Affiliation:
1. Department of Otolaryngology‐Head and Neck Surgery University of California, San Francisco School of Medicine San Francisco California U.S.A.
2. Division of Pulmonary, Critical Care, and Sleep Medicine University Hospitals Cleveland Medical Center Cleveland Ohio U.S.A.
3. Osher Center for Integrative Health University of California, San Francisco San Francisco California U.S.A.
4. Department of Psychiatry University of California, San Francisco San Francisco California U.S.A.
5. Surgery Service Department of Veterans Affairs Medical Center San Francisco California U.S.A.
Abstract
ObjectivesObstructive 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.MethodsIn 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.ResultsSeven 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).ConclusionA 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.Level of Evidence4 Laryngoscope, 134:3406–3411, 2024
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