Study Objectives: The incidence of sleep-related breathing disorder (SRBD) remains unclear in patients with a continuous flow left ventricular assist device (LVAD). Polysomnography (PSG) remains the gold standard for diagnosis, but logistical challenges make home sleep apnea testing (HSAT) a more practical alternative. WatchPat has failed to accurately diagnose SRBD 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 versus PSG in detecting SRBD in patients with a durable LVAD.
Methods: This is a single-center, prospective, observational pilot study. Patients with LVAD who screened positive on the STOP-BANG questionnaire were referred to sleep clinic. Patients recommended for PSG by a sleep physician underwent PSG and NOX-T3 simultaneously. Apnea-hypopnea index (AHI) with the PSG and the respiratory event index (REI) using the NOX-T3 were compared as well as time spent with oxygen (O) saturation ≤ 88% using Spearman's correlation. P values less than 0.05 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 HeartMate3 device. There was a strong correlation between the AHI obtained from NOX T3 and PSG (R=0.984) but the time spent with O saturation ≤88% correlated poorly (r=0.168). The tests identified the same 3 patients meeting the diagnostic criteria for obstructive sleep apnea.
Conclusions: Our results suggest that the NOX-T3 HSAT device is a useful tool in the comprehensive evaluation of SRBD in patients with LVAD.
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