Are Wearable Consumer Sleep Tracking Devices Effective for OSA Assessment?

Certain sleep metrics related to obstructive sleep apnea (OSA) measured with a wearable consumer sleep-tracking device may correlate with sleep symptomatology scores elicited by patient surveys, according to study findings presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) 2022 Annual Meeting and OTO Experience, held from September 10 to 14, 2022, in Philadelphia, Pennsylvania.

Researchers aimed to assess the potential of wearable consumer sleep technologies to measure obstructive sleep apnea (OSA) therapy response over time. To do this, the researchers compared metrics generated by these wearable devices with sleep survey responses in patients with OSA with implanted hypoglossal nerve stimulators (HGNS) who were asked to cease use of the stimulator for a 1-week period.

The prospective study, conducted between May 2021 and August 2021, included 7 patients with implanted HGNS who were stable and consistent in the use of this implant for more than 4 months and had achieved an effective response (apnea-hypopnea index <15). During the 2-month study period, these patients wore a consumer sleep-tracking device, the Oura ring, which measured sleep metrics that included total sleep time, wake time after sleep onset, time in deep sleep, and heart rate.

Patients initially maintained HGNS therapy for 3 weeks (HGNS-on), then turned off their HGNS therapy for 1 week (HGNS-off); following the week off, patients resumed HGNS therapy for 3 weeks (HGNS-resume). During this same period, patients completed the Insomnia Severity Index (ISI); Satisfaction, Alertness, Timing, Efficiency and Duration (SATED); and the Epworth Sleepiness Scale (ESS) questionnaires each week. The researchers used Pearson correlation to assess associations between survey metrics and sleep-related metrics (measured by the Oura ring).

Researchers discovered that the 7 patients showed no statistically significant changes in total sleep time, time in deep sleep percentage, or in wake time after sleep onset. The investigators also found that during the HGNS-off week, there was an increase in ESS scores (8.6±6.4) and ISI scores (11.0±3.0) compared with the same scores noted during the HGNS-on period (ESS 3.6±1.4, P <.001; ISI 5.8±4.2, P <.001) and HGNS-resume period (ESS 4.5±3.5, P <.001; ISI 6.7±4.5, P <.001).

Among the Oura ring metrics, ESS scores correlated with heart rate variability (root mean square of successive differences method [r=-0.19; P =.049]). ISI scores correlated with total sleep time (r=-0.23; P =.017) and with sleep efficiency (r=-0.28; P =.004).

Researchers concluded that “Sleep symptomatology changes with a 1-week HGNS therapy withdrawal period” and that “Select sleep architecture metrics measured by a wearable sleep tracking device may correlate with symptomatology scores.” Study limitations include the underpowered sample size.

Reference

Cai Y, Cheng C, Zheng J, Chang JL. Using wearable consumer technology to assess sleep in OSA. Otolaryngol Head Neck Surg. 2022;167(1 suppl):P303.