Real-World Performance and Safety of Apneal Dx for Sleep Apnea Screening (APNEAL-PMCF)
Real-world Evaluation of the Clinical Performance and Safety of Apneal Dx for the Screening and Aid in the Diagnosis of Obstructive Sleep Apnea-hypopnea Syndrome in Adults: a Post-market Clinical Follow-up Study
Sleep apnea-hypopnea syndrome (SAHS) is a frequent and largely under-diagnosed sleep-related breathing disorder. Adult prevalence is estimated between 9% and 38%. Untreated SAHS increases cardiometabolic and neurocognitive risk. Reference diagnostic methods (in-lab polysomnography and ambulatory ventilatory polygraphy) have limited capacity, which delays care.
Apneal Dx is a Class IIa software as a medical device (CE-marked 10 June 2026). It measures cardiorespiratory sleep activity using the sensors of a standard smartphone worn on the chest, with no additional sensor, to screen for and aid in the diagnosis of adult obstructive sleep apnea-hypopnea syndrome at home.
This study is a non-interventional, prospective, real-world post-market clinical follow-up (PMCF) of Apneal Dx used within its intended purpose in routine care. It does not add any examination, visit, randomisation or change to patient management. Data are collected from automatic device logs and optional in-app questionnaires completed by patients and healthcare professionals. The study covers France, Spain, Italy, the United Kingdom and Germany. There is no investigational site and no principal investigator.
Tutkimuksen yleiskatsaus
Tila
Tila
Ehdot
Ehdot
Yksityiskohtainen kuvaus
OBJECTIVES
This PMCF study addresses residual evidence gaps after CE marking of Apneal Dx, under MDR Articles 61(11), 83, 84 and 86 and Annex XIV Part B, in support of a strategy based on Article 61(10).
Primary objectives:
(A) Demonstrate end-to-end technical performance in the unsupervised home environment and detect safety-relevant failure modes.
(B) Confirm concordance between the Apneal Dx AHI severity category and the healthcare professional's final clinical diagnosis obtained through the routine care pathway.
(C) Quantify real-world false positive and false negative rates at AHI thresholds of 5, 15 and 30 events per hour.
Secondary objectives:
(D) Care-pathway time indicators (time to consultation, diagnosis and treatment).
(E) How device outputs are used in clinical decisions. (F) Diagnostic performance against polysomnography (PSG) and ventilatory polygraphy (PG), when those tests have already been performed in routine care.
(G) Real-world screening utility, conditions of use and usability.
METHODS
Design: observational, prospective, single-cohort, longitudinal real-world data collection. Non-comparative; no randomisation; no blinding; no imposed follow-up visit. Target enrolment: 400 evaluable patients (estimated). Individual participation lasts up to 24 months (questionnaires at 6, 12 and 24 months after the first recording). Study period: 04 September 2026 to 10 June 2031 (57 months, aligned with the CE certificate cycle).
No intervention is assigned by the protocol. Apneal Dx is used under normal conditions of use and within its intended purpose. A PSG or PG result is collected only if the test has already been performed in the usual care pathway; the study never prescribes, prompts, schedules or funds a confirmatory test.
Data sources: (1) automatic technical metadata from the device (session duration, signal quality, processing events, error codes, software version); (2) healthcare professional questionnaire (H01-H14) on the HCP web platform; (3) patient questionnaire (P01-P12) in the mobile application. No medical records, no SNDS, no biospecimens, no linkage with an external database.
Setting: home and routine clinical practice. Decentralised collection with no investigational site, no participating institution and no principal investigator. The sponsor headquarters (Mitral SAS, Charenton-le-Pont, France) is declared as the single administrative location. Participants may reside in France, Spain, Italy, the United Kingdom or Germany.
Ethics: no ethics committee is territorially or institutionally competent in the absence of a site. Human subjects protection review is therefore recorded as not required. Participation follows a dedicated in-app information notice, distinct from the terms of use, and a voluntary in-app agreement. A permanent right to object applies.
Analysis: descriptive (point estimates and 95% Wilson confidence intervals, distributions, weighted Cohen kappa for concordance, sensitivity and specificity by AHI threshold, median delays). No superiority or non-inferiority hypothesis test. No multiplicity adjustment. Missing data are not imputed.
Opintotyyppi
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Ilmoittautuminen
Yhteystiedot ja paikat
Opiskeluyhteys
Opiskeluyhteys
- Nimi: Guillaume Cathelain
- Puhelinnumero: +33672448711
- Sähköposti: guillaume.cathelain@apneal.ai
Opiskelupaikat
-
-
-
Charenton-le-Pont, Ranska, 94220
- Mitral SAS
-
Ottaa yhteyttä:
- Guillaume Cathelain
- Puhelinnumero: +33672448711
- Sähköposti: guillaume.cathelain@apneal.ai
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Näytteenottomenetelmä
Tutkimusväestö
Kuvaus
Inclusion Criteria:
- Aged 18 years or over
- Uses Apneal Dx within its intended purpose in France, Spain, Italy, the United Kingdom or Germany
- Has completed at least one recording generating a night report
- Has received the study information notice
- Has given the in-app agreement to take part
Exclusion Criteria:
- Under 18 years of age
- Adult under legal protection
Both exclusion criteria are applied by design through an application eligibility rule.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
Ryhmien/kohorttien lukumäärä
Kohortit ja interventiot
Ryhmä/KohorttiRyhmä/Kohortti |
|---|
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Apneal Dx users
Adults aged 18 years or over with sleep complaints, using Apneal Dx within its intended purpose at home in routine care, who have completed at least one recording generating a night report.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Patient recording success rate
Aikaikkuna: Continuous, from study start through study completion (up to 57 months)
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Proportion of interpretable nights among all attempted recordings, derived from automatic device logging.
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Continuous, from study start through study completion (up to 57 months)
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Concordance between Apneal Dx severity category and the physician's final clinical diagnosis
Aikaikkuna: Up to 24 months after the first recording, per participant
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Weighted Cohen's kappa and proportion of exact agreement between the AHI severity category produced by Apneal Dx (normal, mild, moderate, severe) and the final clinical diagnosis reported by the healthcare professional, in participants with a documented reference test (PSG or PG) obtained through routine care.
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Up to 24 months after the first recording, per participant
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Real-world false positive and false negative rates by AHI threshold
Aikaikkuna: Up to 24 months after the first recording, per participant
|
False positive and false negative rates at AHI thresholds of 5, 15 and 30 events per hour, against the documented reference test result, with 95% Wilson confidence intervals.
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Up to 24 months after the first recording, per participant
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Toissijaiset tulostoimenpiteet
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Time to consultation
Aikaikkuna: Up to 24 months after the first recording
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Median number of days between the Apneal Dx night report and the first consultation with a healthcare professional.
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Up to 24 months after the first recording
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Time to diagnosis
Aikaikkuna: Up to 24 months after the first recording
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Median number of days between the Apneal Dx night report and the reference sleep test (PSG or PG) performed in routine care.
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Up to 24 months after the first recording
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Time to treatment
Aikaikkuna: Up to 24 months after the first recording
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Median number of days between the reference sleep test and treatment initiation.
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Up to 24 months after the first recording
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Distribution of clinical decisions following the Apneal report
Aikaikkuna: Up to 24 months after the first recording
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Distribution of clinical decisions taken following the Apneal Dx report, by Apneal severity category.
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Up to 24 months after the first recording
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Agreement with PSG and with ventilatory polygraphy
Aikaikkuna: Up to 24 months after the first recording
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Agreement of Apneal Dx with PSG and with ventilatory polygraphy, stratified by reference test type and severity, in participants with a documented routine-care reference test.
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Up to 24 months after the first recording
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Healthcare professional rating of Apneal Dx reliability
Aikaikkuna: Up to 24 months after the first recording
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Proportion of healthcare professionals rating Apneal Dx as reliable (score 4 or 5 on a 1-5 Likert scale).
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Up to 24 months after the first recording
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Usability: navigation ease and instruction clarity
Aikaikkuna: 6 months after the first recording
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Distribution of navigation ease and instruction clarity scores (1-5 Likert scales) reported by patients.
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6 months after the first recording
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Yhteistyökumppanit ja tutkijat
Sponsori
Sponsori
Tutkijat
Tutkijat
- Opintojohtaja: Guillaume Cathelain, Mitral SAS
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Evaluation of the Clinical Performance of Apneal, a Medical Device on Smartphone, for Sleep Apnea-hypopnea Syndrome Diagnosis (EASY). ClinicalTrials.gov Identifier: NCT06474143.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Arvioitu)
Opiskelun aloitus
Ensisijainen valmistuminen (Arvioitu)
Ensisijainen valmistuminen
Opintojen valmistuminen (Arvioitu)
Opintojen valmistuminen
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Ensimmäinen Lähetetty
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin päivitys julkaistu
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Viimeksi vahvistettu
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Muut tutkimustunnusnumerot
Muut tutkimustunnusnumerot
- CIP04
- 2234417 (Muu tunniste: CNIL MR-004 compliance undertaking)
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