title: Capability of a neck worn device to measure sleep/wake, airway position, and differentiate benign snoring from obstructive sleep apnea.
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.
authors.affiliation: Advanced Brain Monitoring Inc., Carlsbad, CA, USA, dan@b-alert.com.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Levendowski
authors.forename: Bratislav
authors.initials: B
authors.lastname: Veljkovic
authors.forename: Sean
authors.initials: S
authors.lastname: Seagraves
authors.forename: Philip R
authors.initials: PR
authors.lastname: Westbrook
mesh_terms: D000162:Acoustics; D056044:Actigraphy / Q000379:methods; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D004594:Electrophysiology; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D017286:Polysomnography / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D012913:Snoring / Q000175:diagnosis*; D055815:Young Adult