Sleep apnoea sufferers have special recorders implanted as UHCW works with BHF on heart disease research

The hearts of 100 patients with sleep apnoea are being monitored in a new trial to help researchers understand why sufferers are more likely to die from heart disease.

The British Heart Foundation (BHF) has awarded University Hospitals Coventry and Warwickshire (UHCW) NHS Trust and the University of Warwick nearly £265,000 to carry out research over three years.

According to the Sleep Apnoea Trust, as many as 10 million people in the UK suffer from the most common form of the condition called Obstructive Sleep Apnoea (OSA).   

OSA causes breathing to stop intermittently due to a blockage of the airways at night which can cause excessive sleepiness in the day. It is also known to be associated with higher rates of illness and death linked to the heart.

The most common way to treat OSA is with a Continuous Positive-Airways Pressure (CPAP) machine which pumps air into the mouth through a mask you wear while you sleep. Although the CPAP machine can help improve sleep and means OSA sufferers feel less tired in the day, research has shown that using the machine doesn’t decrease the risk from heart disease.

Clinicians and scientists now want to find out whether this is because patients with OSA are more likely to suffer with arrhythmias, including the most common rhythm disturbance called atrial fibrillation (AF).

AF happens when the electrical impulses in the top two chambers of the heart fire chaotically when they should be steady and regular, causing them to quiver or twitch (fibrillation).  Although AF on its own may not be dangerous, it can lead to an increased risk of stroke, heart failure or other heart-related problems if left undetected and untreated.

To study the link between OSA and AF, tiny devices called implantable loop recorders are being implanted under the skin of patients to monitor heart rhythms. They will also use other methods including Holter monitors which are portable devices that monitor hearts rhythms.

Consultant Cardiologist Professor Faizel Osman, who is also an Honorary Professor of Cardiology at Warwick Medical School, said it was hoped that by closely monitoring the hearts of patients, they would be able to observe abnormal heart rhythms.

“We know that the pick-up rate for AF in patients with OSA is traditionally very low, but with this trial we’re planning to get, for the very first time in the world that I am aware of, an accurate idea of exactly what the prevalence rate is,” he said.

“We hope that by the end of the trial to know what the true rate of atrial fibrillation and other arrhythmias is in these patients and be able to prove that this is something that is happening to people with OSA but isn’t always discovered.

“This would mean that heart monitoring could become more routine for those at risk who present with OSA with the very real potential to save lives.”

The patients taking part, all living in the Coventry and Warwickshire area, have been chosen because they have OSA but, at the start of the trial at least, do not have any known heart rhythm problems. 

Leo Smith, from Nuneaton, said he has had OSA for as long as he can remember – although it was only officially diagnosed recently.

The 70-year-old, who lives with his wife Angela, said that although the condition itself didn’t really impact his life at all, he was keen to help the researchers find out what the longer-term implications could be on hearts.

“I fall asleep, I stop breathing, then I start breathing again and I wake up and I have no idea anything has happened,” he said.

“But I don’t know what it does to my heart and this is the reason why I have had a loop recorder implanted under my skin.”