EVALUATION OF CLOUD-CONNECTED HOME SENSORS OF APNEA-HYPOPNEA INDEX VERSUS POLYSOMNOGRAPHY AND HOME SLEEP TEST DURING UPPER AIRWAY STIMULATION HOME TITRATION

Abstract Introduction A growing number of cloud-connected sensors can longitudinally record apnea hypopnea index (AHI) at home. The Ectosense NightOwl is an FDA-approved peripheral arterial tomography device; the Withings Sleep Analyzer mat is an under-mattress sensor with AHI data for retrospective research use (CE marked, not FDA approved). We used these sensors to monitor patients with upper airway stimulation (UAS) therapy during therapy acclimatization and post-titration follow-up and compared sensor AHI to polysomnography (PSG) and home sleep test (HST) AHIs. Methods Enrolled patients underwent UAS implantation as part of regular clinical care and were required to have a smartphone. The Ectosense and Withings sensors were distributed at UAS device activation. Patients were asked to use NightOwl weekly, and Withings provided nightly AHI. Sleep studies (PSG & HST) occurred at 3 and 6-mo post implant. Ectosense & Withings AHI were averaged and correlated against the nearest 3- and 6-month sleep study AHIs. Results Patients were 67% male, aged 57 ± 10 years. Smartphone platforms were 59% Apple iOS, 24% Google Android, and 17% Unknown. As of October 2021, 45 patients have had near-simultaneous Withings and PSG/HST AHI, 35 have had near-simultaneous NightOwl and PSG/HST AHI. The Withings AHI was fairly linear against PSG/HST AHI, adjusted R2 = 0.47, p < 0.0001, (y=10 + 0.82x). Withings AHI < 15 (n=18) had a 90% positive predictive value for a PSG/HST AHI less than 15 (n=20). Ectosense data was less linear and more scattered, adjusted R2 = 0.15, p=0.01, (y=14 + 0.47x). Ectosense AHI < 15 (n=12) had an 80% positive predictive value of a PSG/HST AHI less than 15 (n=15). Conclusion Home-based sensors provide longitudinal SDB data in a home setting and may adequately classify patients with mild sleep apnea, and may have utility for home-based management of UAS patients in the post-implantation period. Support (If Any) Inspire Medical Systems