Validation of a novel sleep-monitoring system for diagnosing obstructive sleep apnea: A comparison with polysomnography

Abstract

Overnight polysomnography (PSG) is currently the gold standard for diagnosing obstructive sleep apnea (OSA); however, it is time-consuming, expensive and uncomfortable for the patient. A micromovement sensitive mattress (MSM) sleep-monitoring system was developed as an alternative to PSG, however, there has yet to be a study verifying the accuracy of diagnosing OSA with this device. Therefore, the present study assessed the validity of the MSM sleep-monitoring system. Chinese Han participants who were suspected of having OSA were recruited between June 2013 and June 2014. The MSM sleep-monitoring system and PSG were utilized simultaneously overnight on each subject. The apnea-hypopnea index (AHI) was measured by the MSM sleep-monitoring system (AHIMSM) and compared with that determined by PSG (AHIPSG), revealing a significant correlation between the two values (r=0.97, P<0.001). Bland-Altman plots also indicated good agreement (97%) between MSM and PSG. Using an AHIPSG cut-off of ≥5, ≥15 and ≥30 events/h, the sensitivity (specificity) of detecting an AHIMSM of ≥5, ≥15, and ≥30 events/h were 94.9 (100%), 89.9 (96.9%) and 90.3% (94.9%), respectively. The areas under the receiver operating characteristic curve, which were used to differentiate an AHIPSG of ≥5, ≥15 and ≥30 events/h in clinically diagnosed OSA, were 0.984, 0.982 and 0.980, respectively. Thus, the MSM sleeping system may accurately diagnose OSA in the Chinese Han population. Further community-based studies with larger sample sizes are warranted to confirm the validity of this MSM sleeping system.

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

“…Table 7 shows, in the patient selection domain, 3 studies with a high risk of bias [ 29 , 47 , 50 ], 6 with a low risk [ 16 , 30 , 45 , 48 , 49 , 51 ], and 2 with unclear risk [ 46 , 52 ]. In turn, in the index test domain, 4 studies had a high risk [ 29 , 47 , 51 , 52 ], namely in questions Q5 and Q10, and the other 7 studies presented a low risk of bias [ 16 , 30 , 45 , 46 , 48 - 50 ].…”

“…Another reason was that several designs were faltered in Q3: “Did the study avoid inappropriate exclusions? ” This is mostly because of an imprecise description of the reasons that led to those exclusions, as in one study where patients with back pain were excluded because this would make the use of the mattress sensor more difficult, which can overestimate the applicability of this type of tool [ 47 ]. Moreover, several studies did not include the results for all selected patients (P10), stating that it was attributable to a lack of space [ 29 ] or unreturned devices [ 54 ].…”

“…Bed or mattress-based sensors, for which the description can be found in Table 6, are also a big part of our pool of articles, with 11 (27%) of the 41 studies analyzing the performance and screening capability of these pressure-based sensing devices in the context of OSA [16,30,[45][46][47][48][49][50][51][52]. In addition to under-the-mattress sensors, there is also a smart pillow paired with an oximeter, which offers diagnostic capability by detecting apnea events and interventional intent by being able to inflate and change its conformation and deobstruct the patient's airway [29].…”

Piezoelectric rubber sheet sensor: a promising tool for home sleep apnea testing

“…Home sleep apnea testing (HSAT) [1], as a means of screening sleep apnea, plays a crucial role in efficiently utilizing the limited medical resources of polysomnographic examination. Various types of sensors are utilized in HSAT devices, including those for measuring nasal pressure/temperature [2], respiratory inductance plethysmography [3], peripheral arterial tonometry [4,5], oximetry [6], electrocardiography [7,8], pulse wave photo-plethysmography [9], radio-wave Doppler effect [10] and bed-embedded micromotion sensors [11][12][13][14]. Generally, it is believed that the accuracy of sleep apnea detection improves with an increased number of signals measured [15].…”

Comparison of Polysomnography and Cardiopulmonary Coupling in the Diagnosis of Insomnia, Obstructive Sleep Apnoea, or Comorbidity, a Pilot Study

“…Polysomnography (PSG) is the gold standard for the diagnosis of sleep disorders. However, many limiting factors, such as high cost, tedious operation with many lead wires, poor compliance, and lack of instrument resources [8,9], render PSG unable to be widely performed in clinical practice, resulting in a high missed diagnosis rate of OSA and other sleep-related diseases. Therefore, it is necessary to use a simpler and portable instrument to record sleep status.…”