Screening of obstructive sleep apnea in patients who snore using a patch-type device with electrocardiogram and...

Area of Science:

• Cardiology
• Pulmonology
• Biomedical Engineering

Background:

• Obstructive sleep apnea (OSA) diagnosis is challenging due to a lack of comfortable and accessible screening tools.
• Current diagnostic methods often require extensive equipment and specialized facilities.

Purpose of the Study:

• To evaluate the diagnostic accuracy of chest wall motion and cyclic variation of heart rate (CVHR) for detecting OSA.
• To compare the efficacy of these two metrics using a single-lead electrocardiogram (ECG) patch with a 3-axis accelerometer.

Main Methods:

• 119 patients underwent polysomnography with a single-lead ECG patch.
• Chest wall motion was measured using the chest effort index (CEI) via a 3-axis accelerometer.
• CVHR signals were collected from the ECG patch, and both indices were compared for diagnosing moderate-to-severe OSA (apnea-hypopnea index ≥ 15) using area under the curve (AUC).

Main Results:

• CVHR showed 52.9% sensitivity and 94.1% specificity (AUC: 0.76) for moderate-to-severe OSA.
• CEI demonstrated 80% sensitivity and 79.4% specificity (AUC: 0.87), significantly outperforming CVHR (ΔAUC: 0.11, P = .032).
• Combining CEI and CVHR improved discrimination for severe OSA (AUC = 0.90).

Conclusions:

• Both CEI and CVHR, derived from a patch-type device with ECG and accelerometer, can effectively detect moderate-to-severe OSA.
• Incorporating CEI enhances the detection of sleep apnea using a single-lead ECG with a 3-axis accelerometer.