Test your knowledge on pulmonary and critical care medicine.
- Patient Information:
- Age: 72
- Symptoms: Daytime sleepiness, snoring, 8 hours of sleep each night, 45-minute naps on most days
- Medical History: Atrial fibrillation, heart failure
- Medications: Valsartan-sacubitril, metoprolol, furosemide, spironolactone, empagliflozin, apixaban
- Physical Examination: Normal vital signs, BMI 27, low-lying soft palate, irregular cardiac rhythm, normal central venous pressure, clear lung fields, chronic venous stasis
- Previous Test: Transthoracic echocardiogram showing left ventricular enlargement, ejection fraction of 40%
Based on the information above, which of the following tests is the most appropriate?
- A wrist-worn device that measures disrupted sleep patterns and sleep-wake cycles over multiple days and nights.
- Home sleep apnea testing:
- Used in patients without comorbid cardiopulmonary disease who are likely to have obstructive sleep apnea of at least moderate severity.
- Overnight oximetry:
- Could be reassuring in asymptomatic patients with low pretest probability.
- In-laboratory test considered the gold standard for diagnosing sleep apnea in mission-critical workers and patients with complicated obstructive sleep apnea or comorbid conditions.
Did You Know?
Obstructive sleep apnea (OSA) affects an estimated 22 million Americans, with 80% of moderate to severe cases remaining undiagnosed.