Feasibility, acceptability, and usability of a novel self-monitoring program utilizing a consumer-grade wearable...

Obstructive sleep apnea (OSA) is characterized by repeated airway obstruction and associated oxygen desaturation during sleep. Positive airway pressure remains the most common treatment, but some patients use non-positive airway pressure (non-PAP) therapies such as positional devices and oral appliances. Unlike PAP devices, these therapies do not typically provide ongoing physiologic feedback. This lack of feedback can make it difficult for patients to understand their nightly physiology between sleep studies. While consumer-grade wearables are not intended to diagnose OSA, they offer an opportunity to design patient-facing tools that support access to and interpretation of peripheral oxygen saturation (SpO₂) data for self-management and treatment decision-making.

This clinical demonstration project developed and iteratively refined a workflow for generating a weekly report that combined smartwatch-derived SpO₂ data with self-reported sleep-related outcomes for patients using non-PAP OSA therapies. Patients viewed a weekly electronic report on their own and again with a clinician at program completion. Report content and implementation procedures were adjusted through a series of Plan-Do-Study-Act cycles, with emphasis on reducing information complexity and supporting patient sensemaking. Think-aloud interviews with a subset of patients explored how they interpreted and used the report. Post-program survey data were summarized descriptively, and interview notes were reviewed to identify report-related interpretive challenges and guide iterative refinement.

Of the 17 patients who enrolled, 16 completed the program and 15 completed the post-program survey. At least 70% of respondents agreed that the program was feasible, acceptable, and appropriate. The System Usability Scale score was 75.8, indicating above-average usability. The Net Promoter Score was 64, suggesting willingness to recommend the program. Most respondents (≥85%) reported that "at least some effort" was made to engage them in shared decision-making during the clinician review session. Think-aloud interviews indicated that patients who were interviewed found the report helpful for making sense of their data and preferred side-by-side visualizations of higher (≥93%) and lower (<93%) SpO₂ levels, which informed revisions to simplify and clarify the report.

Incorporating consumer-grade smartwatch SpO₂ data into a structured, patient-facing weekly report appears to be a feasible and acceptable way to complement OSA care for patients using non-PAP therapies.