Capability of a neck worn device to measure sleep/wake, airway position, and differentiate benign snoring from obstructive sleep apnea

Daniel J Levendowski, Bratislav Veljkovic, Sean Seagraves, Philip R Westbrook, Daniel J Levendowski, Bratislav Veljkovic, Sean Seagraves, Philip R Westbrook

Abstract

To evaluate the accuracy of a neck-worn device in measuring sleep/wake, detecting supine airway position, and using loud snoring to screen for obstructive sleep apnea. Study A included 20 subjects who wore the neck-device during polysomnography (PSG), with 31 records obtained from diagnostic and split-night studies. Study B included 24 community-based snorers studied in-home for up to three-nights with obstructive sleep apnea (OSA) severity measured with a validated Level III recorder. The accuracy of neck actigraphy-based sleep/wake was measured by assessing sleep efficiency (SE). Differences in sleep position measured at the chest and neck during PSG were compared to video-editing. Loud snoring acquired with an acoustic microphone was compared to the apnea-hypopnea index (AHI) by- and acrosspositions. Over-reported SE by neck actigraphy was inversely related to OSA severity. Measurement of neck and chest supine position were highly correlated with video-edits (r=0.93, 0.78). Chest was bias toward over-estimating supine time while the majority of neck-device supine position errors occurred during CPAP titrations. Snoring was highly correlated with the overall, supine, and non-supine PSG-AHI (r=0.79, 0.74, 0.83) and was both sensitive and specific in detecting overall, supine, and non-supine PSGAHI>10 (sensitivity=81, 88, 82%; specificity=87, 79, 100%). At home sleep testing-AHI>10, the sensitivity and specificity of loud snoring was superior when users were predominantly non-supine as compared to baseline (sensitivity=100, 92%; specificity=88, 77%). Neck actigraphy appears capable of estimating sleep/wake. The accuracy of supine airway detection with the neck-device warrants further investigation. Measurement of loud snoring appears to provide a screening tool for differentiating positional apneic and benign snorers.

Figures

Fig. 1
Fig. 1
Photograph of neck-device from a back and b front
Fig. 2
Fig. 2
Bland–Altman plot comparing sleep efficiency between PSG and neck actigraphy
Fig. 3
Fig. 3
Bland–Altman plots between edited and unedited actigraphy-based position from lights out to lights on from a chest and b neck
Fig. 4
Fig. 4
Photos of two cases of gross under-reporting of supine by the neck-device with a S22 misclassified as upright by neck and supine by video, and b S12 misclassified as lateral by neck
Fig. 5
Fig. 5
a Bland–Altman plot between sleep efficiency (SE) measured by actigraphy from the neck and forehead HST across all nights, and b correlation plots between HST-AHI and sleep efficiency (SE) by neck actigraphy across all nights

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Source: PubMed

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