Home sleep apnea testing in patients with continuous flow left ventricular assist device: is it feasible?

Study Objectives: The incidence of sleep-related breathing disorder remains unclear in patients with a continuous flow left ventricular assist device. Polysomnography (PSG) remains the gold standard for diagnosis, but logistical challenges make home sleep apnea testing a more practical alternative. WatchPat has failed to accurately diagnose sleep-related breathing disorder 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 vs PSG in detecting sleep-related breathing disorder in patients with a durable left ventricular assist device. Methods: This is a single-center, prospective, observational pilot study. Patients with left ventricular assist device who screened positive on the STOP-BANG Sleep Apnea Questionnaire were referred to sleep clinic. Patients recommended for PSG by a sleep physician underwent PSG and NOX-T3 simultaneously. Apnea-hypopnea index with the PSG and the respiratory event index using the NOX-T3 were compared as well as time spent with oxygen saturation ≤ 88% using Spearman’s correlation. P values less than .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 HeartMate III device. There was a strong correlation between the apnea-hypopnea index obtained from NOX-T3 and PSG (R² = .984) but the time spent with oxygen saturation ≤ 88% correlated poorly (r = .168). The tests identified the same 3 patients meeting the diagnostic criteria for obstructive sleep apnea. Conclusions: Our results suggest that the NOX-T3 home sleep apnea testing device is a useful tool in the comprehensive evaluation of sleep-related breathing disorder in patients with left ventricular assist device.