Wireless wearable sensors can facilitate rapid detection of sleep apnea in hospitalized stroke patients

SLEEP, Год журнала: 2024, Номер 47(11)

Опубликована: Май 30, 2024

Abstract Study Objectives To evaluate wearable devices and machine learning for detecting sleep apnea in patients with stroke at an acute inpatient rehabilitation facility (IRF). Methods A total of 76 individuals wore a standard home test (ApneaLink Air), multimodal, wireless sensor system (ANNE), research-grade actigraphy device (ActiWatch) least 1 night during their first week after IRF admission as part larger clinical trial. Logistic regression algorithms were trained to detect using biometric features obtained from the ANNE sensors ground truth rating ApneaLink Air. Multiple evaluated different combinations detection criteria based on apnea–hypopnea index (AHI ≥ 5, AHI 15). Results Seventy-one (96%) participants multiple nights. In contrast, only 48 (63%) could be successfully assessed obstructive by ApneaLink; 28 (37%) refused testing. The best-performing model utilized photoplethysmography (PPG) finger-temperature moderate-severe 15), 88% sensitivity positive likelihood ratio (LR+) 44.00. This was tested additional nights data achieving 71% (10.14 LR+) when considering each independently 86% accuracy averaging multi-night predictions. Conclusions research demonstrates feasibility accurately early recovery process techniques. These findings can inform future efforts improve post-stroke disorders, thereby enhancing patient long-term outcomes. Clinical Trial SIESTA (Sleep Inpatients: Empower Staff Act) Acute Stroke Rehabilitation, https://clinicaltrials.gov/study/NCT04254484?term=SIESTA&checkSpell=false&rank=1, NCT04254484

Язык: Английский

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Longitudinal effect of nocturnal R-R intervals changes on cardiovascular outcome in a community-based cohort

BMJ Open, Год журнала: 2019, Номер 9(7), С. e030559 - e030559

Опубликована: Июль 1, 2019

Rationale Sleep-disordered breathing (SDB) is strongly linked to adverse cardiovascular outcomes (cardiovascular diseases (CVD)). Whether heart rate changes measured by nocturnal R-R interval (RRI) dips (RRI dip index (RRDI)) adversely affect the CVD unknown. Objectives To test whether RRDI predicts incidence and mortality in Wisconsin Sleep Cohort study (WSCS), independent of known effects SDB on beat-to-beat variability. Methods The analysed electrocardiograph obtained from polysomnography assess total (the number RRI divided recording time) sleep time). A composite risk as a function was estimated Cox proportional hazards WSCS. Results sample consisted 569 participants WSCS with no prior at baseline were followed up for 15 years. Nocturnal (10-unit change) associated event(s) (HR, 1.24 per 10-unit increment (95% CI 1.10 1.39), p<0.001). After adjusting demographic factors (age 58±8 years old; 53% male; body mass 31±7 kg/m 2 ), apnoea–hypopnoea (AHI 4%), individuals highest category (≥28 vs<15 dips/hour) had significant HR increased 7.4(95% 1.97 27.7), p=0.003). significantly new-onset 1.21 1.09 1.35), p<0.001) which remained after factors, AHI 4%, hypoxemia other comorbidities. Conclusion Increased morbidity, frequency higher men than women, but not women.

Язык: Английский

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Salivary biomarkers associated with obstructive sleep apnea: a systematic review

Expert Review of Molecular Diagnostics, Год журнала: 2021, Номер 21(2), С. 223 - 233

Опубликована: Янв. 6, 2021

Introduction: This study aimed to define and characterize current literature describing salivary biomarker changes with the goal of improving diagnosis treatment outcomes for sleep apnea.Area Covered: A search six databases yielded 401 peer-reviewed articles published through October 2019 corresponded 221 unique references following deduplication. Twenty studies were selected. The sample size ranged from 17 99. samples mostly whole saliva selected glandular areas.Expert Opinion: Most targeted focused on level cortisol ɑ-amylase. One used RNA transcriptome analysis 96 genes. Only two explored novel targets using mass spectrometry. ɑ-amylase, myeloperoxidase, IL-6 among those biomarkers found associated OSA. Cytokeratin, CystatinB, calgranulin A, alpha-2-HS-glycoprotein are upregulated in OSA patients based non-targeting Salivary ɑ-amylase others appeared be severity treatment. There inconsistencies collection processing protocols. More needed exploring examine if these capable diagnosing monitoring proteomics or transcriptomics. have a potential noninvasive measure disease outcome apnea.

Язык: Английский

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Incidence of hypertension in obstructive sleep apnea using hypopneas defined by 3 percent oxygen desaturation or arousal but not by only 4 percent oxygen desaturation

Journal of Clinical Sleep Medicine, Год журнала: 2020, Номер 16(10), С. 1753 - 1760

Опубликована: Июль 9, 2020

This analysis determined ∼5-year incident hypertension rates using the 2017 American College of Cardiology/American Heart Association blood pressure (BP) guidelines in individuals with obstructive sleep apnea (OSA) hypopneas defined by a ≥ 3% oxygen desaturation or arousal but not hypopnea criterion 4% (4% only).Data were analyzed from participants Sleep Health Study exam 2 (n = 1219) who normotensive (BP ≤ 120/80 mm Hg) at 1. The AHI 1 was classified into 4 categories OSA severity: < 5, 5 15, 15 30, and 30 events/h both only definitions. Three definitions hypertension-elevated BP (> Hg), stage 130/80 140/90 Hg)-were used to determine incidence 2.Five-year follow-up available for 476 as having standard Incident Association-defined these discordantly 15% (elevated BP), (stage 1), 6% 2). Hypertensive medications normotensive. overall rate least an elevated 40% (191/476) those criterion.Use definition resulted failure identify significant number eventually developed could have benefited earlier diagnosis treatment.

Язык: Английский

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Respiratory Mandibular Movement Signals Reliably Identify Obstructive Hypopnea Events During Sleep

Frontiers in Neurology, Год журнала: 2019, Номер 10

Опубликована: Авг. 13, 2019

Context: Accurate discrimination between obstructive and central hypopneas requires quantitative assessments of respiratory effort by esophageal pressure (OeP) measurements, which preclude widespread implementation in sleep medicine practice. Mandibular Movement (MM) signals are closely associated with diaphragmatic during sleep. Objective: We aimed at reliably detecting off events using MM statistical characteristics. Methods: A bio-signal learning approach was implemented whereby raw fragments corresponding to normal breathing (NPB; n = 501), (n 263), 1861) were collected from 28 consecutive patients (mean age 54 years, mean AHI 34.7 n/h) undergoing in-lab polysomnography (PSG) coupled a magnetometer, OeP recordings. Twenty three input features extracted data explore distinctive changes signals. Random Forest model built upon those classify the hypopnea events. External validation interpretive analysis performed evaluate model's performance contribution each feature output. Results: Obstructive characterized longer duration (21.9 vs. 17.8 s, p < 10-6), more extreme low values (p negative trend reflecting mouth opening amplitude, wider variation, asymmetrical distribution amplitude. showed reliable features-based classification rule (Kappa coefficient 0.879 balanced accuracy 0.872). The revealed that event duration, lower percentiles, tendency, amplitude most important determinants Conclusions: can be used as surrogate markers differentiate

Язык: Английский

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Age related disparities in sleep apnea diagnosis using a wearable device: Implications of 4% vs. 3% hypopnea scoring criteria

Sleep Medicine, Год журнала: 2024, Номер 118, С. 88 - 92

Опубликована: Апрель 1, 2024

Язык: Английский

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Association between obstructive sleep apnea and multiple involuntary job loss history among recently unemployed adults

Sleep Health, Год журнала: 2020, Номер 7(1), С. 118 - 122

Опубликована: Окт. 6, 2020

Язык: Английский

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Quality measures for the care of adult patients with obstructive sleep apnea: 2022 update after measure maintenance

Journal of Clinical Sleep Medicine, Год журнала: 2022, Номер 18(11), С. 2673 - 2680

Опубликована: Авг. 11, 2022

Obstructive sleep apnea (OSA) remains a highly prevalent disorder that can lead to multiple adverse outcomes when undiagnosed and/or left untreated. There continue be gaps and variations in the provision of care for adult patient population with OSA, which emphasizes importance measure maintenance initiative The Quality Measures Care Adult Patients Sleep Apnea (originally developed 2015). American Academy Medicine (AASM) convened Task Force 2018 review current medical literature, other existing quality measures focused on same population, any performance data or literature show care, inform potential revisions set. These revised will implemented AASM Clinical Data Registry (Sleep CDR) capture encourage continuous improvement associated diagnosing managing OSA population.Lloyd R, Morgenthaler TI, Donald et al. patients obstructive apnea: 2022 update after maintenance. J Clin Med. 2022;18(11):2673-2680.

Язык: Английский

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The (Still) Elusive Definition of Hypopnea

Journal of Clinical Sleep Medicine, Год журнала: 2018, Номер 14(12), С. 1971 - 1972

Опубликована: Дек. 14, 2018

Once upon a time there was 30-apnea rule that used by Medicare to determine candidacy for positive airway pressure (PAP) treatment.The origin of this is somewhat obscure but probably based on the initial studies obstructive sleep apnea (OSA) in early 1970s. 1 To characterize manifestations OSA comparison control group, inclusion criterion established be at least 5 apneas/h during 6-hour polysomnography-thus, 30 apneas.This did not recognize existence hypopneas, and it complicated practical definition sleep-disordered breathing as rapidly became clear many patients expressed polysomnographic patterns were characterized hypopneas-whatever they were-rather than apneas. 2While performing split-night studies, technicians would literally count apneas until threshold reached which point titration PAP could commence.Often insufficient remaining successfully identify effective treatment.There also occasions when hypopneas scored facilitate needed treatment with hope records audited.Most importantly, using rule, qualify payment through their insurance provider.The first comprehensive effort define published 1999. 3This report concluded necessary "distinguish from because both types events have similar pathophysiology."This rather vague perhaps overly flexible resolve controversy related rule.In 2001, Clinical Practice Review Committee American Academy Sleep Medicine (AASM) position paper recommended specific criteria hypopnea. 4The advanced Heart Health Study: 30% or greater reduction airflow chest wall movement accompanied decrease oxyhemoglobin desaturation ≥ 4%.While rigorously evidence-based current standards, felt these result high interobserver agreement, seemed reasonable findings Study.This ultimately recognized Centers Medicaid Services (CMS) reimbursement resulting welcome passing rule.

Язык: Английский

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Predictive Analytics for OSA Detection Using Non-Conventional Metrics

International Journal of Knowledge-Based Organizations, Год журнала: 2020, Номер 10(4), С. 13 - 23

Опубликована: Сен. 23, 2020

Early diagnosis in the case of sleep apnea has its own set benefits for treating cases. However, there are many challenges and limitations that impact current conditions testing. In this manuscript, a model is proposed early OSA, using non-conventional metrics. Profoundly, metrics used combination symptoms, causes, effects problem. Using machine learning two sets classifiers, inputs collected as part training datasets analysis. The data classifiers tests NB SVM. comparative analysis results, it imperative SVM classifier-based algorithm giving more effective performance.

Язык: Английский

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