Original ArticleComparison of in-laboratory and home diagnosis of sleep apnea using a cordless portable acoustic device

- We developed a cordless acoustic device (BresoDx) for home diagnosis of sleep apnea.
- There was good agreement in apnea diagnosis by BresoDx and simultaneous polysomnography (PSG) in 135 subjects.
- BresoDx at home showed very good diagnostic concordance with PSG in 100 subjects.
- Relatively low night-to-night apnea-hypopnea index (AHI) variability was observed between in-laboratory and home tests.
- AHI in the home was somewhat lower than in the laboratory.

Background and ObjectivesSleep apnea (SA) is a common, serious, but underdiagnosed condition. There is a need for more accessible and economic means of diagnosing SA in the home. The aim of this study was to test the validity of a cordless acoustic portable device (BresoDx™) for home diagnosis of SA compared with standard polysomnography (PSG).MethodsA total of 135 subjects underwent full overnight PSG and simultaneous recording of breath sounds by BresoDx in the sleep laboratory. Acoustic data extracted from BresoDx were analyzed using validated computer acoustic algorithms. The PSG-derived apnea-hypopnea index (AHI-p) and the acoustic AHI (AHI-a) were calculated and compared. A subset of 100 subjects used the device in a subsequent night in their home from which home AHI (AHI-h) was determined.ResultsThe correlation between AHI-a and simultaneous AHI-p was 95.2% and diagnostic accuracy of BresoDx ranged between 88.9% and 93.3% around AHI cutoffs of 5-15. In the home, AHI-h did not differ significantly from AHI-p (p = 0.60). Using an AHI-p cutoff ≥ 10 BresoDx's accuracy was 81%. Of the 100 subjects, 81 (81%) had low inter-night variability measured by a difference between home AHI-h and PSG AHI-p < 10 event/h, while 19% had higher inter-night variability.ConclusionAHI determined using BresoDx was in excellent agreement with simultaneous AHI-p. The majority of patients had a consistent AHI in their subsequent home study with very good overall diagnostic accuracy. We conclude that BresoDx is a reliable device for diagnosing SA that can be used by subjects, unattended in their own homes.

Graphical Abstract69