Diagnostic value of wearable and contactless technologies for detecting obstructive sleep apnea: a systematic review...

BACKGROUND​: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder, affecting an estimated 1 billion adults worldwide. This study evaluates the diagnostic accuracy of wearable and contactless sleep technologies as alternatives to Polysomnography (PSG) for the detection of OSA.

A comprehensive search was conducted from inception to September 2025 on PubMed, Cochrane Library, ClinicalTrials.gov, and ScienceDirect. Studies including adults diagnosed with OSA using PSG or HSAT and evaluated with wearable or contactless devices were included. Studies assessing the diagnostic performance of these consumer devices and reporting diagnostic accuracy measures were included. QUADAS-2 was used to assess the risk of bias, and meta-analysis was performed.

A total of 59 studies were included, with 3,768 participants in the contactless group and 2,743 participants in the wearable group. For AHI > 15, contactless devices demonstrated a pooled sensitivity of 0.88 (95% CI: 0.86-0.90) and specificity of 0.87 (95% CI: 0.82-0.91), with an AUC of 0.92 (95% CI: 0.89-0.94). Wearable devices showed a pooled sensitivity of 0.87 (95% CI: 0.81-0.92), specificity of 0.86 (95% CI: 0.78-0.91), and an AUC of 0.93 (95% CI: 0.90-0.95).

Wearable and contactless sleep technologies demonstrate strong diagnostic accuracy. Their role is likely going to be to screen, and compliment PSG rather than replacing it, and providing utility in settings where access to traditional sleep testing is limited. More validation studies across populations, care settings, and comorbidities are needed to make clinical guidelines.