Global Brain Health Institute, University of California, San Francisco (UCSF), San Francisco, California.
Department of Global Health, University of California, San Francisco (UCSF), San Francisco, California.
J Clin Sleep Med. 2018 Sep 15;14(9):1605-1620. doi: 10.5664/jcsm.7346.
Sleep disorders in most individuals remain undiagnosed and without treatment. The use of novel tools and mobile technology has the potential to increase access to diagnosis. The objective of this study was to perform a quantitative and qualitative analysis of the available literature evaluating the accuracy of smartphones and portable devices to screen for sleep-disordered breathing (SDB).
A literature review was performed between February 18, 2017 and March 15, 2017. We included studies evaluating adults with SDB symptoms through the use mobile phones and/or portable devices, using standard polysomnography as a comparison. A qualitative evaluation of studies was performed with the QUADAS-2 rating. A bivariate random-effects meta-analysis was used to obtain the estimated sensitivity and specificity of screening SDB for four groups of devices: bed/mattress-based, contactless, contact with three or more sensors, and contact with fewer than three sensors. For each group, we also reported positive predictive values and negative predictive values for mild, moderate, and severe obstructive sleep apnea (OSA) screening.
Of the 22 included studies, 18 were pooled in the meta-analysis. Devices that were bed/mattress-based were found to have the best sensitivity overall (0.921, 95% confidence interval [CI] 0.870, 0.953). The sensitivity of contactless devices to detect mild OSA cases was the highest of all groups (0.976, 95% CI 0.899, 0.995), but provided a high false positive rate (0.487, 95% CI 0.137, 0.851). The remaining groups of devices showed low sensitivity and heterogeneous results.
This study evidenced the limitations and potential use of portable devices in screening patients for SDB. Additional research should evaluate the accuracy of devices when used at home.
大多数人存在睡眠障碍，但并未得到诊断和治疗。新型工具和移动技术的使用有可能增加诊断的机会。本研究的目的是对评估智能手机和平板设备筛查睡眠呼吸障碍（SDB）准确性的现有文献进行定量和定性分析。
我们于 2017 年 2 月 18 日至 3 月 15 日进行了文献回顾。我们纳入了通过使用移动电话和/或便携式设备评估有 SDB 症状的成年人的研究，同时将标准多导睡眠图作为对照。使用 QUADAS-2 评分对研究进行定性评估。使用双变量随机效应荟萃分析，获得了用于筛查 SDB 的 4 组设备的估计敏感性和特异性：基于床/床垫、非接触式、与 3 个或更多传感器接触和与少于 3 个传感器接触。对于每组设备，我们还报告了轻度、中度和重度阻塞性睡眠呼吸暂停（OSA）筛查的阳性预测值和阴性预测值。
在纳入的 22 项研究中，有 18 项研究被纳入荟萃分析。总体而言，基于床/床垫的设备的敏感性最高（0.921，95%置信区间[CI] 0.870，0.953）。非接触式设备检测轻度 OSA 病例的敏感性是所有组中最高的（0.976，95%CI 0.899，0.995），但假阳性率较高（0.487，95%CI 0.137，0.851）。其余组设备的敏感性较低，结果不一致。
本研究证明了便携式设备在筛查 SDB 患者方面的局限性和潜在用途。应开展更多研究评估这些设备在家庭中使用时的准确性。
