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Diagnosis of obstructive sleep apnoea hypopnoea syndrome in chronic heart failure

What we are doing:

Primary objectives


  • To prospectively evaluate the ability of the STOP-Bang questionnaire to detect or exclude obstructive sleep apnoea hypopnoea syndrome (OSAHS) in patients with stable heart failure. 


  • To identify barriers to, and facilitators of, the diagnosis of OSAHS from patient accounts.

Secondary objectives

  • To evaluate heart failure clinicians’ knowledge and beliefs about obstructive sleep apnoea hypopnoea syndrome (OSAHS) using the modified OSAKA (obstructive sleep apnoea knowledge and attitudes) questionnaire.
  • To assess variation in practice with regards to the diagnosis and management of suspected adult OSAHS amongst heart failure clinicians in the UK.

Why we are doing it:

Chronic heart failure (CHF) is a costly condition with high risk of hospitalisation. The foundation of CHF management is medication, device therapy and the management of illnesses that co-exist with heart failure. 

One of these conditions is obstructive sleep apnoea hypopnea syndrome (OSAHS), a condition where the walls of the throat relax and narrow during sleep and as a result interrupt normal breathing. If left untreated, OSAHS can contribute to poor sleep, poor quality of life and increased risk of heart disease, accidents and healthcare costs.

OSAHS is significantly under diagnosed and under treated. Research suggests this may be due to poor understanding among healthcare professionals, and the lack of a validated screening tool, to help identify CHF patients that are most at risk of OSAHS and may require further sleep testing. 

The aim of this research is to explore the factors associated with the diagnosis of OSAHS in patients with CHF. 

To improve healthcare professionals’ understanding, we need to know more about their knowledge, beliefs and the questionnaires they use daily. Doctors, nurses and pharmacists with an interest in CHF will be invited to complete an online survey that will take around 15 minutes. It will help to highlight differences in practice and topics that could benefit from an education programme.

To understand how well the STOP-Bang screening questionnaire can identify patients with OSAHS, participants will be recruited from the Sleep Disorders Service at Leicester General Hospital. CHF patients, referred to the local sleep clinic, will be invited to complete a short questionnaire that will take around five minutes. A small number of these patients will be invited to participate in an interview that will last around 60 minutes to help us understand what helps or hinders the diagnosis and treatment of OSAHS. 

What the benefits will be:

It is anticipated that evaluating the performance of a screening questionnaire (STOP-Bang questionnaire) and its predictive ability to identify moderate-severe OSAHS in patients with CHF, will optimise patient prognosis by enabling the clinician to select an adequate therapeutic strategy, which is an essential step in the process of clinical decision making.

Furthermore, the findings of both the survey and interview aspects of the study, will support the development of strategies to improve the care of patients with OSAHS through the identification of topics for education and practical guidelines and ultimately to increase awareness and management of OSAHS among patients with CHF.

Who we are working with:

Professor Iain Squire

Professor Noelle Robertson

Dr Andrew Hall


Lizelle Bernhardt,


Photo by Kuo-Chiao Lin on Unsplash