Feasibility of unattended home sleep apnea testing in a cognitively impaired clinic population

• Published in: Journal of clinical sleep medicine 2021-03, Vol.17 (3), p.435-444
• Main Authors: Colelli, David R, Black, Sandra E, Masellis, Mario, Lam, Benjamin, Lim, Andrew S P, Boulos, Mark I
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Feasibility Studies; Humans; Male; Middle Aged; Polysomnography; Scientific Investigations; Sleep; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
• ISSN: 1550-9389; 1550-9397
• DOI: 10.5664/jcsm.8918

Obstructive sleep apnea (OSA) increases the risk of developing dementia. Home sleep apnea testing (HSAT) is a convenient and validated method to screen for OSA among cognitively well individuals; however, it is unknown if it is a clinically feasible and practical approach in clinic patients with cognitive impairment. We evaluated if HSAT was a feasible and practical approach to screen for OSA in clinic patients with cognitive impairment. Patients with cognitive impairment due to neurodegenerative and/or vascular etiologies completed OSA screening using HSAT. HSAT was considered a feasible technique if ≥ 80% of those who attempted HSAT obtained analyzable data (ie, ≥ 4 hours of flow, effort, and oxygen evaluation), and a practical technique if ≥ 50% of all patients approached for study inclusion obtained analyzable data. Of the 119 patients who were approached for participation, 83 were enrolled and offered HSAT; 5 did not complete HSAT screening, and the remaining 78 patients attempted HSAT; mean age (± standard deviation) of 72.86 (± 9.89) years and 46% were male. In those that attempted HSAT, 85.9% (67/78) obtained analyzable data and 56.3% (67/119) of eligible patients approached for study inclusion obtained analyzable data. HSAT is a feasible and practical technique in a clinic population with cognitive impairment. As OSA is a modifiable risk factor for patients with dementia, HSAT has the potential to lead to expedited treatment for OSA, which may potentially improve health-related outcomes such as cognition.