LAUSR

Sleep related breathing disorders, including central sleep apnea (CSA), are frequent in patients with heart failure however, only limited data is known about the effect of left ventricular assist device (LVAD) placement on OSA and even less about the accuracy of home sleep apnea testing in this population (HSAT). Performing the gold standard polysomnography (PSG) is challenging in this cohort due to logistics, especially during the COVID-19 pandemic. Extending HSAT to the LVAD population would be beneficial, yet initial tests with the WatchPat® were deemed inconclusive. We decided to evaluate the validity of NOX-T3 device for HSAT compared to PSG. This was a single center prospective, observational study that included LVAD patients who screened positive on the STOP-BANG questionnaire. A sleep study was indicated based on consultation with a sleep physician and a standard PSG was ordered. During the PSG, the NOX-T3 was also applied with the results analyzed and compared after test completion. In this preliminary analysis, 4 patients (3 male, 1 female) with a LVAD completed a PSG along with the NOX-T3. The overall severity of sleep apnea indicated by apnea hypopnea index during the PSG and the respiratory event index during the NOX-T3 were similar in this small cohort. In 2 of the 4 patients, the oximetry finding (minutes with oxygen saturations at or below 88%) were also similar during both the PSG and the NOX-T3. Based on this preliminary analysis, data obtained with the NOX-T3 system were valid and compared well to the standard of care PSG in patients with a LVAD. We plan to enroll at least 10 patients in this ongoing trial, further studies will be needed to validate these results. Performing HSAT with the NOX-T3 in this unique population if PSG is not feasible would be of significant value given the morbidity of sleep apnea in this population.