Nightly Wearable Monitoring During Home-Based Submental Electrical Stimulation for Obstructive Sleep Apnea

November 2, 2026 updated by: Chih-Chun-Wang, E-DA Hospital

Clinical Testing of a Physiological Signal Detection, Recognition and Feedback System for Obstructive Sleep Apnea: Home-Based Submental Transcutaneous Neuromuscular Electrical Stimulation With Nightly Ring-Type Monitoring

This single-arm pilot study evaluates the feasibility of nightly wearable monitoring with a ring-type sleep monitor during a 4-week home-based program of submental transcutaneous neuromuscular electrical stimulation in adults with obstructive sleep apnea, and describes changes in the ring-derived apnea-hypopnea index, sleep continuity, STOP-Bang score and upper-airway anatomy on CT before and after training.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

50

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Taiwan
      • Kaohsiung City, Taiwan, 82445
        • Recruiting
        • E-Da Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Adults aged 20 to 65 years
  • Obstructive sleep apnea diagnosed by a physician on polysomnography or an equivalent respiratory-event index test with AHI >= 5 events/h (mild 5-14.9, moderate 15-29.9, severe >= 30)

Exclusion Criteria:

  • AHI < 5 events/h
  • Pregnancy
  • Prior nasal CPAP therapy
  • Inflammation, rash, broken skin, swelling or infection at the stimulation site
  • Cardiac disease, pacemaker or other implanted electronic or metallic device
  • Allergic reaction to the device
  • Concurrent use of other wearable medical devices (e.g., insulin pump)
  • Cognitive impairment
  • Suspected or confirmed epilepsy
  • Central pain syndromes including headache

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Submental NMES with nightly ring monitoring

Adults with obstructive sleep apnea perform home-based submental transcutaneous neuromuscular electrical stimulation (30 minutes every evening for 28 consecutive nights) and wear a ring-type sleep monitor every night during and after training.
Device: Submental transcutaneous neuromuscular electrical stimulation (RS-18)

Submental transcutaneous neuromuscular electrical stimulation with the RS-18 wireless low-frequency stimulator (Jie-Mai Medical Technology; TFDA license 007859; off-label use). Biphasic symmetrical pulses, 250 us, 30-100 Hz program, intensity self-titrated to a strong but comfortable contraction. One 30-minute session every evening before bedtime for 28 consecutive nights at home, after supervised instruction.

Device: Ring-type sleep monitor (Belun Ring BLS-100)

A ring-type wearable sleep monitor (Belun Ring BLS-100) worn on the finger every night during the 4-week training period to record pulse oximetry, heart rate and accelerometry signals for ring-derived apnea-hypopnea index, oxygen desaturation index and sleep parameters. Used for monitoring only; no therapeutic function.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Ring-Derived Apnea-Hypopnea Index (bAHI3)
Time Frame: Baseline (first 7 nights) and end of training (nights 22-28 or last 7 recordings)

Change in the ring-derived apnea-hypopnea index (bAHI3, events/h) measured by a ring-type sleep monitor (Belun Ring BLS-100), comparing the mean of the first 7 nightly recordings with the mean of the last 7 nightly recordings.
Baseline (first 7 nights) and end of training (nights 22-28 or last 7 recordings)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Ring-Derived Apnea-Hypopnea Index Using the 4% Desaturation Criterion (bAHI4)
Time Frame: Baseline (first 7 valid nights) and end of training (last 7 valid nights), 4 weeks

Ring-derived apnea-hypopnea index using the 4% oxygen desaturation criterion (bAHI4, events/h) measured by a ring-type sleep monitor (Belun Ring BLS-100), comparing the mean of the first 7 valid nightly recordings with the mean of the last 7 valid nightly recordings.
Baseline (first 7 valid nights) and end of training (last 7 valid nights), 4 weeks
Change in Ring-Derived Sleep Efficiency
Time Frame: Baseline (first 7 valid nights) and end of training (last 7 valid nights), 4 weeks

Ring-derived sleep efficiency (%, total sleep time divided by total recording time) measured by a ring-type sleep monitor (Belun Ring BLS-100), comparing the mean of the first 7 valid nightly recordings with the mean of the last 7 valid nightly recordings.
Baseline (first 7 valid nights) and end of training (last 7 valid nights), 4 weeks
Change in STOP-Bang Score
Time Frame: Baseline and end of 4-week training

STOP-Bang questionnaire score (range 0-8; higher scores indicate higher risk of obstructive sleep apnea), before vs after training.
Baseline and end of 4-week training
Change in Minimal Nasopharyngeal Cross-Sectional Area on Supine CT
Time Frame: Baseline and end of 4-week training

Minimal nasopharyngeal cross-sectional area (mm2) measured on supine computed tomography, before vs after training.
Baseline and end of 4-week training
Post-Training Satisfaction Score
Time Frame: End of 4-week training

Participant-rated satisfaction with the training program on a 0-100 scale (higher scores indicate greater satisfaction).
End of 4-week training
Adherence: Proportion of Nights With a Valid Ring Recording
Time Frame: 4 weeks

Number of nights with a valid ring-type monitor recording divided by the number of scheduled nights, expressed as a percentage.
4 weeks
Number of Participants With Adverse Events
Time Frame: During the 4-week training and up to 90 days of follow-up

Adverse events related to electrical stimulation or ring wear (e.g., skin irritation, pain, discomfort), recorded during training and follow-up.
During the 4-week training and up to 90 days of follow-up
Change in Ring-Derived Oxygen Desaturation Index (ODI)
Time Frame: Baseline (first 7 valid nights) and end of training (last 7 valid nights), 4 weeks

Ring-derived oxygen desaturation index (events/h) measured by a ring-type sleep monitor (Belun Ring BLS-100), comparing the mean of the first 7 valid nightly recordings with the mean of the last 7 valid nightly recordings.
Baseline (first 7 valid nights) and end of training (last 7 valid nights), 4 weeks
Change in Ring-Derived Sleep-Onset Latency
Time Frame: Baseline (first 7 valid nights) and end of training (last 7 valid nights), 4 weeks

Ring-derived sleep-onset latency (min) measured by a ring-type sleep monitor (Belun Ring BLS-100), comparing the mean of the first 7 valid nightly recordings with the mean of the last 7 valid nightly recordings.
Baseline (first 7 valid nights) and end of training (last 7 valid nights), 4 weeks
Change in Ring-Derived Total Sleep Time
Time Frame: Baseline (first 7 valid nights) and end of training (last 7 valid nights), 4 weeks

Ring-derived total sleep time (min) measured by a ring-type sleep monitor (Belun Ring BLS-100), comparing the mean of the first 7 valid nightly recordings with the mean of the last 7 valid nightly recordings.
Baseline (first 7 valid nights) and end of training (last 7 valid nights), 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

E-DA Hospital

Collaborators

National Cheng Kung University
Metal Industries Research & Development Centre (MIRDC)

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 7, 2025

Primary Completion (Estimated)

January 1, 2028

Study Completion (Estimated)

January 1, 2028

Study Registration Dates

First Submitted

November 2, 2026

First Submitted That Met QC Criteria

November 2, 2026

First Posted (Actual)

November 6, 2026

Study Record Updates

Last Update Posted (Actual)

November 6, 2026

Last Update Submitted That Met QC Criteria

November 2, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • AF10-008
  • EMRP37113N (Other Identifier: Institutional Review Board of E-Da Hospital)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

De-identified nightly data are available from the corresponding author on reasonable request.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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