Utility of Screening for Obstructive Sleep Apnea in Cardiac Rehabilitation

Abstract

More than three quarters of patients in diabetes and CRPs scored high on ≥1 questionnaire suggesting signs/symptoms of OSA. However, only 16.6% were prescribed CPAP and compliance to treatment was poor (63.3%). Education and communication of OSA risk with patients and physicians resulted in a de novo diagnosis in at least 1 of 10 patients screened and 16.7% restarted CPAP.

The Impact of Underlying Obstructive Sleep Apnea Treatment on Exercise Capacity in Patients With Pulmonary Hypertension Undergoing a Cardiac Rehabilitation Program

“…In general, OSA has been underdiagnosed and undertreated. 32 The reasons for this finding are unclear 33 but may relate to lack of awareness among patients and providers regarding the potential importance of untreated sleep disorders on overall health. In addition, the diagnostic testing has been considered cumbersome, even though home testing has greatly facilitated establishing an OSA diagnosis.…”

“…In general, OSA has been underdiagnosed and undertreated 32. The reasons for this finding are unclear33 but may relate to lack of awareness among patients and providers regarding the potential importance of untreated sleep disorders on overall health.…”

Prevalence of obstructive sleep apnoea in acute coronary syndrome patients: systematic review and meta-analysis

“…Individual studies that utilised objective measurement [27,43,44] and questionnaires [45][46][47] support the conclusion that OSA prevalence is high upon entry to CR programs. Second, our meta-regression confirmed that any estimate of OSA prevalence is influenced by gender mix, with lower prevalence rates obtained when greater percentages of females are included in the study.…”

Prevalence, Impact, and Trajectories of Sleep Disturbance in Cardiac Rehabilitation

“…41,[52][53][54][55] Participants in CR also experience higher than normal or excessive daytime sleepiness, a common symptom of sleep apnea. 52,56 Effects of Sleep Disturbance on the CR Process of Care Insomnia symptoms and sleep quality: Among CR participants, poor sleep quality has been cross-sectionally associated with higher levels of depression symptoms and lower quality of life 42 ; insomnia symptoms have been associated with lower pleasant mood, positive affect, and tranquility, and higher levels of fatigue. Interestingly, more severe insomnia symptoms have been associated with greater improvements in mood and tranquility during a CR exercise session.…”

“…By comparison, studies using objective assessment methods (eg, polysomnography, home sleep apnea testing, ECG Holter) estimate that 40-100% of CR patients have at least mild sleep apnea and 33-85% have at least moderate sleep apnea 41,52–55. Participants in CR also experience higher than normal or excessive daytime sleepiness, a common symptom of sleep apnea 52,56…”