Cai Yi, Zheng Yixuan James, Cheng Chloe M, Strohl Kingman P, Mason Ashley E, Chang Jolie L
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A.
Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, U.S.A.
Laryngoscope. 2024 Jul;134(7):3406-3411. doi: 10.1002/lary.31398. Epub 2024 Mar 22.
Obstructive sleep apnea (OSA) is usually assessed at discrete and infrequent timepoints. Wearable consumer sleep technologies (CST) may allow for more granular and longitudinal assessments of OSA therapy responses and OSA-related symptoms.
In this case series, we enrolled hypoglossal nerve stimulator (HGNS) patients who had an effective treatment response for an 8-week study using a wearable CST. Participants started with "HGNS-on," were randomized to turn off HGNS therapy during either week 4 or 5 ("HGNS-off"), followed by a return to therapy, "HGNS-resume." Participants completed validated symptom questionnaires assessing sleepiness, insomnia symptoms, functional status, and overall sleep health (Satisfaction, Alertness, Timing, Efficiency, and Duration, SATED) each week. CST metrics and survey scores were compared between HGNS treatment phases. Associations between CST metrics and survey scores were assessed.
Seven participants with a total of 304 nights of CST data showed no statistically significant changes in total sleep time (TST), wake time after sleep onset, or sleep efficiency (SE) across the study periods. During HGNS-off, survey scores indicated significantly worsened OSA-related symptom scores. Two participants had significantly higher heart rate variability (HRV) during HGNS-off (by 3.3 and 6.3 ms) when compared to HGNS active therapy periods. Amongst CST metrics, SATED scores correlated with TST (r = 0.434, p < 0.0001), HRV (r = -0.486, p < 0.0001), and SE (r = 0.320, = 0.0014). In addition, FOSQ-10 scores correlated with average HR during sleep (r = -0.489, p < 0.001).
A 1-week HGNS therapy withdrawal period impacted OSA-related sleep symptoms. Sleep-related metrics measured by a wearable CST correlated with symptom scores indicating potential value in the use of CSTs for longitudinal sleep-tracking in OSA patients.
4 Laryngoscope, 134:3406-3411, 2024.
阻塞性睡眠呼吸暂停（OSA）通常在离散且不频繁的时间点进行评估。可穿戴式消费睡眠技术（CST）可能允许对OSA治疗反应和OSA相关症状进行更细致和纵向的评估。
在本病例系列中，我们招募了舌下神经刺激器（HGNS）患者，这些患者在一项为期8周的研究中使用可穿戴CST有有效的治疗反应。参与者从“HGNS开启”开始，随机在第4周或第5周关闭HGNS治疗（“HGNS关闭”），然后恢复治疗，即“HGNS恢复”。参与者每周完成经过验证的症状问卷，评估嗜睡、失眠症状、功能状态和整体睡眠健康（满意度、警觉性、时间、效率和持续时间，SATED）。比较HGNS治疗阶段之间的CST指标和调查得分。评估CST指标与调查得分之间的关联。
7名参与者共有304个晚上的CST数据，在整个研究期间总睡眠时间（TST）、睡眠开始后的清醒时间或睡眠效率（SE）没有统计学上的显著变化。在HGNS关闭期间，调查得分表明OSA相关症状得分显著恶化。与HGNS积极治疗期相比，2名参与者在HGNS关闭期间心率变异性（HRV）显著更高（分别高3.3和6.3毫秒）。在CST指标中，SATED得分与TST（r = 0.434，p < 0.0001）、HRV（r = -0.486，p < 0.0001）和SE（r = 0.320，= 0.0014）相关。此外，FOSQ - 10得分与睡眠期间的平均心率相关（r = -0.489，p < 0.001）。
1周的HGNS治疗撤药期影响了OSA相关的睡眠症状。可穿戴CST测量的与睡眠相关的指标与症状得分相关，表明CST在OSA患者纵向睡眠跟踪中的潜在价值。
4 《喉镜》，134:3406 - 3411，2024年。
