Non-invasive residence monitoring over a number of nights alerts a excessive prevalence of obstructive sleep apnea

December 29, 2021

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Lechat does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Non-invasive monitoring of sleep and obstructive sleep apnea for several nights can aid current diagnosis and treatment of OSA, researchers reported in a recent study.

“Data from a novel, non-invasive sensor technology under the mattress, which was collected over an average of at least 8 months of nightly monitoring at in a large, non-random sample of the population from 20 countries / regions, indicates a global prevalence of moderate to severe OSA from [approximately] 20%. The likelihood of a misdiagnosis based on a single night of , as is currently common in clinical practice, was high at [approximately] 20% in the currently selected population sample and increased to [approximately] 50% in people with mild to moderate OSA, ”wrote Bastien Lechat, BSc, research fellow at the Adelaide Institute for Sleep Health and FHMRI Sleep Health at the College of Medicine and Public Health at Flinders University, Adelaide, Australia, and colleagues in the American Journal of Respiratory and Critical Care Medicine.

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The researchers evaluated 67,278 people aged 18 to 90 (mean age 47; 78% men; 62% from Europe) from a large, global, non-random community sample from a consumer database of new, validated purchases of under-mattress sleep analyzers . The sleep sensor technology under the mattress (Withings Sleep Analyzer) has pneumatic and acoustic sensors that can detect body movements, heart rate, breathing rate, and episodes of respiratory failure. All individuals were monitored at at night for an average of approximately 170 nights per person from July 2020 to March 2021.

Results included the global multi-night prevalence of OSA and the likelihood of misclassification based on an apnea-hypopnea index (AHI) value for one night. OSA was defined as the nocturnal mean AHI of more than 15 events per hour.

The researchers collected more than 11.6 million nights of data; 30,051 people had no OSA, 21,573 had mild OSA, 9,982 had moderate OSA, and 5,672 had severe OSA.

The global prevalence of OSA was 22.6%. The chance of misdiagnosis ranged from 20% to 50% based on single night studies. With the increase in monitoring nights, the error rates for misdiagnosis decreased and remained stable after 14 monitoring nights.

The misclassification of sleep apnea based on single night studies was higher in people with mild and / or moderate OSA. Only 54% of people with mild and 52% of people with moderate OSA were correctly classified, compared with 85% of people without OSA and 77% of people with severe OSA.

“The current results also highlight the potential benefits of non-invasive sleep and OSA screening over multiple nights at home to support current clinical diagnostic and management practices, which provide advantages in terms of cost-effectiveness and better access to care over current routine practice can offer. Nonetheless, our results do not rule out the need for gold standard polysomnography, especially in more complex cases or in people with severe or multiple comorbidities where additional information on hypoxemia and OSA endotypes may be clinically indicated and instructive, ”the researchers wrote. “Further prospective work on randomly selected populations is required in order to examine the generalizability of the current results.”

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