Screening for obstructive sleep apnoea in cardiac rehabilitation: A position statement from the Australian Centre for Heart Health and the Australian Cardiovascular Health and Rehabilitation Association.
Obstructive sleep apnoea is highly prevalent in acute coronary syndrome patients eligible for enrolment in cardiac rehabilitation programmes. This condition is an independent predictor of increased morbidity and comorbid conditions in the general population and can lead to an increase in major adverse cardiac events such as revascularization, heart failure and hospital readmission in cardiac patients. There is convincing evidence that treatments such as continuous positive airway pressure or mandibular advancement devices can successfully treat obstructive sleep apnoea and these conditions can be improved or negated resulting in improved cardiac rehabilitation outcomes and improved health related quality of life. Given the potential benefits of obstructive sleep apnoea treatment it would make sense to screen for this condition upon entry to out-patient cardiac rehabilitation programmes. A two-stage approach to screening is recommended, where patients are initially evaluated for the probability of having obstructive sleep apnoea using a brief questionnaire (The STOP-Bang) and then followed up with objective evaluation (portable home monitor or polysomnography) where necessary. Potential barriers to further referral and treatment could be partly mitigated by the training of cardiac rehabilitation staff in sleep disorders and screening.
Australian Centre for Heart Health (formerly Heart Research Centre), Melbourne, Australia Faculty of Health, Deakin University, Melbourne, Australia michael.legrande@australianhearthealth.org.au.
Michael R
MR
Le Grande
Sydney Nursing School and Charles Perkins Centre, University of Sydney, Australia Australian Cardiovascular Health and Rehabilitation Association, Australia.
Lis
L
Neubeck
Australian Centre for Heart Health (formerly Heart Research Centre), Melbourne, Australia Faculty of Health, Deakin University, Melbourne, Australia School of Psychological Sciences, University of Melbourne, Australia School of Medicine and Public Health, University of Newcastle, Australia.
Barbara M
BM
Murphy
Australian Cardiovascular Health and Rehabilitation Association, Australia CNC Cardiology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia.
Dawn
D
McIvor
Australian Cardiovascular Health and Rehabilitation Association, Australia Ashford Hospital, Australia.
Dianna
D
Lynch
Australian Cardiovascular Health and Rehabilitation Association, Australia Royal Perth Hospital, Australia.
Helen
H
McLean
Australian Centre for Heart Health (formerly Heart Research Centre), Melbourne, Australia Faculty of Health, Deakin University, Melbourne, Australia Australian Cardiovascular Health and Rehabilitation Association, Australia University of Hong Kong, Centre on Behavioural Health, Hong Kong.
Alun C
AC
Jackson
D001315:Australia / Q000453:epidemiology; D000072038:Cardiac Rehabilitation / Q000379:methods*; D002309:Cardiology; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology / Q000534:rehabilitation; D006801:Humans; D008403:Mass Screening; D015995:Prevalence; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D012955:Societies, Medical
Obstructive sleep apnoea; cardiac rehabilitation; screening