scholarly journals Accuracy of a Smartphone Application Measuring Snoring in Adults—How Smart Is It Actually?

2021 ◽  
Vol 18 (14) ◽  
pp. 7326
Author(s):  
Katharina Klaus ◽  
Anna-Lena Stummer ◽  
Sabine Ruf
Keyword(s):  
Adult Population ◽  
Smartphone Application ◽  
Apnea Hypopnea Index ◽  
Quiet Sleep ◽  
Predictive Values ◽  
Acceptable Accuracy ◽  
Time In Bed ◽  
Monitoring Time ◽  
Obstructive Sleep ◽  
At Home

About 40% of the adult population is affected by snoring, which is closely related to obstructive sleep apnea (OSA) and can be associated with serious health implications. Commercial smartphone applications (apps) offer the possibility of monitoring snoring at home. However, the number of validation studies addressing snoring apps is limited. The purpose of the present study was to assess the accuracy of recorded snoring using the free version of the app SnoreLab (Reviva Softworks Ltd., London, United Kingdom) in comparison to a full-night polygraphic measurement (Miniscreen plus, Löwenstein Medical GmbH & Co., KG, Bad Ems, Germany). Nineteen healthy adult volunteers (4 female, 15 male, mean age: 38.9 ± 19.4 years) underwent simultaneous polygraphic and SnoreLab app measurement for one night at home. Parameters obtained by the SnoreLab app were: starting/ending time of monitoring, time in bed, duration and percent of quiet sleep, light, loud and epic snoring, total snoring time and Snore Score, a specific score obtained by the SnoreLab app. Data obtained from polygraphy were: starting/ending time of monitoring, time in bed, total snoring time, snore index (SI), snore index obstructive (SI obstructive) and apnea-hypopnea-index (AHI). For different thresholds of percentage snoring per night, accuracy, sensitivity, specificity, positive and negative predictive values were calculated. Comparison of methods was undertaken by Spearman-Rho correlations and Bland-Altman plots. The SnoreLab app provides acceptable accuracy values measuring snoring >50% per night: 94.7% accuracy, 100% sensitivity, 94.1% specificity, 66.6% positive prediction value and 100% negative prediction value. Best agreement between both methods was achieved in comparing the sum of loud and epic snoring ratios obtained by the SnoreLab app with the total snoring ratio measured by polygraphy. Obstructive events could not be detected by the SnoreLab app. Compared to polygraphy, the SnoreLab app provides acceptable accuracy values regarding the measurement of especially heavy snoring.

Reliability of Holter Oximetry for Home Sleep Apnea Testing

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P83-P84 ◽  
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.

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

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.

scholarly journals 0616 Validation of a Sleep Headband for Detecting Obstructive Sleep Apnea

SLEEP ◽  
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.

567 Validity of Sleep Related Breathing Disorder Scale and Anthropometrics in Obese/Overweight Children with Obstructive Sleep Apnea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A224-A224
Author(s):  
Leyden Lozada Jimenez ◽  
Jennifer Brubaker ◽  
Nicolas Thompson ◽  
Ryan Honomichl ◽  
Reena Mehra ◽  
...  
Keyword(s):  
Prediction Models ◽  
Population Characteristics ◽  
Outcome Variable ◽  
Apnea Hypopnea Index ◽  
Cutoff Score ◽  
Model Interaction ◽  
Predictive Values ◽  
Obesity Epidemic ◽  
Obstructive Sleep ◽  
Youden’S Index

Abstract Introduction Prevalence of OSA, a multifactorial disorder associated with significant morbidity, has increased due to the pediatric obesity epidemic. A key existing gap is lack of a valid OSA screening tool in overweight/obese pediatric patients incorporating anthropometrics. Our aim is to examine the validity of inclusion of anthropometrics to the existing SRBD scale to detect moderate (apnea hypopnea index-AHI≥5) or severe OSA(AHI≥10). Methods Consecutive obese/overweight(n=89) patients(body mass index-BMI percentile>85th for age/gender) in obesity management clinic with SRBD scale, polysomnogram(PSG) and anthropometrics (neck circumference (NC),waist circumferences(WC), height), systolic and diastolic blood pressure(BP) percentiles are included. Receiver operating characteristic(ROC) analysis with AHI as the outcome variable, sensitivity, specificity, positive(PPV), negative predictive values(NPV) for an SRBD cutoff score of 8 and SRBD score found using Youden’s index in ROC and 95% confidence intervals using the exact binomial method are presented. Prediction model, interaction and discrimination (Outcome:AHI; Independent: age, sex, WC, NC, SRBD) were analyzed. Results Study population characteristics: age 12.6±3.4years, 55% female, 62% non-white and AHI=13.0±20.7,AHI>5=65.1% and AHI>10=37.1%. No significant differences were noted in item endorsement or SRBD total score using either AHI≥5 or AHI≥10 (all P>0.10). The area under the ROC curve for SRBD detecting AHI≥5 and 10 was 0.491(95%CI=0.352–0.630) and 0.559(95%CI=0.439–0.679). SRBD≥8 had sensitivity 0.759(0.628–0.861), specificity 0.387(0.218–0.578), PPV 0.698(0.570–0.808), NPV 0.462(0.266–0.666), for AHI≥5 and for AHI≥10, 0.848(0.681–0.949), 0.375(0.249–0.515), 0.444(0.319–0.575), 0.808(0.606–0.934) respectively. The SRBD cutoff score for Youden’s index was 7 for both AHI cutoffs of 5 and 10 and produced similar results to using SRBD cutoff score of 8. The prediction models including age, sex and WC (NC was not significant) had optimism-corrected c-statistics of 0.724 and 0.627 for AHI≥5 and 10, respectively. Adding SRBD total score to the models actually reduced these values to 0.702 and 0.614. Conclusion SRBD alone has fair sensitivity, but poor specificity for significant OSA in overweight/obese. The addition of anthropometrics to SRBD decreased discrimination of OSA in prediction models. Anthropometrics may differ in pre pubertal and post pubertal phenotypes of OSA and may or may not aid in increasing predictability of OSA with SRBD. Support (if any):

scholarly journals Evaluating four –variable screening tool in european population of a sleep clinic for assessing obstructive sleep apnea syndrome

2015 ◽  
Vol 7 (2) ◽  
pp. 21-27 ◽  
Author(s):  
Athanasia Pataka ◽  
Seraphim Kotoulas ◽  
Evdokia Sourla ◽  
Sofia Akritidou ◽  
Evangelia Panagiotidou ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Roc Curve ◽  
Screening Tool ◽  
European Population ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Predictive Values ◽  
Variable Screening ◽  
Obstructive Sleep

Background: Different questionnaires have been used to evaluate patients with Obstructive sleep apnea/hypopnea syndrome (OSAHS). The 4-Variable screening tool (4-V) was developed and validated in Asian population for identifying moderate to severe OSAHS.Aims and Objectives: To evaluate the ability of 4-V to identify patients at high risk for OSAHS in a European Population visiting a Sleep Clinic. Methods: 1057 (73.8% males), 52±14 years, BMI 33±7kg/m2, Epworth Sleepiness Scale (ESS) 11.5±5.4 and Apnea Hypopnea Index (AHI) 32.7±26.5 were included. All patients had an in laboratory sleep study and  4-V was calculated.Results: The mean 4-V score was 13.3±2.5. Sensitivities of 4-V≥11 for AHI ≥5, ≥15 and ≥30 were 78%, 79% and 81%, respectively; specificities 40.8%, 36%, 32%;  positive predictive values (PPV)  84.3%, 71%, 52%;  negative predictive values (NPV) 31% , 46.5%, 65% and  area under the ROC curve at AHI≥ 15 was 0.58. For  4-V ≥14, sensitivities  for AHI ≥5, ≥15 and ≥30 were 50.7%, 55% and 61%, respectively; specificities 78%, 74.4%, 69%; PPV  90.3%, 81%, 64%; NPV 27.9%, 45%, 66%  and area under the ROC curve at AHI≥ 15 was 0.68. The 4-V differed significantly between no and mild and between moderate and severe OSAHS, but not  between mild and moderate OSAHS  in both genders. Sensitivity was better in men, but specificity was higher in women.Conclusion: In Caucasians the 4-V≥14 had low sensitivity and NPV, rather good specificity and PPV. For a cut-off ≥11, sensitivity was better but specificity was low. However the predictive values differed between genders. Asian Journal of Medical Sciences Vol.7(2) 2015 21-27

scholarly journals Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-Analysis

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Rashid Nadeem ◽  
Michael Harvey ◽  
Mukesh Singh ◽  
Ahmed Abdullah Khan ◽  
Mustafa Albustani ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Meta Analysis ◽  
Adult Population ◽  
Intima Media Thickness ◽  
Cochrane Library ◽  
Apnea Hypopnea Index ◽  
Data Set ◽  
Media Thickness ◽  
Obstructive Sleep

Background. Obstructive sleep apnea (OSA) is associated with coronary artery disease. Intermittent hypoxia associated with OSA increases sympathetic activity and may cause systemic inflammation, which may contribute to atherosclerosis leading to an increase in the size of carotid intima media thickness (CIMT).Methods. PubMed and Cochrane library were reviewed by utilizing different combinations of key words: sleep apnea, carotid disease, intima media thickness, and carotid atherosclerosis. Inclusion criteria were English articles; studies with adult population with OSA and without OSA; CIMT recorded by ultrasound in mean and standard deviation or median with 95% confidence interval; and OSA defined as apnea hypopnea index of ≥5/h. A total of 95 studies were reviewed for inclusion, with 16 studies being pooled for analysis.Results. Ninety-five studies were reviewed, while 16 studies were pooled for analysis; since some studies have more than one data set, there were 25 data sets with 1415 patients being pooled for meta-analysis. All studies used ultrasound to measure CIMT. CIMT standardized difference in means ranged from −0.883 to 8.01. The pooled standardized difference in means was 1.40 (lower limit 0.996 to upper limit 1.803, (P<0.0001).Conclusion. Patients with OSA appear to have increased CIMT suggestive of an atherosclerotic process.

scholarly journals Comparison of Predictor of Desaturation Disorders and Daytime Sleepiness Based On Epworth Sleepiness Scale and STOP-BANG Questionnaires in Mild to Moderate Obstructive Sleep Apnea Patients

2018 ◽  
Vol 6 (9) ◽  
pp. 1617-1621 ◽  
Author(s):  
Zohreh Kahramfar ◽  
Besharat Rahimi
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Epworth Sleepiness Scale ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Predictive Values ◽  
Desaturation Index ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Severity Of The Disease

BACKGROUND: Obstructive sleep apnea (OSA) is characterised by recurrence in upper airway obstruction during sleep. AIM: This study aimed to compare the predictive values of the Epworth Sleepiness Scale (ESS) and STOP-BANG in the desaturation of patients with mild to moderate obstructive apnea based on the apnea-hypopnea index (AHI) scale. METHODS: A group of 79 patients (43 male and 36 female) were selected. The suspected patients were introduced to the sleep clinic, and the ESS and STOP-BANG questionnaires were filled up, then subjected to polysomnography test, and the scores of the disease were also determined based on an apnoea-hypopnoea index (AHI). Finally, the desaturation rate (SO2 < 3% based on the baseline) and desaturation index were determined in patients. Consequently, the finding was compared with the results of the questionnaires. RESULTS: Patients with STOP-BANG score above 3 had significantly higher weight, oxygen desaturation index (ODI) index and average desatu, while peripheral capillary oxygen saturation (SpO2) base and average SpO2 were lower than those with scores below 3 (P < 0.05). However, there was no significant difference between the patients with the ESS questionnaire score above 10 and below 10 (P > 0.05). CONCLUSION: The results of these two questionnaires reflect the unsaturated oxygen index in the blood, and can be considered for the evaluation of the severity of the disease.

scholarly journals The Validity and Reliability of an Arabic Version of the STOP-Bang Questionnaire for Identifying Obstructive Sleep Apnea

2015 ◽  
Vol 9 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Ahmed S. BaHammam ◽  
Alaa M. Al-Aqeel ◽  
Alanoud A. Alhedyani ◽  
Ghaida I. Al-Obaid ◽  
Mashail M. Al-Owais ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Apnea Hypopnea Index ◽  
Arabic Version ◽  
Validity And Reliability ◽  
Predictive Values ◽  
Obstructive Sleep ◽  
Patients At Risk ◽  
The Cost

Background:Obstructive sleep apnea (OSA) is a common, serious, under-recognized and under-diagnosed medical disorder. Polysomnography (PSG) is the gold standard diagnostic test for OSA; however, the cost of testing and the shortage of sleep disorders laboratories limit access to this tool. Therefore, there is a need for a simple and reliable diagnostic tool to screen patients at risk of OSA.Objective:This study was conducted to evaluate the validity and reliability of an Arabic version of the STOP-Bang questionnaire (SBQ) as a screening tool for OSA.Methods:This study was conducted in three steps, as follows: Step 1: the SBQ was translated from English to Arabic (examining both forward and backward translations); Step 2: the test-retest reliability of the questionnaire was investigated; and Step 3: the questionnaire was validated against PSG data prospectively on 100 patients attending a sleep disorders clinic who were subjected to a full-night PSG study after completing the translated version of the SBQ. The validity of the test was tested against the apnea-hypopnea index (AHI).Results:The study group had a mean age of 46.6 ± 14.0 years and a mean AHI of 50.0 ± 37.0/hour. The study demonstrated a high degree of internal consistency and stability over time for the translated SBQ. The Cronbach’s alpha coefficient for the 8-item tool was 0.7. Validation of the SBQ against the AHI at a cut-off of 5 revealed a sensitivity of 98% and positive and negative predictive values of 86% and 67%, respectively.Conclusion:The Arabic version of the SBQ is an easy-to-administer, simple, reliable and valid tool for the identification of OSA in the sleep disorders clinic setting.

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Lifeng Li ◽  
Demin Han ◽  
Hongrui Zang ◽  
Nyall R. London
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Nasal Surgery ◽  
Subjective Sleep Quality ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

<b><i>Objective:</i></b> The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. <b><i>Methods:</i></b> Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. <b><i>Results:</i></b> By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (<i>p</i> &#x3c; 0.05), while the Apnea-Hypopnea Index (AHI) changed little (<i>p</i> = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all <i>p</i> &#x3c; 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (<i>p</i> &#x3c; 0.05), except with the AHI (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

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