A WatchPAT-based home sleep apnea test-first pathway in a tertiary hypertension unit was feasible and efficient, eliminating diagnostic delays, but the high reclassification rate on confirmatory polysomnography underscores the almost mandatory role of confirmatory polysomnography for milder or equivocal results, suspected comorbid sleep disorders, or high STOP-Bag score.
The WatchPAT 300 pathway achieved high technical success in a hypertension center.
The pathway drastically shortened time to diagnosis compared with in-laboratory polysomnography.
The pathway triaged over half of the cohort without needing further testing.
Many patients initially classified as none-to-mild OSA by WatchPAT were reclassified as moderate-to-severe on confirmatory polysomnography.
Most patients who completed confirmatory polysomnography required treatment.
Symptoms were dissociated from OSA severity, and STOP-Bag did not significantly predict severity after multiplicity correction.
The authors conclude a WatchPAT-first model is feasible but that confirmatory polysomnography is needed in selected situations, and symptom-based screening alone is inadequate in hypertension.
This study tested a faster way to diagnose obstructive sleep apnea (OSA) in people with hypertension at a specialist center in France. Instead of waiting for an overnight sleep lab study, 200 patients used a wrist-worn home device (WatchPAT 300). The test worked technically in 97.5% of patients, and the average time to diagnosis was about 3.5 days compared with 154 days for in-lab testing. The home test allowed over half of patients to be sorted quickly: about 30% clearly met criteria for treatment and 22% were ruled out. However, among patients whose home test suggested none-to-mild OSA and who then had a lab sleep study, 83% turned out to have moderate-to-severe OSA, and 77% of those completing the lab study needed treatment. Also, symptoms and the STOP-Bag questionnaire did not reliably indicate how severe the apnea was. This research suggests that home testing can speed up diagnosis for clear-cut cases, but a mild or unclear home result may not be reliable enough to rule out significant OSA, particularly with other suspected sleep disorders or a high STOP-Bag score. It also suggests that relying on symptoms alone to screen people with hypertension may miss cases. The study was single-center and observational, with only a subgroup receiving confirmatory lab testing.
Boutigny A, Motiejunaite J, Balagny P, Arnoult F, Vidal-Petiot E, Mohamedi N, et al.. (2026). Implementation of a WatchPAT-Based Diagnostic Pathway for Obstructive Sleep Apnea in a Tertiary Hypertension Center: A Feasibility Study.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.126.049285