Cheyne-Stokes respiration tracked by CPAP telemonitoring can detect serious cardiac events

Abstract

<b>Background:</b> Case-reports have suggested that continuous positive airway pressure (CPAP) home telemonitoring can detect the onset of acute cardiac events such as decompensated heart failure or atrial fibrillation through an increase in the apnoea-hypopnea index (AHI) and onset of Cheyne-Stokes Respiration (CSR). <b>Aim:</b> This study aimed to evaluate if long-term remote CPAP treatment telemonitoring revealing CSR could help detect serious cardiac events in obstructive sleep apnoea (OSA) patients. <b>Methods:</b> This monocentric prospective cohort study included adults receiving CPAP therapy for OSA with daily telemonitoring. Any sudden increase in AHI generated an alert for the home healthcare provider to download CPAP data to identify CSR. Then, a&nbsp;medical consultation was scheduled. <b>Results:</b> We included 555 adults. During the one-year follow-up 78 CSR episodes were detected in 74 patients (CSR+). The main conditions associated with incident CSR were heart failure (30·8%), ventilatory instability (26·9%), leaks (16·7%), medications (9·0%), arrhythmias (7·7%), and renal failure (2·6%). Fifteen (20·3%) CSR+ patients had a confirmed serious cardiac event. In univariate analysis a CSR episode increased the risk of a serious cardiac event by 13·8, with an adjusted odds-ratio of 5·7 in multivariate analysis. <b>Conclusions:</b> Our findings provide a strong rationale for systematically tracking incident Cheyne-Stokes respiration in CPAP-treated patients.