It amazes me how things that are routine at one facility are completely the opposite at another facility, even within the same geographic region. Dr. Ilene Rosen, past president of the AASM, was kind enough to talk to me about a program they had for patients with atrial fibrillation at Penn.
All patients who underwent ablation for atrial fibrillation were first tested for sleep apnea. It was part of their protocol. All of the healthcare workers involved understood that this was part of the algorithm that had been determined to be best for the patient. Their process was smooth and clear - and universally applied.
She believes it was this program that "led to providers to think about this (OSA) more in their patients with atrial fibrillation." The data supports this as well - according to an article from Frontiers in Neurology, patients with obstructive sleep apnea have a "higher incidence of atrial fibrillation than the general population." For patients who need to undergo catheter-based ablation, their chances of maintaining sinus rhythm improve greatly if their sleep apnea is treated.
Dr. Rosen also tells me that the cardiologists were very appreciative of the collaborative care approach at their facility. They evaluated patients from a multi-disciplinary perspective. The sleep team worked well with the primary care clinicians and the cardiologists in order to provide a more holistic approach to patient care. For years, she has advocated for better collaboration between sleep medicine physicians and other disciplines. As part of her keynote address at the AASM Sleep Medicine Trends a few years ago, she encouraged all of us to move out of our siloes and engage with our colleagues to improve patient care.
One of the silver linings of the pandemic that I have appreciated is how everyone is working together to solve an urgent, universal issue. It has been heartwarming to see scientists from around the globe share RNA sequencing, treatment protocols, and safety precaution guidelines. I hope we can continue to value the power of collaboration as we navigate our new normal.