Use Of A Disposable At-Home System To Support Contactless Sleep Apnea Testing & Therapy Initiation In A HF Clinic During The Covid-19 Pandemic

• Published in: Journal of cardiac failure 2022-04, Vol.28 (5), p.S97-S97
• Main Authors: Bensimhon, Daniel R., Curran, Lisa M., Schub, Heather, Turner, Traci R.
• Format: Article
• Language: English
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2022.03.246

Background: The COVID pandemic presented many challenges to providing care to our HF patients. One of our challenges was the closure of our sleep lab for sleep apnea testing and CPAP titration. We also encountered patient reluctance to perform sleep testing with re-usable home equipment. In attempt to address these issues, we employed the WatchPATTM ONE device (Itamar Medical) - a disposable Bluetooth-enabled technology that uses peripheral arterial tonometry - to assess patients for sleep-disordered breathing (SDB) without an in-person visit or a facemask. At-home CPAP initiation and auto-titration was performed in appropriate patients to create a fully contactless testing and treatment program. Methods: From March 2020 - March 2021 patients with suspected SDB during a virtual HF Clinic visit were referred for home sleep testing using the WatchPATTM ONE device. Suspicion for SDB breathing was based on meeting at least 1 of 5 screening criteria used in our HF Clinic and a STOP-BANG score > 3. After insurance approval, a device was mailed to the patient for overnight testing. Results were uploaded into the CloudPAT platform and read by our Center's sleep cardiologist. Patients without complex SDB, underwent remote device fitting via an online DME company followed by CPAP auto-titration. Time to therapy and compliance with CPAP was assessed using the cloud-based system.Cone Health SDB Screening CriteriaPoorly-controlled HTNRecurrent/refractory AFFrequent PVCsFatigue out of proportion to HF severityBMI > 35 Results:Patients tested111Positive for SDB (AHI ≥ 5)81 (73%)Patients with significant central SA (cAHI > 5)20%Patients with successful remote CPAP initiation24 (30%)Mean time from virtual visit to therapy53d Conclusions:• Sleep apnea is a common comorbidity in HF patients • The WatchPATTM ONE system was an effective way to continue to test our HF patients for SDB in a virtual setting with a disease prevalence similar to standard in-lab testing and had the ability to discern between obstructive and central sleep apnea • In our initial virtual sleep apnea program, nearly 1/3 of patients with SDB went onto CPAP treatment via a remote DME Turnkey service with a favorable time to treatment and a completely contactless workflow