Monitoring Sound To Quantify Snoring and Sleep Apnea Severity Using a Smartphone: Proof of Concept

Nakano, Hiroshi; Hirayama, Kenji; Sadamitsu, Yumiko; Toshimitsu, Ayaka; Fujita, Hisayuki; Shin, Shizue; Tanigawa, Takeshi

doi:10.5664/jcsm.3364

Cited by 119 publications

(96 citation statements)

References 24 publications

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“…Sleep related concerns are commonplace as well, and given the burgeoning popularity and easy availability of inexpensive apps that purport to monitor multiple physiological parameters, it is not surprising that several apps have been designed to evaluate sleep quality. 2 The inexorable permeation of smartphones into the fi eld of sleep medicine has resulted in the development of promising apps that screen for obstructive sleep apnea (OSA) 3,4 and periodic limb movements in sleep (PLMS). 5 Most of them do not, however, record sleep stages.…”

mentioning

confidence: 99%

Is There a Clinical Role For Smartphone Sleep Apps? Comparison of Sleep Cycle Detection by a Smartphone Application to Polysomnography

Bhat

Ferraris

Gupta

et al. 2015

Journal of Clinical Sleep Medicine

110

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Study Objectives: Several inexpensive, readily available smartphone apps that claim to monitor sleep are popular among patients. However, their accuracy is unknown, which limits their widespread clinical use. We therefore conducted this study to evaluate the validity of parameters reported by one such app, the Sleep Time app (Azumio, Inc., Palo Alto, CA, USA) for iPhones. Methods: Twenty volunteers with no previously diagnosed sleep disorders underwent in-laboratory polysomnography (PSG) while simultaneously using the app. Parameters reported by the app were then compared to those obtained by PSG. In addition, an epoch-by-epoch analysis was performed by dividing the PSG and app graph into 15-min epochs. S martphones are now ubiquitous. As their technological capabilities continue to improve, both consumers and healthcare personnel are constantly fi nding new and innovative uses for smartphone apps in the fi eld of health and medicine.1 Apps have been incorporated into the practice of medical specialties as diverse as diabetology and neurosurgery, and have found a role in activities ranging from interpretation of radiology imaging to smoking cessation counseling. Sleep related concerns are commonplace as well, and given the burgeoning popularity and easy availability of inexpensive apps that purport to monitor multiple physiological parameters, it is not surprising that several apps have been designed to evaluate sleep quality.2 The inexorable permeation of smartphones into the fi eld of sleep medicine has resulted in the development of promising apps that screen for obstructive sleep apnea (OSA) 3,4 and periodic limb movements in sleep (PLMS). S C I E N T I F I C I N V E S T I G AT I O N Sinsomnia, circadian rhythm disorders, and hypersomnolence to have objective data about sleep patterns in order to make diagnoses and treatment recommendations. There are several apps that allow users to report and analyze their sleep quality and duration, 6 but such data are often intrinsically subjective. In-laboratory polysomnography (PSG) is the gold standard for BRIEF SUMMARY Current Knowledge/Study Rationale: There are several preexisting, widely available, inexpensive smartphone apps designed to monitor sleep, but it is unclear whether they have clinical utility. Our goal was to systematically compare the results obtained by using one such app, the Sleep Time app (Azumio, Inc.) to the gold standard, polysomnography (PSG). Study Impact: Our study shows that the absolute parameters and sleep staging reported by the Sleep Time app (Azumio, Inc.) for iPhones correlate poorly with PSG. Further studies comparing app sleep-wake detection to actigraphy may help elucidate its potential clinical utility.

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mentioning

confidence: 99%

Is There a Clinical Role For Smartphone Sleep Apps? Comparison of Sleep Cycle Detection by a Smartphone Application to Polysomnography

Bhat

Ferraris

Gupta

et al. 2015

Journal of Clinical Sleep Medicine

110

View full text Add to dashboard Cite

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“…1,62,63 A recent study compared data from conventional PSG with snore recordings from a standard smartphone taped to a subject's chest, and found good agreement on snore data, high correlation between respiratory disturbance index ("smart-RDI") on the smartphone and apnea-hypopnea index (AHI) on the PSG, and high specificity of the smart-RDI for diagnosing moderate to severe OSA (AHI ≥ 15 identified on PSG). 64 The Sonomat, a contactless sleep monitoring system embedded into a foam mattress and designed to detect conventional events such as apneas and hypopneas, was recently compared to PSG and found to have good AHI, apnea index, and hypopnea index correlation, especially for AHI < 50. Interscorer agreement for events scored on Sonomat, differentiation of central versus obstructive events, and evaluation of snoring were also comparable to that of PSG.…”

Section: Discussionmentioning

confidence: 99%

Consumer Sleep Technologies: A Review of the Landscape

Kientz

Choe

et al. 2015

Journal of Clinical Sleep Medicine

184

148

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Objective: To review sleep related consumer technologies, including mobile electronic device "apps," wearable devices, and other technologies. Validation and methodological transparency, the effect on clinical sleep medicine, and various social, legal, and ethical issues are discussed. C onsumer sleep technologies (CSTs) are increasingly popular computer-based systems available to the general public for the purpose of improving or self-monitoring sleep. Their primary goals include sleep induction, wake induction, selfguided sleep assessment, entertainment, social connection, information sharing, and sleep education. There is scant literature discussing these technologies.1,2 Despite a paucity of clinical validation with traditional sleep technologies (e.g., polysomnography (PSG), multiple sleep latency testing (MSLT), and clinical-grade actigraphy), CSTs are here to stay because of their innovative nature, convenience, and affordability.Although adoption rates are not available, sleep-tracking products such as Fitbit and Jawbone are top sellers in consumer health products.3,4 The highest-funded health device on Kickstarter was a sleep monitor, which garnered more than $2.4 million in fi nancial backing. 5 A recent search for "sleep" in the Apple iTunes app store returned over 500 different sleep related applications, or "apps," available for download 6 ; similar searches on Android and Microsoft's app stores return hundreds of results. 7,8 Certain apps boast more than fi ve million downloads; one of the top fi ve paid apps in 2014 on iTunes was a sleep tracker and alarm clock. 9 We use the metaphor "over-the-counter" to describe these CSTs, because they are mostly available without a prescription or clinical guidance. Clinical sleep specialists should be aware of these increasingly popular technologies, as patients may request interpretation of derived data. This paper aims to provide a general overview of CSTs and their potential social, ethical, legal, and clinical effect. Although rapid development of these technologies obviates an exhaustive review, we outline some of the more popular, illustrative, or innovative technologies to give sleep specialists an idea of the recent landscape. Consumer Sleep Technologies: A Review of the Landscape METHODSWe searched PubMed and the digital libraries of the Association for Computing Machinery and Institute of Electrical and Electronics Engineers (where technology developers publish peer-reviewed articles), with search terms including "sleep technology," "sleep app," and "sleep monitoring." We eliminated articles that were not relevant to sleep (e.g., applications for controlling a computer's hibernation mode). We ran similar searches on Google, specifi cally focusing on consumer technology-related websites such as MIT Technology Review, 10

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“…Using signal processing and pattern recognition algorithms, several studies have addressed the detection of snoring and breathing sounds during sleep. An algorithm for analysis and recording of snoring sounds using a smartphone was implemented by Nakano et al, 41 and their results showed a high correlation between the snoring time measured by the smartphone and that measured during the PSG test. However, the authors argued that use of this approach was unproven in a noisy home environment, and that further investigation was needed.…”

Section: Audio Recording: Snoring and Breathmentioning

confidence: 99%

The role of telemedicine and mobile health in the monitoring of sleep-breathing disorders: improving patient outcomes

Villanueva¹,

Suárez²,

Garmendia³

et al. 2017

SHTT

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Monitoring Sound To Quantify Snoring and Sleep Apnea Severity Using a Smartphone: Proof of Concept

Abstract: A smartphone can be used for effectively monitoring snoring and OSA in a controlled laboratory setting. Use of this technology in a noisy home environment remains unproven, and further investigation is needed.

Cited by 119 publications

References 24 publications

Is There a Clinical Role For Smartphone Sleep Apps? Comparison of Sleep Cycle Detection by a Smartphone Application to Polysomnography

Is There a Clinical Role For Smartphone Sleep Apps? Comparison of Sleep Cycle Detection by a Smartphone Application to Polysomnography

Consumer Sleep Technologies: A Review of the Landscape

The role of telemedicine and mobile health in the monitoring of sleep-breathing disorders: improving patient outcomes

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