Accuracy of Smartphone Application Screening for Obstructive Sleep Apnea in Adults

Background: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a common sleep disorder that affects millions of adults worldwide, with higher prevalence reported in Asia compared to Western countries. If left untreated, OSAHS can lead to serious health complications such as high blood pressure, heart disease, stroke, and diabetes. While polysomnography (PSG) is considered the gold standard of sleep testing, it may not be suitable for all OSAHS patients due to its cost and invasiveness. In recent years, the development of mobile applications has provided a convenient and accessible tool for screening and diagnosis of OSAHS. This study aimed to evaluate the efficacy of the Dr. Being app, a snoring analysis software for smartphones, in screening Chinese adults for OSAHS. The findings of this study will provide insights into the potential of mobile health technologies in improving the detection and management of OSAHS in China.Methods: In this prospective study conducted between December 2021 to December 2022, 50 patients were recruited from the sleep center of Shanghai Sixth People's Hospital. The study participants had a mean age of 49.7±17.4 years, with a male predominance of 70%, and a mean body mass index of 28.2±5.0 kg/m². Each participant underwent monitoring throughout the night using both the Dr. Being app and polysomnography (PSG). The Dr. Being app's automatic analysis generated relevant indicators, which were then compared with the results obtained from PSG interpreted by sleep professionals according to recommended guidelines. The study aimed to evaluate the concordance between the apnea-hypopnea index (AHI) obtained by the Dr. Being app and PSG results. Furthermore, the researchers assessed the sensitivity and specificity of the Dr. Being app in diagnosing OSAHS, which could provide valuable insights into the effectiveness of smartphone apps in sleep testing. Results: This study's findings suggest that there were significant differences between the total sleep time (TST) and apnea-hypopnea index (AHI) measured by the Dr. Being app and PSG. Specifically, the TST measured by the Dr. Being app was found to be significantly higher than PSG, while PSG had a slightly higher AHI measurement than the Dr. Being app. Despite these differences, the Bland-Altman consistency test showed that the AHI measurements obtained from both methods were statistically consistent, indicating that the Dr. Being app can provide accurate measurements of AHI, which is a crucial indicator of OSAHS severity. Furthermore, the study assessed the sensitivity and specificity of the Dr. Being app in diagnosing OSAHS at different AHI thresholds. The results indicated that the app had high sensitivity and specificity for OSAHS diagnosis at an AHI threshold of 5/h and moderate sensitivity and specificity at an AHI threshold of 15/h. However, the sensitivity decreased while the specificity increased as the AHI threshold increased to 30/h. Overall, these findings suggest that the Dr. Being app could be a valuable tool for OSAHS screening and diagnosis, particularly in resource-limited areas. Conclusion: These findings highlight the usefulness of the Dr. Being app in the screening and diagnosis of OSAHS, particularly in resource-limited areas where access to PSG may be limited. The app's high sensitivity in detecting early OSAHS index indicates its potential as a valuable tool for both clinicians and patients. With its ability to provide accurate measurements of mild AHI, the Dr. Being app could aid in the early detection of this condition. Overall, the Dr. Being app could serve as a valuable supplement to traditional sleep testing methods, potentially improving the accessibility and affordability of OSAHS diagnosis and management.