39 The prevalence of sleep disordered breathing in elderly patients with persistent atrial fibrillation

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Abstract

Introduction

Epidemiological data have demonstrated an independent association between sleep-disordered breathing (SDB) and atrial fibrillation (AF). We have developed an efficient and reliable screening service investigating SDB in patients (pts)>65 years with persistent AF. Polysomnography (PSG) in a sleep laboratory (lab) is the gold standard diagnostic tool but expense and waiting lists for sleep centres have resulted in a search for alternative methods. The Watch PAT (WP) is efficient and reliable with strong correlation to PSG, potentially negating the requirement for sleep lab investigation.

Methods

20 pts>65 years, mean age 71 (45% male), with persistent AF awaiting treatment were investigated for SDB with WP. Total device expenditure including pt and technician cost were compared with predictive cost of PSG and sleep lab studies.

Results

See table 1.

Results

According to the UK NICE definition 18/20 (90%) had evidence of SDB. 8/20 (40%) could be considered to have severe sleep apnoea. The mean REM sleep percentage was 20.4% and mean snoring intensity was 40.9 dB. WP cost was significantly less than predictive cost of PSG (p<0.0001). Conclusion: There is a high prevalence of SDB in older pts with AF and use of the WP as a screening option is feasible. The higher than average non-REM sleep and only mildly elevated snoring intensity implicates a central component in these pts related to cardiac co-morbidity. Further study is ongoing to assess AF therapy outcomes in such pts.

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