Low Burden Wearable Sensor System for Diagnosing Obstructive Sleep Apnea in Older Adults - 1 PROJECT SUMMARY: >50% of adults aged 65+ have a high risk of obstructive sleep
2 apnea (OSA), a condition that increases the risk of stroke, heart attack, and death. The
3 prevalence of OSA is at least twice as high in older adults compared to younger age
4 groups. Despite this increased risk and prevalence, only 8% of older adults at high risk
5 of OSA receive evaluation by either in-laboratory polysomnography (PSG) or home
6 sleep apnea testing (HSAT). Accessing sleep laboratories for PSG is burdensome for
7 older adults given their frailty or dependence on others. While there are several FDA-
8 approved HSAT devices that allow for diagnosis of OSA in the home setting
9 unmonitored—these systems remain a significant challenge to operate for older adults
10 given the multitude of wires, chest bands, and nasal cannulas required for setup. As
11 such, the reported sensor loss and technically inadequate recordings occur in up to 30%
12 of cases. Currently, there is no existing technology designed explicitly for older adults
13 that can cost-effectively, comprehensively, and unobtrusively measure the wide range of
14 physiological parameters necessary in diagnosing OSA. In this proposal, we will modify
15 our existing wireless, flexible, and miniaturized vital signs monitoring system–composed
16 of a chest patch and finger patch that recapitulate the form factor of a Band-Aid. The
17 chest unit has a continuous 1-lead ECG (heart rate, heart rate variability), accelerometer
18 (respiratory rate, chest wall movement, inspiratory effort, body position, sleep time,
19 snoring time), bio-impedance (respiratory rate) and temperature sensor. The limb patch
20 incorporates a photoplethysmograph (PPG for SpO2). Together, the chest and limb
21 sensor captures an advanced measurement: pulse arrival time (PAT) and pulse transit
22 time (PTT). PAT/PTT waveforms have been shown to detect sleep arousal events,
23 quantify inspiratory effort, differentiate central from obstructive apnea, and identify
24 patients in need of nasal CPAP. Applying these sensors involve simply removing an
25 adhesive liner prior to placement. We will develop a new, ultra-simplified user interface
26 on the iPad that follows best practices for those with low technical literacy, visual
27 impairments, or hearing impairments. We hypothesize that a low-burden, wireless, and
28 wearable monitoring system that allows for continuous measurement of multiple
29 physiologic parameters specific to sleep in a highly comfortable form factor will facilitate
30 diagnosis and treatment of OSA in older adults.
