Detection of obstructive sleep apnea using Belun Sleep Platform wearable with neural network-based algorithm and its combined use with STOP-Bang questionnaire

Abstract

Many wearables allow physiological data acquisition in sleep and enable clinicians to assess sleep outside of sleep labs. Belun Sleep Platform (BSP) is a novel neural network-based home sleep apnea testing system utilizing a wearable ring device to detect obstructive sleep apnea (OSA). The objective of the study is to assess the performance of BSP for the evaluation of OSA. Subjects who take heart rate-affecting medications and those with non-arrhythmic comorbidities were included in this cohort. Polysomnography (PSG) studies were performed simultaneously with the Belun Ring in individuals who were referred to the sleep lab for an overnight sleep study. The sleep studies were manually scored using the American Academy of Sleep Medicine Scoring Manual (version 2.4) with 4% desaturation hypopnea criteria. A total of 78 subjects were recruited. Of these, 45% had AHI < 5; 18% had AHI 5–15; 19% had AHI 15–30; 18% had AHI ≥ 30. The Belun apnea-hypopnea index (bAHI) correlated well with the PSG-AHI (r = 0.888, P < 0.001). The Belun total sleep time (bTST) and PSG-TST had a high correlation coefficient (r = 0.967, P < 0.001). The accuracy, sensitivity, specificity in categorizing AHI ≥ 15 were 0.808 [95% CI, 0.703–0.888], 0.931 [95% CI, 0.772–0.992], and 0.735 [95% CI, 0.589–0.850], respectively. The use of beta-blocker/calcium-receptor antagonist and the presence of comorbidities did not negatively affect the sensitivity and specificity of BSP in predicting OSA. A diagnostic algorithm combining STOP-Bang cutoff of 5 and bAHI cutoff of 15 events/h demonstrated an accuracy, sensitivity, specificity of 0.938 [95% CI, 0.828–0.987], 0.944 [95% CI, 0.727–0.999], and 0.933 [95% CI, 0.779–0.992], respectively, for the diagnosis of moderate to severe OSA. BSP is a promising testing tool for OSA assessment and can potentially be incorporated into clinical practices for the identification of OSA. Trial registration: ClinicalTrial.org NCT03997916 https://clinicaltrials.gov/ct2/show/NCT03997916?term=belun+ring&draw=2&rank=1

The Belun sleep platform to diagnose obstructive sleep apnea in patients with hypertension and high cardiovascular risk

“…Using an AHI at least 15 events/h to diagnose OSA, the sensitivity, specificity, positive predictive value, and negative predictive value of the Belum Sleep Platform were found to be 85, 87, 88, and 83%, respectively [11]. In the second study, which included 78 patients (African–American 53%, Asian 38%) referred from a sleep laboratory for suspected OSA, the corresponding values were 93, 74, 68, and 95% [12]. These values are similar to our findings (95.7, 77.6, 85.3, and 93.8%, respectively) in 129 Asian individuals with hypertension and high cardiovascular risk.…”

“…A proof-of-concept study has revealed close agreement between the apnea-hypopnea indexes (AHIs) from the Belun Ring and PSG in 50 participants without significant comorbidity [11]. A subsequent cohort study that included 78 patients referred by sleep physicians for suspected OSA reported similar results [12]. In this study, we aimed to evaluate the applicability of the Belun Sleep Platform in real-world patients with hypertension and high cardiovascular risk.…”

“…The electroencephalogram (EEG) was used as a measurement of sleep stages (N1, N2, N3, and REM). Stage N1 is also known as wake to sleep transition wherein the EEG transition from a clear rhythmic alpha (8)(9)(10)(11)(12)(13) to low-voltage mixed frequency accompanied by vertex wave. In Stage N2, the EEG progressed to high-voltage slow wave sleep accompanied by sleep spindles or K-complexes.…”

Penggunaan Platform Cloud Computing dalam Screening dan Monitoring Pada Pasien Gangguan Sistem Pernafasan

“…Penggunaan Cloud Computing dapat pula digunakan sebagai pendeteksi Obstructive Sleep Apnea (OSA). Penelitian (13) Memanfaatkan sensor yang digabungkan dalam bentuk perangkat wearable yang dapat dipakai oleh setiap individu untuk mengetahui dalam beberapa detik apakah orang tersebut sehat atau diragukan membawa penyakit. Perangkat medis yang digunakan terdiri dari sensor yang dapat dikomposisikan untuk memantau dari jarak jauh dan secara real-time status kesehatan mereka yang memiliki gejala virus corona atau mereka yang terinfeksi.…”

The Role of Novel Digital Clinical Tools in the Screening or Diagnosis of Obstructive Sleep Apnea: Systematic Review

“…Yeh et al[44], 2021 N/A Fedorin and Slyusarenko[36], 2021 N/A Xu et al[22], 2022 a Indicates low risk of bias.b Indicates unclear risk of bias. c N/A: not applicable.d Indicates high risk of bias.…”