Evaluation of an OSA Risk Screening Smartphone App in a General, Non-Symptomatic Population Sample (ESOSA)

Background: Obstructive Sleep apnea (OSA) is a prevalent sleep disorder, risk factor for cardiovascular disease and imposes a substantial global socioeconomic and health burden. OSA is insufficiently diagnosed as it often presents with unspecific or no symptoms. This study compares the effectiveness of a smartphone-based screening method to polysomnography (PSG) in a general, non-symptomatic population sample. Methods: Adult subjects were recruited from the general population. Subjects reporting OSA-related symptoms suggesting an increased OSA risk were excluded. Included subjects underwent Type-II PSG and a parallel breathing sound analysis using the Snorefox M smartphone app. The PSG scores were compared with the results of the Snorefox M app for its ability to detect moderate to severe OSA (AHI ≥ 15). Results: 150 subjects were included. All subjects completed the diagnostic night, no adverse events occurred. A valid analysis result was obtained for 142 subjects. A total of 24% of subjects had moderate to severe OSA based on the PSG results. The Snorefox M software app showed a sensitivity of 0.91 (0.76, 0.98), specificity of 0.83, PPV of 0.63 (0.48, 0.77), and NPV of 0.97 (0.91, 0.99) to detect AHI ≥ 15 compared with the reference PSG (95% CI). Conclusions: This study compares for the first time, the performance of an app-based OSA screening tool with PSG in a non-symptomatic population sample. Easily accessible screening tools can play a role in complementing existing diagnostic possibilities, helping to increase the diagnosis rate, with a positive effect on cardiovascular health in a relevant population share.