CONTINUOUS NOCTURNAL BP MONITORING DURING POLYSOMNOGRAPHY: PROOF OF CONCEPT STUDY

SESSION TITLE: Sleep Disorders Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Obstructive sleep apnea (OSA) is associated with cardiovascular disease, but recent randomized trials showed that current diagnostic and therapeutic algorithms for treating OSA do not lead to ideal improvements in cardiovascular outcomes. Nocturnal blood pressure (BP) is a strong predictor of adverse cardiac events, yet nocturnal BP is an under-explored modality in assessing cardiovascular impacts of OSA in part because previous BP technologies were interruptive to sleep and difficult to integrate with multi-channel PSG. METHODS: We set to develop an expanded PSG set-up which would: 1) enable a continuous BP recording without interrupting sleep, 2) allow integration of the BP channel into the existing multi-lead PSG, and 3) record accurate BP measurements as compared with traditional brachial cuff-based nocturnal BP measurements. To achieve these aims, we modified a non-invasive finger-based continuous hemodynamic monitor (plethysmograph and finger-based BP cuff system) to complement an existing attended in-laboratory PSG. This novel expanded PSG set-up was tested on a healthy sleeping subject. RESULTS: In this proof-of-concept study performed during sleep we showed that our novel expanded PSG set-up: 1) continuously recorded BP without interrupting sleep; 2) modifications to the existing non-invasive hemodynamic monitor allowed for integration into existing PSG recording system with direct display of continuous BP on the PSG monitor screens (Figure); 3) the accuracy of the continuous finger-based BP measurement was similar to the traditional BP obtained from brachial cuff [mean BP difference = 1.8 +/- 4.9 mmHg]. CONCLUSIONS: Continuous nocturnal non-invasive BP recording is feasible and could be cost-effectively added to presently used PSG laboratory set-up. Finger based BP recording accurately corresponds to brachial BP, and it does not interrupt sleep or cause excessive arousals. CLINICAL IMPLICATIONS: Our methodology of continuous nocturnal BP recording can be effectively used in subsequent clinical studies. This novel set-up would allow for routine assessment of OSA-induced nocturnal BP changes, and it would allow for BP directed titration of OSA therapies. DISCLOSURES: No relevant relationships by Richard Castriotta, source=Web Response No relevant relationships by Alexander Gong, source=Web Response Speaker/Speaker's Bureau relationship with Respicardia Please note: $1001 - $5000 Added 06/22/2020 by Vincent Grbach, source=Web Response, value=Honoraria No relevant relationships by Howard Hodis, source=Web Response No relevant relationships by Michael Khoo, source=Web Response No relevant relationships by Tomas Konecny, source=Web Response No relevant relationships by Andrew Lee, source=Web Response No relevant relationships by Arash Motamed, source=Web Response No relevant relationships by Winston Tran, source=Web Response no disclosure on file for Edwin Valladares