Author + information
- Shahrokh Javaheri, MD∗ (, )
- Virend K. Somers, MD, PhD and
- Francisco Campos-Rodriguez, MD
- ↵∗Bethesda Sleep Laboratory, Pulmonology and Sleep, 10535 Montgomery Road, Suite 200, Cincinnati, Ohio 45242
We appreciate the interest of Drs. Matusik and Stein in our paper (1), and are familiar with the excellent work of Stein et al. (2) and other investigators who used the variability patterns of heart rate as a screening tool for sleep apnea. Because of word limitations, we were not able to cover several cardiovascular aspects of sleep apnea. Characteristic patterns of heart rate fluctuations during Holter monitoring may well be useful, particularly in patients with a high pre-test probability of having sleep apnea. Caveats include patients with autonomic neuropathy in whom heart rate changes may be blunted. Further validation of this method will be important to enable its widespread use. Perhaps the addition of overnight oximetry to Holter monitoring in selected patients may further improve sensitivity of screening for sleep apnea in those patients with cardiovascular disease, who could potentially benefit from treatment of any comorbid sleep apnea.
Please note: All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- 2017 American College of Cardiology Foundation