STUDY OBJECTIVES

The Belun ring is a new home sleep apnea testing device using a pulse oximeter sensor and a neural network algorithm, but its data in children are limited. This study aims to evaluate the correlation and agreement of the Belun ring, compared with polysomnography (PSG) and determine the diagnostic accuracy of the Belun ring for moderate-to-severe obstructive sleep apnea (OSA).

METHODS

This is a cross-sectional observational study in children aged 5-18 years with suspected OSA between June 2023 and February 2024. The Belun ring and PSG were undertaken on eligible participants to assess apnea-hypopnea index (AHI) in the same sleep test session.

RESULTS

Of 75 children enrolled, OSA was diagnosed in 74 children by PSG. The Belun AHI (B-AHI) was moderately correlated with the PSG AHI (P-AHI) ( .63, < .001) with mean difference (standard deviation) -7.8 (13.91) events/h. The area under the receiver operating characteristic curve of the B-AHI to identify moderate-to-severe OSA (P-AHI > 5 events/h) was 0.66, and the B-AHI cut-off of 3 events/h yielded 74.1% sensitivity and 52.4% specificity. The B-AHI cut-off of 2 events/h yielded 92.6% sensitivity, and 7 events/h yielded 95.2% specificity.

CONCLUSIONS

Despite the correlation, the difference in AHI between the Belun ring and PSG in children was noted. Either single or multiple B-AHI cut-offs to diagnose, include or exclude moderate-to-severe OSA may be valuable, but their implementation must be approached with caution.

CLINICAL TRIAL REGISTRATION

Registry: Thai Clinical Trials Registry; Name: Diagnostic Accuracy of the Belun Ring in Children at Risk of Obstructive Sleep Apnea; URL: https://www.thaiclinicaltrials.org/show/TCTR20240604003; Identifier: TCTR20240604003.

CITATION

Panichapat N, Niyomkarn W, Boonjindasup W, Thiamrakij P, Sritippayawan S, Deerojanawong J. Diagnostic accuracy of the Belun ring in children at risk of obstructive sleep apnea. . 2025;21(1):123-128.