Oximetry-based devices in diagnosis of obstructive sleep apnea: A systematic review and meta-analysis

Obstructive sleep apnea (OSA) is a common disorder, associated with significant morbidity and mortality. Recently, several oximetry-based devices have been developed to assist with diagnosing OSA. Therefore, this study aims to evaluate the diagnostic performance of these tools compared to PSG. We included studies that evaluated oximetry-based devices in comparison to PSG for OSA diagnosis in adults. 18 selected studies were divided into two subgroups: consumer wearable and medical devices. Overall sensitivity was 97 % (95 % Confidence Interval [CI]: 96-97 %) and specificity, 63 % (95 % CI: 61-65. In the consumer wearable devices subgroup, sensitivity was 93 % (95 % CI: 90 - 96) and specificity, 63 % (95 % CI: 53 - 71). In the medical devices subgroup, sensitivity was also high as 97 % (95 % CI: 96-97) with a specificity of 63 % (95 % CI: 61-65). Accuracy measured by area under the curve and post-test probability were both 90 %. Oximetry-based devices demonstrate high sensitivity for ruling out OSA in high-risk adults. However, their low specificity raises concerns regarding potential unnecessary healthcare costs. Therefore, these devices may be considered for screening in high-risk individuals, provided that all positive results are confirmed by a gold-standard diagnostic method.