Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Mar 19, 2021)
Date Submitted: Mar 23, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A single-center validation of the effectiveness photoplethysmography-based smart device in screening obstructive sleep apnea
ABSTRACT
Background:
Obstructive sleep apnea (OSA), the most common upper-airway disease, is closely associated with cardiovascular risk. However, the early detection of OSA is challenging, relying on polysomnography (PSG) or home sleep apnea test (HSAT) in hospitals. A novel technology, PPG (Photoplethysmography), has been developed for OSA screening. However, the validation of PPG-based smart devices is limited as compared to that for PSG or HSAT.
Objective:
This study aimed to investigate the feasibility and validity of PPG-based smart devices in the detection of OSA.
Methods:
A total of 119 consecutive outpatients were recruited from the Chinese PLA General Hospital and assessed using a smart watch, PSG or HSAT for a whole night sleep.
Results:
17/119 patients were excluded due to poor quality of PPG-signals. Among the rest, 83 patients were diagnosed with OSA. Compared to HSAT devices, the accuracy, sensitivity, and specificity of PPG-based smart device in predicting moderate to severe OSA patients (Apnea Hypopnea Index, AHI≥15) were 87.9%, 89.7%, and 86.0%, respectively. Compared to PSG, the accuracy, sensitivity, and specificity in predicting the sleep apnea in patients (AHI≥5) were 81.1%, 76.5%, and 100%, respectively. Moreover, for moderate to severe OSA patients (AHI≥15), the predictive ability of PPG-based smart device in OSA did no differ significantly as compared to HSAT (P=0.75) or PSG (P=0.52).
Conclusions:
The PPG-based smart devices demonstrated good performance in detecting OSA; nevertheless, validation in a large-scale population is imperative. Clinical Trial: Chinese Clinical Trial Registry of the International Clinical Trials Registry Platform of the World Health Organization ChiCTR-OOC-17014138; http://www.chictr.org.cn/showprojen.aspx?proj=24191.
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