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In-hospital diagnosis of sleep apnea in stroke patients using a portable acoustic device

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Sleep apnea (SA) is highly prevalent in post-stroke patients. Due to physical disability and relative inaccessibility of polysomnography (PSG) to test for SA, patients with stroke frequently remain undiagnosed and untreated. Portable SA monitoring can facilitate at-home or in-hospital testing for SA. However, portable SA monitoring is not recommended in those with complex medical conditions, such as stroke, due to the lack of validation of portable monitoring in such patients.

Methods

The objective of our study was to test the accuracy and feasibility of a portable single-channel acoustic device, BresoDx™ for quantifying the apnea-hypopnea index (AHI) and diagnosing SA in a post-stroke population. Patients who recently suffered a stroke and were undergoing rehabilitation in a stroke rehabilitation unit (SRU) underwent testing with BresoDx both simultaneously during attended PSG and unattended on the SRU.

Results

We studied 23 stroke patients of whom 78% had SA (defined by AHI ≥15) on PSG. All of the patients tolerated the BresoDx. Using cutoff AHI of ≥15 by PSG to diagnose SA, BresoDx had sensitivity of 90.0%, specificity of 84.6%, and overall accuracy of 87.0% in the laboratory.

Conclusions

This study demonstrates that BresoDx is well tolerated and feasible to use in the post-stroke population where it was found to have excellent positive and negative predictive values for the diagnosis of SA.

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Acknowledgements

This project has been funded by the Ministry of Research and Innovation of Ontario, MaRS Innovation, Ontario Centers of Excellence, Ontario Brain Institute-Fed Dev Development Program for Southern Ontario, and Johnson and Johnson Inc. Toronto Rehabilitation Institute receives funding from the Ontario Ministry of Health and Long-Term Care. H. Alshaer was supported by a Natural Sciences and Engineering Research Council of Canada Scholarship, and T.D. Bradley by the Clifford Nordal Chair in Sleep Apnea and Rehabilitation Research and the Godfrey S. Pettit Chair in Respiratory Medicine.

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Authors and Affiliations

  1. Department of Medicine, University of Toronto, Toronto, ON, Canada

    Clodagh M. Ryan, Kelly Wilton & T. Douglas Bradley

  2. University Health Network, Toronto, ON, Canada

    Clodagh M. Ryan & T. Douglas Bradley

  3. Sleep Research Laboratory of the Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada

    Clodagh M. Ryan, T. Douglas Bradley & Hisham Alshaer

  4. Centre for Sleep Health and Research, Toronto General Hospital, 9N-967 585 University Avenue, Toronto, ON, M5G2N2, Canada

    Clodagh M. Ryan

Authors
  1. Clodagh M. Ryan
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Corresponding author

Correspondence to Clodagh M. Ryan.

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Funding

The sponsors had no role in the design or conduct of this research.

Conflicts of interest

C. Ryan and K. Wilton certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. H. Alshaer and T.D. Bradley are inventors of the technology being examined in this study—BresoDx. A start-up company (BresoTec Inc.) has been founded to commercialize it. They have potential for financial gains from sales of the device. They have not generated any revenue to date.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Ryan, C.M., Wilton, K., Bradley, T.D. et al. In-hospital diagnosis of sleep apnea in stroke patients using a portable acoustic device. Sleep Breath 21, 453–460 (2017). https://doi.org/10.1007/s11325-016-1438-5

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  • DOI: https://doi.org/10.1007/s11325-016-1438-5

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