Automatic Event Detector from Smartphone Accelerometry: Pilot mHealth Study for Obstructive Sleep Apnea Monitoring at Home

Abstract Purpose Diagnosis and treatment of obstructive sleep apnea are traditionally performed in sleep laboratories with polysomnography (PSG) and are associated with significant waiting times for patients and high cost. We investigated if initiation of auto-titrating CPAP (APAP) treatment at home in patients with obstructive sleep apnea (OSA) and subsequent telemonitoring by a homecare provider would be non-inferior to in-lab management with diagnostic PSG, subsequent in-lab APAP initiation, and standard follow-up regarding compliance and disease-specific quality of life. Methods This randomized, open-label, single-center study was conducted in Germany. Screening occurred between December 2013 and November 2015. Eligible patients with moderate-to-severe OSA documented by polygraphy (PG) were randomized to home management or standard care. All patients were managed by certified sleep physicians. The home management group received APAP therapy at home, followed by telemonitoring. The control group received a diagnostic PSG, followed by therapy initiation in the sleep laboratory. The primary endpoint was therapy compliance, measured as average APAP usage after 6 months. Results The intention-to-treat population (ITT) included 224 patients (110 home therapy, 114 controls); the per-protocol population (PP) included 182 patients with 6-month device usage data (89 home therapy, 93 controls). In the PP analysis, mean APAP usage at 6 months was not different in the home therapy and control groups (4.38 ± 2.04 vs. 4.32 ± 2.28, p = 0.845). The pre-specified non-inferiority margin (NIM) of 0.3 h/day was not achieved (p = 0.130); statistical significance was achieved in a post hoc analysis when NIM was set at 0.5 h/day (p < 0.05). Time to APAP initiation was significantly shorter in the home therapy group (7.6 ± 7.2 vs. 46.1 ± 23.8 days; p < 0.0001). Conclusion Use of a home-based telemonitoring strategy for initiation of APAP in selected patients with OSA managed by sleep physicians is feasible, appears to be non-inferior to standard sleep laboratory procedures, and facilitates faster access to therapy.

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Reliability of Holter Oximetry for Home Sleep Apnea Testing

Otolaryngology ◽

10.1016/j.otohns.2008.05.269 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P83-P84 ◽

Cited By ~ 1

Author(s):

Jordan C Stern ◽

Conor Heneghan ◽

Redmond Shouldice

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Apnea Hypopnea Index ◽

Patients Âgés ◽

Home Testing ◽

Obstructive Sleep ◽

Adults And Children ◽

Home Sleep Apnea Testing ◽

A Prospective Study ◽

At Home

Objective To test the reliability of the Holter Oximeter for home testing of obstructive sleep apnea. Previous reports have shown a 96% correlation with simultaneous polysomnography and Holter Oximetry in the sleep laboratory. This study was designed to measure reliability of data obtained at home, as well as to obtain information from patients regarding comfort of the device. Methods A prospective study of 120 consecutive patients (ages 5 to 85) presenting to an otolaryngology practice during a 4-month period with complaints of snoring or sleep apnea symptoms. Device: The Holter Oximeter produces an apnea hypopnea index (AHI) based on an automated processing method of a continuous electrocardiogram and pulse oximeter. The reliability of the test was determined by the number of tests completed without interruption due to patient discomfort, electrode or device failure. Results There was 97% data recovery from the home testing device. Data failure was due to faulty memory cards in the device or surface electrode failure. All patients tolerated wearing the device at home, and there were no voluntary interruptions of the tests by patients. On a discomfort scale of 0 to 10 (0: no discomfort and 10: maximal discomfort), the average discomfort score was 2. Conclusions Holter Oximetry represents a new, easy to use, and reliable device for the home diagnosis of obstructive sleep apnea. It can also be used to measure outcomes for the surgical and non-surgical treatment of obstructive sleep apnea in adults and children.

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Cardiorespiratory Polygraphy for Detection of Obstructive Sleep Apnea in Patients With Atrial Fibrillation

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.758548 ◽

2021 ◽

Vol 8 ◽

Author(s):

Michiel Delesie ◽

Lieselotte Knaepen ◽

Johan Verbraecken ◽

Karolien Weytjens ◽

Paul Dendale ◽

...

Keyword(s):

Atrial Fibrillation ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Screening Tool ◽

Area Under The Curve ◽

Screening Tools ◽

Apnea Hypopnea Index ◽

Automated Algorithm ◽

Obstructive Sleep ◽

At Home

Background: Obstructive sleep apnea (OSA) is a modifiable risk factor of atrial fibrillation (AF) but is underdiagnosed in these patients due to absence of good OSA screening pathways. Polysomnography (PSG) is the gold standard for diagnosing OSA but too resource-intensive as a screening tool. We explored whether cardiorespiratory polygraphy (PG) devices using an automated algorithm for Apnea-Hypopnea Index (AHI) determination can meet the requirements of a good screening tool in AF patients.Methods: This prospective study validated the performance of three PGs [ApneaLink Air (ALA), SOMNOtouch RESP (STR) and SpiderSAS (SpS)] in consecutive AF patients who were referred for PSG evaluation. Patients wore one of the three PGs simultaneously with PSG, and a different PG during each of three consecutive nights at home. Severity of OSA was classified according to the AHI during PSG (<5 = no OSA, 5–14 = mild, 15–30 = moderate, >30 = severe).Results: Of the 100 included AF patients, PSG diagnosed at least moderate in 69% and severe OSA in 33%. Successful PG execution at home was obtained in 79.1, 80.2 and 86.8% of patients with the ALA, STR and SpS, respectively. For the detection of clinically relevant OSA (AHI ≥ 15), an area under the curve of 0.802, 0.772 and 0.803 was calculated for the ALA, STR and SpS, respectively.Conclusions: This study indicates that home-worn PGs with an automated AHI algorithm can be used as OSA screening tools in AF patients. Based on an appropriate AHI cut-off value for each PG, the device can guide referral for definite PSG diagnosis.

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Positional therapy for obstructive sleep apnea: An objective measurement of patients’ usage and efficacy at home

Sleep Medicine ◽

10.1016/j.sleep.2011.11.004 ◽

2012 ◽

Vol 13 (4) ◽

pp. 425-428 ◽

Cited By ~ 29

Author(s):

Raphael C. Heinzer ◽

Cyril Pellaton ◽

Vincianne Rey ◽

Andrea O. Rossetti ◽

Gianpaolo Lecciso ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Objective Measurement ◽

Positional Therapy ◽

Obstructive Sleep ◽

At Home

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0616 Validation of a Sleep Headband for Detecting Obstructive Sleep Apnea

SLEEP ◽

10.1093/sleep/zsaa056.613 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A236-A236

Author(s):

A Guillot ◽

T Moutakanni ◽

M Harris ◽

P J Arnal ◽

V Thorey

Keyword(s):

Obstructive Sleep Apnea ◽

Deep Learning ◽

Sleep Apnea ◽

Cross Validation ◽

Apnea Hypopnea Index ◽

Learning Approach ◽

Specificity And Sensitivity ◽

Obstructive Sleep ◽

Fold Cross Validation ◽

At Home

Abstract Introduction Polysomnography (PSG) is the gold-standard to diagnose obstructive sleep apnea (OSA). OSA severity diagnosis is defined by the apnea-hypopnea index (AHI) defined as the number of apnea and hypopnea events measured per hour of sleep. The Dreem2 headband (DH) is a self-administered, easy to use device that measure EEG, breathing frequency, heart rate and sound at-home. In our study, we assessed the performance of the DH to automatically detects OSA compared to 3 sleep’s experts scoring on PSG. Methods 41 subjects (8 females, 42.6 ± 13.7 y.o.) having a suspicion of OSA performed a night at-home wearing both a PSG and the DH. Each PSG record was scored for apnea and hypopnea events by 3 independent trained sleep experts following AASM guidelines. The deep learning approach DOSED, was trained on the DH signals using the manual apnea scoring. 10-fold cross-validation was used to provide predictions for each of the 41 subjects with the DH. Results We observed an average AHI expert’s scoring of 13.6 ± 10.1 CI[10.5, 16.5] compared to 12.9 ± 10.3 CI[9.6, 15.8] for the DH. Both, the correlation between the 3 scorers (r= 0.88, p < 0.001) and the DH and the scorers (r=0.79, p< 0.001) were significant. The specificity and sensitivity to detect mild OSA (AHI ≤ 5) was 84.4 % and 96.4 % for the DH and 86.5 % and 86.0% for the scorers. Conclusion The results show that the DH using deep learning can detect OSA with an accuracy similar to the sleep experts. The use of DH paves the way for longitudinal monitoring of patients with a suspicion of OSA and its accessibility could lead to better screening of the general population. Support This Study has been supported by Dreem sas.

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Usefulness of linear discriminant analysis of overnight oximetry from respiratory polygraphy at home to assist in the diagnosis of pediatric obstructive sleep apnea hypopnea syndrome

10.1183/13993003.congress-2015.pa3369 ◽

2015 ◽

Author(s):

Andrea Crespo ◽

Félix Del Campo ◽

Roberto Hornero ◽

Daniel Álvarez ◽

Joaquin Terán ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Discriminant Analysis ◽

Linear Discriminant Analysis ◽

Linear Discriminant ◽

Obstructive Sleep ◽

Respiratory Polygraphy ◽

Overnight Oximetry ◽

Hypopnea Syndrome ◽

At Home

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Late Breaking Abstract - Diagnostic accuracy of a respiratory portable monitor, placed at home for obstructive sleep apnea in Mexican children

10.1183/13993003.congress-2019.pa886 ◽

2019 ◽

Author(s):

Martha Guadalupe Torres Fraga ◽

Tania Margarita Silva Cruz ◽

José Luis Carrillo Alduenda ◽

Emma Rosario García Colín ◽

Maria Teresa Tejeda Santos ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Diagnostic Accuracy ◽

Portable Monitor ◽

Mexican Children ◽

Obstructive Sleep ◽

At Home

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Age and seasons influence on at-home pulse oximetry results in children evaluated for suspected obstructive sleep apnea

Italian Journal of Pediatrics ◽

10.1186/s13052-017-0428-y ◽

2017 ◽

Vol 43 (1) ◽

Cited By ~ 1

Author(s):

Martino Pavone ◽

Elisabetta Verrillo ◽

Nicola Ullmann ◽

Serena Caggiano ◽

Valentina Negro ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Pulse Oximetry ◽

Obstructive Sleep ◽

At Home

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Micro-Fabricated Skin-Like AlN/Polyimide/PDMS Sensor for Obstructive Sleep Apnea Monitoring

2020 IEEE 33rd International Conference on Micro Electro Mechanical Systems (MEMS) ◽

10.1109/mems46641.2020.9056237 ◽

2020 ◽

Author(s):

Tao Sun ◽

Wei Mong Tsang

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep ◽

Apnea Monitoring

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A Study on Obstructive Sleep Apnea by Using MindSet Platform

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.889-890.687 ◽

2014 ◽

Vol 889-890 ◽

pp. 687-690

Author(s):

Dan Yang Qiao ◽

Yi Jing Guo ◽

Bin Lin ◽

Hai Hang Zeng ◽

Qin Xiu Qiu ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Daily Life ◽

Monitoring Equipment ◽

Self Monitoring ◽

Monitoring Tools ◽

Obstructive Sleep ◽

Apnea Monitoring ◽

Structure Monitoring ◽

Apnea Syndrome

BCI technology as a widely used technique is gradually into daily life. Based on the study of this technique and taking advantage of MindSet extraction equipment of EEG which is available in the market, we design a portable sleep apnea monitoring tools which use MindSet as a platform, which has comfortable pillow structure. Monitoring equipment described in the text achieves real-time monitoring for apnea, also has an alarm function. Apnea syndrome on self-monitoring and alarm has better effects.

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