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Patient Screening and Sleep Testing

Background and Prevalence of Sleep Disordered Breathing

Central Sleep Apnea (CSA) is much more prevalent in cardiovascular patient populations.1 Sleep Disordered Breathing (SDB) is the most common comorbid condition in patients with heart failure (HF), as nearly threequarters of all heart failure patients have some form of SDB. It is estimated that half of those suffer from predominantly Central Sleep Apnea.1 CSA is associated with a two-fold increase of both HF hospitalizations and mortality among HF patients and can cause symptoms that resemble those commonly associated with HF.2-4 SDB is also prevalent in patients with Atrial Fibrillation (AF), with an estimated 74% of patients with AF having some form of SDB.5 CSA is associated with a 2- or 3-fold increase in risk of developing AF.6

WATCH: Treating Sleep Apnea in Cardiology Patients

WATCH: Sleep Apnea in Atrial Fibrillation

Opportunities for Screening in
Cardiovascular Settings Include:

  • Initial heart failure consultation visits
  • Post discharge clinic visits following HF-related hospitalization
  • Atrial Fibrillation patients prior to ablation procedures
  • Cardiac device patients with documented Implantable
    Cardiac Defibrillator (ICD) shocks or arrhythmias
Sleep Testing Order Template thumbnail

Download the Sleep Testing Order Template

Pre-Screening Questionnaires

Patients with CSA often do not display common symptoms associated with SDB such as snoring and daytime sleepiness.7 Common pre-screening questionnaires have not been validated in CSA and can fail to identify these patients, but can help identify risk factors for and symptoms of SDB, as patients with CSA often do not display common symptoms such as snoring and daytime sleepiness.7,8 Literature suggests that STOP-BANG scoring of ≥ 3 or Epworth Sleepiness Scale of ≥ 8 may be more reliable for detecting SDB in patients with cardiovascular diseases.9 More general questions to assess HF patients for symptoms of excessive daytime fatigue, observed >apneas, nocturnal dyspnea and impaired cognition may more accurately identify patients who need further screening for sleep apnea.10

Sleep Testing Decision Tree Example

Sleep Testing Decision Tree

Tools for Screening for Sleep Apnea

Screening poster for clinics are available framed or as an 8.5” x 11” foam core easel

Contact your remedē
representative to order.

Patient brochures for screening and education are available

Contact your remedē
representative to order.

Sleep Apnea Risk Assessment thumbnail

Sleep apnea risk assessment form

Or contact your remedē
representative to order
tear-off pads.

Resources for Screening for Sleep Apnea

Epworth Sleep Scale webpage thumbnail

Epworth Sleepiness Scale webpage thumbnail

STOP-Bang Questionnaire

These links are provided as a convenience to identify resources that may be useful in your practice. No rights to use the materials found at these links is granted or implied. Please secure permission to use questionnaires or other materials from the copyright owners.