0601 DETECTION OF OBSTRUCTIVE SLEEP APNEA AND ASSESSMENT OF SLEEP AND MOOD SYMPTOMS IN ARRHYTHMIA CLINIC OUTPATIENTS

Obstructive sleep apnea (OSA) is a sleep disorder with serious cardiovascular consequences. OSA is associated with different types of arrhythmia. We aimed to determine (1) The percentage of patients with arrhythmia, not suspected/diagnosed with OSA, who have OSA; (2) The percentage of patients in outpatient arrhythmia clinics who show symptoms indicative of poor sleep, excessive daytime sleepiness, decreased alertness, fatigue and/or depression; and (3) If these symptoms predict the presence of OSA in these patients. We recruited non-selected consecutive patients from three arrhythmia clinics. Patients with previously diagnosed and/or treated OSA were excluded. Validated screening tools were administered: (1) Epworth Sleepiness Scale (ESS); (2) Fatigue Severity Scale (FSS); (3) The Non-Restorative Sleep Scale (NRSS); (4) Insomnia Severity Index (ISI); (5) The Center for Epidemiological Studies-Depression Scale (CES-D); and (6) Toronto Hospital Alertness Test (THAT). Patients were diagnosed with OSA (AHI >5 /hour of sleep) by a home sleep study. We recruited 75 participants (72% Males). Mean age was 64. Mean BMI was 28 kg/m2. Twenty-seven percent had a BMI >30, and 7% had a BMI >35 kg/m2. Sleep related instruments showed: (1) Thirty-two percent of patients had an ESS score ≥8, which indicates a high level of daytime sleepiness; (2) Forty-seven percent showed a high level of fatigue as suggested by a FSS score >3; (3) Symptoms of non-restorative sleep were detected in 15% (NRSS score ≤46); (4) Seventeen percent had a CESD score ≥16, which is suggestive of depression; (5) Thirty-three percent had an ISI score suggestive of mild insomnia, 46% moderate insomnia, and 11% severe insomnia; (6) Four percent had a score <20 on THAT, which indicates decreased alertness. Eighty-five percent of patients were positive for OSA. A binary logistic regression analysis showed that only age and male gender were predictors of OSA (p=0.002, p=0.014 respectively). Eighty-five percent of patients in general arrhythmia clinics have undetected obstructive sleep apnea. High scores suggestive of daytime sleepiness, fatigue, insomnia, depression, and poor sleep did not predict the presence of OSA. Sleep studies should be considered for detection of OSA in arrhythmia clinic outpatients.

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