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Study Objectives: <p>Patients with atrial fibrillation have elevated risk of obstructive sleep apnea (OSA). A peripheral arterial tonometry-based device, the Watch-PAT (WP) has been increasingly used as a home OSA test. We conducted a multisetting evaluation of WP in OSA diagnosis by comparing results from in-laboratory polysomnography (PSG), in-laboratory WP, and home WP in patients with atrial fibrillation.</p> Methods: <p>Patients with atrial fibrillation underwent an in-laboratory PSG with concurrent in-laboratory WP and 2 consecutive nights of home WP. OSA was categorized into no OSA, mild, moderate, and severe OSA by apnea-hypopnea index (&lt; 5, ≥ 5 to &lt; 15, ≥ 15 to &lt; 29, ≥ 30 events/h). The primary outcome was OSA severity agreement between in-laboratory PSG vs home WP. Secondary outcomes included the agreement between in-laboratory PSG vs in-laboratory WP, as well as in-laboratory WP vs home WP. Night-to-night variability of consecutive nights of home WP was also evaluated. Results were expressed by Cohen’s kappa (κ) for apnea-hypopnea index scoring rules 1a and 1b.</p> Results: <p>A total of 27 patients were included for analysis. There was slight and fair agreement between in-laboratory PSG and home WP (κ = 0.15, 0.40 for score rule 1a and 1b, respectively), substantial agreement between in-laboratory PSG vs in-laboratory WP (κ = 0.63, 0.71), moderate agreement between in-laboratory WP and home WP (κ = 0.59, 0.59), and almost perfect agreement between first night home WP and second night home WP (κ = 0.87, 0.89).</p> Conclusions: <p>We demonstrate overall slight to fair agreement between home WP vs in-laboratory PSG, suggesting inadequate performance against the standard reference test. This should be considered when interpreting the results of home WP. Other evaluations demonstrated moderate agreement for in-laboratory WP and home WP in the classification of OSA severity, substantial agreement between in-laboratory PSG and in-laboratory WP, and almost perfect agreement in the comparison of both home WP.</p> Citation: <p>Stafford PL, Roth R, Ferguson J, et&#xa0;al. Multisetting evaluation of Watch-PAT in obstructive sleep apnea diagnosis in patients with atrial fibrillation. <i>J Clin Sleep Med</i>. 2025;21(12):2139–2154.</p>

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Multisetting evaluation of Watch-PAT in obstructive sleep apnea diagnosis in patients with atrial fibrillation

  • 期刊论文

  • 发表日期：

    2025年12月1日

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  • Patrick L. Stafford,
  • Robert Roth,
  • John Ferguson,
  • Kenneth C. Bilchick,
  • Andrew E. Darby,
  • Sula Mazimba,
  • Nishaki Mehta,
  • Eric M. Davis,
  • Heather Bonner,
  • Yeilim Cho,
  • Jeongok Logan,
  • Michelle Sobremonte-King,
  • Younghoon Kwon

摘要

Study Objectives:

Patients with atrial fibrillation have elevated risk of obstructive sleep apnea (OSA). A peripheral arterial tonometry-based device, the Watch-PAT (WP) has been increasingly used as a home OSA test. We conducted a multisetting evaluation of WP in OSA diagnosis by comparing results from in-laboratory polysomnography (PSG), in-laboratory WP, and home WP in patients with atrial fibrillation.

Methods:

Patients with atrial fibrillation underwent an in-laboratory PSG with concurrent in-laboratory WP and 2 consecutive nights of home WP. OSA was categorized into no OSA, mild, moderate, and severe OSA by apnea-hypopnea index (< 5, ≥ 5 to < 15, ≥ 15 to < 29, ≥ 30 events/h). The primary outcome was OSA severity agreement between in-laboratory PSG vs home WP. Secondary outcomes included the agreement between in-laboratory PSG vs in-laboratory WP, as well as in-laboratory WP vs home WP. Night-to-night variability of consecutive nights of home WP was also evaluated. Results were expressed by Cohen’s kappa (κ) for apnea-hypopnea index scoring rules 1a and 1b.

Results:

A total of 27 patients were included for analysis. There was slight and fair agreement between in-laboratory PSG and home WP (κ = 0.15, 0.40 for score rule 1a and 1b, respectively), substantial agreement between in-laboratory PSG vs in-laboratory WP (κ = 0.63, 0.71), moderate agreement between in-laboratory WP and home WP (κ = 0.59, 0.59), and almost perfect agreement between first night home WP and second night home WP (κ = 0.87, 0.89).

Conclusions:

We demonstrate overall slight to fair agreement between home WP vs in-laboratory PSG, suggesting inadequate performance against the standard reference test. This should be considered when interpreting the results of home WP. Other evaluations demonstrated moderate agreement for in-laboratory WP and home WP in the classification of OSA severity, substantial agreement between in-laboratory PSG and in-laboratory WP, and almost perfect agreement in the comparison of both home WP.

Citation:

Stafford PL, Roth R, Ferguson J, et al. Multisetting evaluation of Watch-PAT in obstructive sleep apnea diagnosis in patients with atrial fibrillation. J Clin Sleep Med. 2025;21(12):2139–2154.