Screening of Obstructive Sleep Apnea in Snoring Patients Using a Patch-Type Device With Electrocardiogram and 3-Axis Accelerometer.

Screening of Obstructive Sleep Apnea in Snoring Patients Using a Patch-Type Device With Electrocardiogram and 3-Axis Accelerometer.:

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Screening of Obstructive Sleep Apnea in Snoring Patients Using a Patch-Type Device With Electrocardiogram and 3-Axis Accelerometer.

J Clin Sleep Med. 2020 Apr 08;:

Authors: Hsu YS, Chen TY, Wu D, Lin CM, Juang JN, Liu WT

Abstract

STUDY OBJECTIVES: People with obstructive sleep apnea (OSA) remain undiagnosed owing to lack of easy and comfortable screening tools. Through this study, we aimed to compare the diagnostic accuracy of chest wall motion and cyclic variation of heart rate (CVHR) in detecting OSA by using a single-lead electrocardiogram (ECG) patch with a 3-axis accelerometer.

METHODS: In total, 119 snoring patients simultaneously underwent polysomnography (PSG) with a single-lead ECG patch. Signals of chest wall motion and CVHR from the single-lead ECG patch were collected. The chest effort index (CEI) was calculated using the chest wall motion recorded by a 3-axis accelerometer in the device. The ability of CEI and CVHR indices in diagnosing moderate-to-severe OSA (apnea hypopnea index ≥ 15) was compared using the area under the curve (AUC) by using the DeLong test.

RESULTS: CVHR detected moderate-to-severe OSA with 52.9% sensitivity and 94.1% specificity (AUC: 0.76, 95% confidence interval [CI]: 0.67-0.84, optimal cutoff: 21.2 events/h). By contrast, CEI identified moderate-to-severe OSA with 80% sensitivity and 79.4% specificity (AUC: 0.87, 95% CI: 0.80-0.94, optimal cutoff: 7.1 events/h). CEI significantly outperformed CVHR with regard to the discrimination ability for moderate-to-severe OSA (delta AUC: 0.11, 95% CI: 0.009-0.21, P = 0.032). For determining severe OSA, the performance of discrimination ability was greater (AUC = 0.90, 95% CI: 0.85-0.95) when combining these two signals.

CONCLUSIONS: Both CEI and CVHR recorded from a patch-type device with ECG and a 3-axis accelerometer can be used to detect moderate-to-severe OSA. Thus, incorporation of CEI is helpful in the detection of sleep apnea by using a single-lead ECG with a 3-axis accelerometer.

PMID: 32267228 [PubMed - as supplied by publisher]