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

• Published in: Journal of clinical monitoring and computing Vol. 29; no. 1; pp. 53 - 64
• Main Authors: Levendowski, Daniel J., Veljkovic, Bratislav, Seagraves, Sean, Westbrook, Philip R.
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.02.2015; Springer Nature B.V
• Subjects: Acoustics; Actigraphy - methods; Adult; Aerodynamics; Aged; Airways; Anesthesiology; Body Mass Index; Chest; Cohort Studies; Critical Care Medicine; Devices; Electrophysiology; Equipment Design; Female; Health Sciences; Humans; Intensive; Male; Medicine; Medicine & Public Health; Middle Aged; Neck - pathology; Necks; Original Paper; Polysomnography - instrumentation; Polysomnography - methods; Position measurement; Reproducibility of Results; Sensitivity and Specificity; Sleep; Sleep Apnea, Obstructive - diagnosis; Snoring - diagnosis; Statistics for Life Sciences; Wakes; Young Adult; Validation; Actigraphy; Screening; OSA; Positional; Snoring
• ISSN: 1387-1307; 1573-2614; 1573-2614
• DOI: 10.1007/s10877-014-9569-3

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.