0.81). 31 , 32 , 33 Correlation of nightly differences between AHI and time in the supine position have been reported 30 that we were not able to reproduce, although we observed high variability in the supine position. Our study, investigating consecutive nights and variability over a span of up to 4 weeks, adds important information on previous evaluations of variability in polysomnography-derived endotypic trait measurements that evaluated variability within one night or changes over multiple years.…”

High prevalence of obstructive sleep apnea in a surgical aortic valve replacement cohort: an observational study

“…Mean sleep continuity values suggested impaired sleep although, except for sleep latency, the level of impairment was broadly consistent with a first night of PSG among healthy older adults in this age range [ 21 ]. The prolonged REM latency could be related to a first-night effect with this device [ 22 ]. There was, however, a shift to lighter sleep stages.…”

Snoring and Obstructive Sleep Apnea in Children with Class II Skeletal Malocclusion: Efficacy of Twin Block Management

“…This results in autonomic system activation supported by the following findings: increased urinary catecholamines, decreased pulse transit time, and alterations in blood pressure regulation in OSA. Right ventricular dysfunction has also been demonstrated [27]. Cardiac benefits of treatment for OSA have been shown.…”