Wearable at-home recording system for sleep apnea

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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A multisensor detector of a sleep apnea for using at home

2013 6th International Conference on Human System Interactions (HSI) ◽

10.1109/hsi.2013.6577874 ◽

2013 ◽

Cited By ~ 13

Author(s):

Piotr Przystup ◽

Adam Bujnowski ◽

Jacek Ruminski ◽

Jerzy Wtorek

Keyword(s):

Sleep Apnea ◽

At Home

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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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Electrode Belt: A New Method for Long-Term Monitoring

PEDIATRICS ◽

10.1542/peds.63.4.670 ◽

1979 ◽

Vol 63 (4) ◽

pp. 670-673

Author(s):

Dorothy H. Kelly ◽

Kathleen O'Connell ◽

Daniel C. Shannon

Keyword(s):

Heart Rate ◽

Sleep Apnea ◽

Electronic Monitoring ◽

False Alarms ◽

American Academy Of Pediatrics ◽

Long Term Monitoring ◽

Monitoring Devices ◽

Term Monitoring ◽

At Home

Infants who have experienced an episode of prolonged sleep apnea associated with cyanosis, pallor, and limpness requiring vigorous stimulation or mouth-to-mouth resuscitation to restore breathing, are at risk of experiencing a recurrence that may result in death1.2. The American Academy of Pediatrics has recommended that such infants be treated by 24-hour surveillance either in the home or in the hospital. Electronic monitoring devices "may be useful adjuncts" to such surveillance.3 Since 1973, we have monitored 270 infants at home with apnea or cardiac monitors. A major problem with monitoring infants at home has been false alarms, such as alarms for apnea when the infant is breathing, on heart rate or apnea alarms due to a loose electrode.

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Automatic Silence Events Detector from Smartphone Audio Signals: A Pilot mHealth System for Sleep Apnea Monitoring at Home

2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) ◽

10.1109/embc.2019.8857906 ◽

2019 ◽

Cited By ~ 1

Author(s):

Yolanda Castillo-Escario ◽

Ignasi Ferrer-Lluis ◽

Josep Maria Montserrat ◽

Raimon Jane

Keyword(s):

Sleep Apnea ◽

Audio Signals ◽

Apnea Monitoring ◽

At Home

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1010 Individuals with Metabolic Syndrome and Unrecognized Sleep Apnea Can Be Identified by an Employer-Sponsored Healthcare Program and At-Home Sleep Study

SLEEP ◽

10.1093/sleep/zsaa056.1006 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A384-A384

Author(s):

O A Iakoubova ◽

C H Tong ◽

A R Arellano ◽

L A Bare ◽

M S Fragala ◽

...

Keyword(s):

Metabolic Syndrome ◽

Sleep Apnea ◽

Health Claims ◽

Therapeutic Interventions ◽

Outreach Program ◽

Berlin Questionnaire ◽

Cvd Risk ◽

Sleep Study ◽

Obstructive Sleep ◽

At Home

Abstract Introduction Obstructive sleep apnea (OSA) is common in individuals with metabolic syndrome (MetS) and increases risk of cardiovascular (CVD) events. Once recognized, therapeutic interventions can reduce OSA severity and associated CVD risk. Of the 25 million Americans with OSA, 80% are unaware of their disease. To facilitate and improve diagnosis of OSA, diagnostic devices for at-home OSA testing have been developed in clinical studies and approved by FDA. We evaluated an employer-sponsored healthcare outreach program and at-home OSA testing as a means of identifying individuals likely to have OSA and referring them into care. Methods Nine-hundred individuals with MetS, positive OSA Berlin questionnaire score and no prior diagnosis of OSA, as determined by annual workplace screening and health claims, were invited to participate in the sleep program. Those who agreed to participate (9.9%) received a diagnostic device for at-home OSA testing. Apnea-hypoapnea index (AHI) results recorded on returned diagnostic devices were evaluated by a sleep specialist. A telephone consultation with a program physician then provided each participant with an explanation of test results and referral into care. Based on AHI we identified individuals with moderate (AHI 16-30) to severe (AHI >30) OSA and referred them to care. Results Of the 89 participating individuals, 21% had 3 MetS components, 53% had 4 components, and 20% had 5 components; 30% were diabetic; 83% had hypertension; and >50% were obese. Moderate to severe OSA was diagnosed in 52 (58%) of participants. Of those, 50% had moderate OSA and 50%, had severe OSA. Among individuals with moderate to severe OSA, 29 (56%) had a physician consultation and were referred to treatment. Conclusion A personalized employer-sponsored healthcare outreach program identified individuals with unrecognized OSA and referred them into care. Support

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