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Peer-reviewedCC BY-NCJournal of the American Heart Association

Implementation of a WatchPAT‐Based Diagnostic Pathway for Obstructive Sleep Apnea in a Tertiary Hypertension Center: A Feasibility Study

  • Alexandre Boutigny1,2,3
  • Justina Motiejunaite1,3,4
  • Pauline Balagny1,3,5
  • Florence Arnoult1,3
  • Emmanuelle Vidal‐Petiot1,3,6
  • Nassim Mohamedi2,3
  • Justine Frija1,3,7
  • Marie‐Pia d’Ortho1,3,7
7 affiliations
  1. 1Service de Physiologie ‐Explorations Fonctionnelles, Hôpital Bichat, Assistance Publique ‐ Hôpitaux de Paris, Paris, France
  2. 2Service de Physiologie Clinique‐Explorations Fonctionnelles, Hôpital Lariboisière, Assistance Publique ‐ Hôpitaux de Paris, Paris, France
  3. 3Université Paris Cité
  4. 4Paris‐Saclay University, Inserm U1018, Versailles Saint‐Quentin University, Clinical Epidemiology Team
  5. 5Paris Saclay University, Université de Versailles Saint‐Quentin‐en‐Yvelines
  6. 6Université Paris Cité and Université Sorbonne Paris Nord, INSERM U1148, LVTS
  7. 7INSERM, UMR NeuroDiderot
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Abstract

BACKGROUND: Obstructive sleep apnea (OSA) is a prevalent yet underdiagnosed in hypertension, affecting 30% to 83% of patients. Limited polysomnography access delays diagnosis. We evaluated the feasibility, diagnostic yield, and downstream management decisions of an integrated diagnostic pathway using WatchPAT 300, a peripheral arterial tonometry-based home sleep apnea test, in a tertiary hypertension unit. METHODS: In this single-center, prospective, observational study, 200 patients underwent ambulatory OSA assessment from May 2023 through August 2025. We recorded clinical variables, peripheral arterial tonometry data, and management decisions. A subgroup underwent confirmatory in-laboratory polysomnography. Patients were classified as none-to-mild OSA (peripheral apneahypopnea index <15/h) and moderate-to-severe OSA (≥15/h). RESULTS: The pathway achieved 97.5% (95% CI, 94%-99%) technical success and reduced the mean time-to-diagnosis to 3.5±4.5 days, versus 154 days for in-laboratory polysomnography. Over half of the cohort was triaged: ∼30% met treatment criteria directly, and 22% were ruled out. Among patients completing confirmatory polysomnography, 83% (95% CI, 61%-94%) initially classified as none-to-mild were reclassified as moderate-to-severe OSA, and 77% required treatment. Furthermore, symptoms were dissociated from severity, and Snoring-Tired-Observed-Pressure-BMI-Age-Gender (STOP-Bag) association with severity did not remain significant after multiplicity correction. CONCLUSIONS: A peripheral arterial tonometry-based home sleep apnea test-first model is feasible and efficient, eliminating diagnostic delays. Although effective for triaging clear-cut cases, the high reclassification rate underscores the almost mandatory role of confirmatory polysomnography for milder or equivocal results, suspected comorbid sleep disorders, or high STOP-Bag score. These data argue against symptoms-based screening alone to screen populations with hypertension.

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Cite

BibTeXRIS
BibTeX
@article{boutigny2026implementation,
  title = {{Implementation of a WatchPAT‐Based Diagnostic Pathway for Obstructive Sleep Apnea in a Tertiary Hypertension Center: A Feasibility Study}},
  author = {Alexandre Boutigny and Justina Motiejunaite and Pauline Balagny and Florence Arnoult and Emmanuelle Vidal‐Petiot and Nassim Mohamedi and Justine Frija and Marie‐Pia d’Ortho},
  journal = {Journal of the American Heart Association},
  year = {2026},
  month = oct,
  doi = {10.1161/jaha.126.049285},
  url = {https://www.ahajournals.org/doi/10.1161/JAHA.126.049285},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Implementation of a WatchPAT‐Based Diagnostic Pathway for Obstructive Sleep Apnea in a Tertiary Hypertension Center: A Feasibility Study
AU  - Alexandre Boutigny
AU  - Justina Motiejunaite
AU  - Pauline Balagny
AU  - Florence Arnoult
AU  - Emmanuelle Vidal‐Petiot
AU  - Nassim Mohamedi
AU  - Justine Frija
AU  - Marie‐Pia d’Ortho
PY  - 2026
DA  - 2026/10/23
JO  - Journal of the American Heart Association
DO  - 10.1161/jaha.126.049285
UR  - https://www.ahajournals.org/doi/10.1161/JAHA.126.049285
AB  - BACKGROUND: Obstructive sleep apnea (OSA) is a prevalent yet underdiagnosed in hypertension, affecting 30% to 83% of patients. Limited polysomnography access delays diagnosis. We evaluated the feasibility, diagnostic yield, and downstream management decisions of an integrated diagnostic pathway using WatchPAT 300, a peripheral arterial tonometry-based home sleep apnea test, in a tertiary hypertension unit. METHODS: In this single-center, prospective, observational study, 200 patients underwent ambulatory OSA assessment from May 2023 through August 2025. We recorded clinical variables, peripheral arterial tonometry data, and management decisions. A subgroup underwent confirmatory in-laboratory polysomnography. Patients were classified as none-to-mild OSA (peripheral apneahypopnea index <15/h) and moderate-to-severe OSA (≥15/h). RESULTS: The pathway achieved 97.5% (95% CI, 94%-99%) technical success and reduced the mean time-to-diagnosis to 3.5±4.5 days, versus 154 days for in-laboratory polysomnography. Over half of the cohort was triaged: ∼30% met treatment criteria directly, and 22% were ruled out. Among patients completing confirmatory polysomnography, 83% (95% CI, 61%-94%) initially classified as none-to-mild were reclassified as moderate-to-severe OSA, and 77% required treatment. Furthermore, symptoms were dissociated from severity, and Snoring-Tired-Observed-Pressure-BMI-Age-Gender (STOP-Bag) association with severity did not remain significant after multiplicity correction. CONCLUSIONS: A peripheral arterial tonometry-based home sleep apnea test-first model is feasible and efficient, eliminating diagnostic delays. Although effective for triaging clear-cut cases, the high reclassification rate underscores the almost mandatory role of confirmatory polysomnography for milder or equivocal results, suspected comorbid sleep disorders, or high STOP-Bag score. These data argue against symptoms-based screening alone to screen populations with hypertension.
SN  - 2047-9980
ER  -