Search Our Scientific Publications & Authors

Drug Des Devel Ther 2019 28;13:809-816. Epub 2019 Feb 28.

Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan,

Purpose: Although patients with suspected obstructive sleep apnea (OSA) might suffer difficulty in falling asleep during overnight polysomnography (PSG), standard hypnotics to obtain sleep during PSG have not been established. The aim of this study was to investigate the safety and efficacy of a new hypnotic agent, suvorexant, a dual orexin receptor antagonist, for insomnia in suspected OSA patients during in-laboratory PSG.

Patients And Methods: An observational study was conducted during PSG for 149 patients with suspected OSA who had no insomnia at home. Read More

Sleep Breath 2019 Mar 12. Epub 2019 Mar 12.

Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China.

Purpose: Portable sleep monitoring devices with less-attached sensors and high-accuracy sleep staging methods can expedite sleep disorder diagnosis. The aim of this study was to propose a single-channel EEG sleep staging model, SleepStageNet, which extracts sleep EEG features by multi-scale convolutional neural networks (CNN) and then infers the type of sleep stages by capturing the contextual information between adjacent epochs using recurrent neural networks (RNN) and conditional random field (CRF).

Methods: To verify the feasibility of our model, two datasets, one composed by two different single-channel EEGs (Fpz-Cz and Pz-Oz) on 20 healthy people and one composed by a single-channel EEG (F4-M1) on 104 obstructive sleep apnea (OSA) patients with different severities, were examined. Read More

J Clin Sleep Med 2019 Mar 15;15(3):463-470. Epub 2019 Mar 15.

Sleep Research Laboratories of the Toronto Rehabilitation Institute and Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.

Study Objectives: Snoring is perceived to be directly proportional to sleep apnea severity, especially obstructive sleep apnea (OSA), but this notion has not been thoroughly and objectively evaluated, despite its popularity in clinical practice. This might lead to overdiagnosis or underdiagnosis of OSA. The goal of this study is to examine this notion and objectively quantify the relationship between sleep apnea and snoring detected using advanced signal processing algorithms. Read More

Sleep Breath 2019 Mar 1. Epub 2019 Mar 1.

Discipline of Sleep Medicine, University of Sydney, Level 4, Chris O'Brien Lifehouse, 119-142 Missenden Road, Camperdown, NSW, 2050, Australia.

Purpose: Polysomnography is not recommended for children at home and does not adequately capture partial upper airway obstruction (snoring and stertor), the dominant pathology in pediatric sleep-disordered breathing. New methods are required for assessment. Aims were to assess sleep disruption linked to partial upper airway obstruction and to evaluate unattended Sonomat use in a large group of children at home. Read More

Sleep Med 2019 Jan 28. Epub 2019 Jan 28.

Yale Pulmonary and Critical Care Medicine, New Haven, CT, USA. Electronic address:

Excessive daytime sleepiness (EDS) is a common complaint in the general population, which may be associated with a wide range of sleep disorders and other medical conditions. Narcolepsy is a sleep disorder characterized primarily by EDS, which involves a substantial burden of illness but is often overlooked or misdiagnosed. In addition to identifying low cerebrospinal fluid (CSF) hypocretin (orexin) levels, evaluation for narcolepsy requires in-laboratory polysomnography (PSG). Read More

Sleep Med 2019 Jan 7. Epub 2019 Jan 7.

L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, University of Toronto Stroke Program, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada.

Purpose: Obstructive sleep apnea (OSA) is a risk factor and common morbidity for stroke and transient ischemic attack (TIA). However, screening for OSA in patients with stroke or TIA is uncommonly performed, due in part to difficulties associated with conducting polysomnography (PSG) and Home Sleep Apnea Tests (HSATs). The 8-point "STOP-BANG" questionnaire has been shown to have high methodological quality in screening for OSA. Read More

Respir Res 2019 Feb 22;20(1):40. Epub 2019 Feb 22.

Division of Respiratory Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong.

Background: Obstructive sleep apnea syndrome (OSAS) is a common disorder with significant morbidity and mortality. We aimed to evaluate the predictive accuracy of the Berlin questionnaire in patients with suspected OSAS undergoing PSG in the sleep laboratory setting against those going through the Embletta™ portable diagnostic system (Embletta PDS) at home.

Methods: Patients with suspected OSAS were recruited from respiratory clinics to complete Berlin questionnaire and Epworth Sleepiness Score (ESS). Read More

Zhongguo Yi Liao Qi Xie Za Zhi 2019 Jan;43(1):29-31

Wenzhou Central Hospital, Wenzhou, 325000.

This paper demonstrates a BSN-based portable monitor integrating micro sensors with mobile devices for monitoring and diagnosing obstructive sleep apnea syndrome (OSAS) at home. The system uses a micro hot-film flow sensor to detect respiratory flow, uses tri-axis micro accelerometer to detect body posture and motion intensity, and uses a micro photoelectric sensor to detect oxygen saturation of blood. The real-time vital signs are detected and transmitted wirelessly to a mobile device. Read More

Sleep Sci 2018 Jul-Aug;11(4):269-273

National Institute of Respiratory Diseases, Sleep Medicine Unit - Mexico - Mexico City - Mexico.

Objectives: To: 1) evaluate the quality of an ambulatory monitoring technique for diagnosing Obstructive Sleep Apnea Syndrome (OSAS) while patients move through the city; and 2) identify factors that lead to data loss.

Methods: Clinical histories were reviewed and ambulatory portable monitorings of adults with high pretest probability for OSAS were included, the signals monitored were pulse oximetry, heart rate, nasal pressure, snoring, chest band and body position. The equipment was connected from 14:00-20:00 h and then patients moved through the city turning it off and on at home. Read More

J Clin Sleep Med 2019 Feb 4. Epub 2019 Feb 4.

Introduction: This guideline establishes clinical practice recommendations for positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines in the evaluation and treatment of sleep-disordered breathing in adults.

Methods: The AASM commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process was used to assess the evidence. Read More

J Clin Sleep Med 2019 Feb 15;15(2):285-292. Epub 2019 Feb 15.

Interdisciplinary Sleep Medicine Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Study Objectives: Evaluation of apnea detection using a tracheal sound (TS) sensor during sleep in patients with obstructive sleep apnea.

Methods: Polysomnographic recordings of 32 patients (25 male, mean age 66.7 ± 15. Read More

J Clin Sleep Med 2019 Feb 15;15(2):183-194. Epub 2019 Feb 15.

Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.

Study Objectives: Apnea-hypopnea index (AHI) is the main polysomnographic measure to diagnose obstructive sleep apnea (OSA). We aimed to evaluate the effect of three standard hypopnea definitions on the prevalence of OSA and its association with cardiometabolic outcomes in the general population.

Methods: We analyzed data from the HypnoLaus study (Lausanne, Switzerland), in which 2,162 participants (51% women, 57 ± 19 years) underwent in-home full polysomnography. Read More

J Clin Endocrinol Metab 2019 Jan 11. Epub 2019 Jan 11.

Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan.

Context: Recent studies based on home sleep apnea testing (HSAT) reported the potential association of sleep disordered breathing (SDB), such as obstructive sleep apnea (OSA), with diabetic retinopathy (DR). A few studies showed that the apnea hypopnea index during rapid eye movement sleep (REM-AHI) is associated with glycated hemoglobin and hypertension, two known risk factors for DR. However, there are no studies that have evaluated the association of REM-AHI with DR because previous studies were based on HSAT. Read More

J Alzheimers Dis 2019 ;67(2):631-638

Advanced Brain Monitoring, Carlsbad, CA, USA.

Background: The characterization of sleep in those with neurodegenerative disease (NDD) is essential in understanding the potential neurobiological mechanisms that underlie the connection between sleep disruption and NDD manifestations and progression.

Objective: Explore the inter-relationships between NDD and age, sex, diagnosis of obstructive sleep apnea, snoring, and duration of sleep time with the head in the supine and non-supine positions.

Methods: A case-control design was used to evaluate differences in sleep position obtained from multi-night, in-home Sleep Profiler recordings in 45 patients with diagnosed NDD (24 with mild cognitive impairment, 15 with Alzheimer's disease, and 6 with Lewy Body, Parkinson's, or other dementias) and 120 age-sex matched controls with normal cognition (NC). Read More

Sleep Med 2018 Nov 30. Epub 2018 Nov 30.

Division of Pulmonary, Critical Care and Sleep Medicine, Yale New Haven Medical Center, Yale School of Medicine, 20 York Street New Haven, CT, 06510, USA. Electronic address:

Objective: Apnea/hypopnea index (AHI), especially without arousal criteria, does not adequately risk stratify patients with mild obstructive sleep apnea (OSA). We describe and test scoring reliability of an event, Flow Limitation/Obstruction With recovery breath (FLOW), representing obstructive airflow disruptions using only pressure transducer and snore signals available without electroencephalography.

Methods: The following process was used (i) Development of FLOW event definition, (ii) Training period and definition refinement, and (iii) Reliability testing on 10 100-epoch polysomnography (PSG) samples and two 100-sample tests. Read More

Ann Am Thorac Soc 2019 Mar;16(3):363-370

2 Department of Medicine, Brigham and Women's Hospital, Harvard School of Medicine, Boston, Massachusetts.

Rationale: Air pollution may influence sleep through airway inflammation or autonomic nervous system pathway alterations. Epidemiological studies may provide evidence of relationships between chronic air pollution exposure and sleep apnea.

Objectives: To determine whether ambient-derived pollution exposure is associated with obstructive sleep apnea and objective sleep disruption. Read More

Front Endocrinol (Lausanne) 2018 29;9:714. Epub 2018 Nov 29.

Second Internal Medicine Department, Vinohrady Teaching Hospital, Prague, Czechia.

Obstructive sleep apnea (OSA) is a common disorder in Type 2 diabetes (T2D) patients further increasing their already high cardiovascular risk. As T2D patients typically not report OSA symptoms, systematic screening for OSA in this population is warranted. We aimed to determine the readiness of T2D patients to undergo screening and to compare their adherence to continuous positive airway pressure (CPAP) therapy with "regular" sleep clinic patients who typically seek medical advice on their own initiative. Read More

Sleep Med 2018 Oct 24. Epub 2018 Oct 24.

Department of Medicine, Division of Neurology, University of Toronto, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Canada; Sleep Laboratory, Sunnybrook Health Sciences Centre, Toronto, Canada. Electronic address:

Objective: Continuous positive airway pressure (CPAP) has been shown to improve functional, motor and cognitive outcomes in post-stroke obstructive sleep apnea (OSA). However, rates of CPAP adherence are often low and factors impacting CPAP adherence remain under-explored. Our objective was to determine predictors of CPAP adherence in patients who had a stroke or transient ischemic attack (TIA). Read More

J Clin Sleep Med 2018 Dec 15;14(12):2075-2077. Epub 2018 Dec 15.

University of Michigan Sleep Disorders Center, University of Michigan, Ann Arbor, Michigan.

Abstract: The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. It is the position of the American Academy of Sleep Medicine (AASM) that only a medical provider can diagnose medical conditions such as OSA and primary snoring. Throughout this statement, the term "medical provider" refers to a licensed physician and any other health care professional who is licensed to practice medicine in accordance with state licensing laws and regulations. Read More

J Clin Sleep Med 2018 Dec 15;14(12):2083-2086. Epub 2018 Dec 15.

Fairview Health Services, Minneapolis, Minnesota; University of Minnesota, Minneapolis, Minnesota.

Abstract: Catathrenia is a rare sleep-related breathing disorder marked by nocturnal groaning during prolonged exhalation. Home sleep apnea tests are growing in popularity, but no prior case reports exist documenting catathrenia detected by a home sleep apnea test. We report two cases of catathrenia incidentally detected in patients with low to intermediate risk of obstructive sleep apnea, in which diagnostic polysomnography was recommended but denied by insurers. Read More

J Clin Sleep Med 2018 Dec 15;14(12):2065-2073. Epub 2018 Dec 15.

Department of Neurology, Boston Medical Center, Boston, Massachusetts.

Study Objectives: Sleep-disordered breathing (SDB) is highly prevalent in patients with acute stroke. SDB is often underdiagnosed and associated with neurological deterioration and stroke recurrence. Polysomnography or home sleep apnea testing (HSAT) is typically used as the diagnostic modality; however, it may not be feasible to use regularly in patients with acute stroke. Read More

J Sleep Res 2019 Apr 26;28(2):e12795. Epub 2018 Nov 26.

Département de Pneumologie, Centre Hospitalier Universitaire, Angers, France.

Polysomnography (PSG) is necessary for the accurate estimation of total sleep time (TST) and the calculation of the apnea-hypopnea index (AHI). In type III home sleep apnea testing (HSAT), TST is overestimated because of the lack of electrophysiological sleep recordings. The aim of this study was to evaluate the accuracy and reliability of a novel automated sleep/wake scoring algorithm combining a single electroencephalogram (EEG) channel with actimetry and HSAT signals. Read More

Pulmonology 2018 Nov 23. Epub 2018 Nov 23.

Respiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Greece.

Objectives: Obstructive sleep apnea syndrome (OSA) is a cause of high morbidity and mortality so diagnosis and treatment is essential. Questionnaires and oximetry have been used for OSA screening.

Aim: To evaluate the clinical utility of different sleep questionnaires (Stop Bang (S-B), Berlin (BQ), Epworth Sleepiness Scale (ESS)) in deciding on treatment with Continuous Positive Airway Pressure (CPAP) and to examine whether the combination of the questionnaires alone or with oximetry improves their predictive value for CPAP initiation. Read More

Sleep Breath 2018 Nov 19. Epub 2018 Nov 19.

Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Bangkok, 10400, Thailand.

Purpose: Hypothyroidism is associated with a high frequency of obstructive sleep apnea (OSA). However, the prevalence of OSA in hypothyroid patients is not different from the general population in many reports. The importance of thyroid function screening in sleep-disordered breathing is still controversial. Read More

Conf Proc IEEE Eng Med Biol Soc 2018 07;2018:457-460

Obstructive Sleep Apnea (OSA) is a common sleep disorder affecting $>10\%$ of the middle-aged population. The gold standard diagnostic procedure is the Polysomnography (PSG), which is both costly and time consuming. A simple and non-expensive screening therefore would be of great value. Read More

Conf Proc IEEE Eng Med Biol Soc 2018 07;2018:179-182

Obstructive Sleep Apnea (OSA) is the most common form of sleep-disordered breathing in children. The gold standard to screen for OSA, polysomnography (PSG), requires an overnight stay in the hospital and is resource intensive. The Phone Oximeter is a non-invasive smartphone-based tool to record pulse oximetry. Read More

Acta Clin Belg 2018 Nov 15:1-9. Epub 2018 Nov 15.

a Leuven University Centre for Sleep and Wake Disorders (LUCS) , University Hospitals Leuven , Leuven , Belgium.

Objectives: Last years, vibrating devices were introduced to treat positional sleep apnoea (POSA). However, few data exist on determinants of effectiveness and adherence in clinical settings.

Methods: The NightBalance Sleep Position Trainer (SPT) analyses the patient's position during the first 2 nights, starts to build up vibrations during the following 7 and is 100% performant from night 10 on; and, reports on %supine, usage time, number of (responses on) vibrations. Read More

J Altern Complement Med 2019 Mar 14;25(3):317-325. Epub 2018 Nov 14.

4 Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Medipol University, Istanbul, Turkey.

Objectives: This study aims to investigate the effects of t'ai chi and qigong (TCQ) training on severity of obstructive sleep apnea (OSA).

Design: A prospective, 12-week, single-center, double-blinded, randomized controlled trial.

Setting: Sleep Disorders Center of Medical Faculty in Istanbul, Turkey. Read More

J Clin Sleep Med 2018 Nov 15;14(11):1859-1863. Epub 2018 Nov 15.

Sleep Unit, Heart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki Finland.

Study Objectives: No consensus exists regarding monitoring the initiation of positive airway pressure (PAP) by oximetry. A PAP device report may be insufficient to ensure a good therapeutic response in all patients. This study aimed to identify patients who would potentially benefit from oximetry monitoring during PAP initiation. Read More

J Clin Sleep Med 2018 Nov 15;14(11):1889-1894. Epub 2018 Nov 15.

Baylor Scott and White Health, Central Division, Temple, Texas.

Study Objectives: A home sleep apnea test (HSAT) is an acceptable alternative to polysomnography (PSG) for the diagnosis of obstructive sleep apnea (OSA) in patients with high pretest probability without certain comorbidities, such as severe pulmonary disease, congestive heart failure, or neuromuscular weakness. Current guidelines recommend repeat in-laborataory PSG in those with an initial negative PSG and high clinical suspicion for OSA. This retrospective study evaluated predictors of OSA on HSAT in patients who had a negative PSG. Read More

Curr Diab Rep 2018 Oct 25;18(12):137. Epub 2018 Oct 25.

Endocrinology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy.

Purpose Of Review: This review considers the relationship between abnormal blood pressure (BP) variability and autonomic dysfunction through an attempt to answer questions about its clinical relevance and pertinence to diabetes and cardiovascular autonomic neuropathy (CAN) and which therapeutic measures can lessen its cardiovascular impact.

Recent Findings: Office, ambulatory, and home BP monitoring identify posture-related, circadian, short-term, and long-term BP variabilities. Abnormal BP variability is a risk marker for organ damage, mortality, and cardiovascular events. Read More

Sleep 2019 Jan;42(1)

Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.

Rationale: Although short sleep duration has been linked to unhealthy dietary patterns, little is known about the association of obstructive sleep apnea (OSA), a disorder characterized by sleep fragmentation and diet.

Study Objectives: Investigate associations between diet quality and OSA in the Multi-Ethnic Study of Atherosclerosis and assess whether reductions in slow-wave sleep (stage N3) and rapid eye movement (REM) sleep are potential mediators for these associations.

Methods: A diverse population (N = 1813) completed a food frequency questionnaire and underwent Type 2 in-home polysomnography, which included measurement of N3 and REM sleep and apnea-hypopnea index (AHI). Read More

Sleep Breath 2018 Dec 11;22(4):1179-1188. Epub 2018 Oct 11.

Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA.

Rationale: Home sleep apnea testing (HSAT) typically does not include electroencephalogram (EEG) monitoring for sleep assessment. In patients with insomnia and low sleep efficiency, overestimation of the sleep period can result from absence of EEG, which will reduce sleep disordered breathing (SDB) indices and may lead to a false-negative result.

Objective: To validate a single channel frontal EEG for scoring sleep versus wake against full EEG during polysomnography, and then to examine the utility of adding this single channel EEG to standard HSAT to prevent false-negative results. Read More

Paediatr Anaesth 2018 11 3;28(11):940-946. Epub 2018 Oct 3.

Department of Pulmonary Medicine, Sleep Disorders Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Sleep-disordered breathing has a prevalence of 12% in the pediatric population. It represents a spectrum of disorders encompassing abnormalities of the upper airway that lead to sleep disruption, including primary snoring, obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation. Sleep-disordered breathing is the most common indication for adenotonsillectomy, one of the most common procedures performed in children. Read More

J Clin Sleep Med 2018 Sep 15;14(9):1605-1620. Epub 2018 Sep 15.

Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery, Stanford University, Stanford, California.

Study Objectives: 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). Read More

J Clin Sleep Med 2018 Sep 15;14(9):1495-1501. Epub 2018 Sep 15.

Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.

Study Objectives: To study the feasibility and accuracy of home sleep apnea testing (HSAT) in the diagnosis of obstructive sleep apnea (OSA) in a stroke rehabilitation unit.

Methods: Stroke patients referred to a neurorehabilitation center underwent OSA screening by means of HSAT within the Home Polygraphic Recording with Telemedicine Monitoring for Diagnosis and Treatment of Sleep Apnea in Stroke, or HOPES study (ClinicalTrials.gov identifier: NCT02748681). Read More

Sleep Med Rev 2018 10 17;41:149-160. Epub 2018 Feb 17.

Charité Universitatsmedizin, Sleep Center, Germany; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.

One of the most common sleep-related disorders is obstructive sleep apnea, characterized by a reduction of airflow while breathing during sleep and cause significant health problems. This disorder is mainly diagnosed in sleep labs with polysomnography, involving high costs and stress for the patient. To address this situation multiple systems have been proposed to conduct the examination and analysis in the patient's home, using sensors to detect physiological signals that are examined by algorithms. Read More

Sleep Med 2018 Nov 10;51:80-84. Epub 2018 Aug 10.

Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Sweden.

Objective: Combined insomnia and obstructive sleep apnea has been the focus of considerable research with respect to its health effects. A related issue is whether sleep disturbances in combination with snoring might exert effects on objective sleep variables in the non-clinical general population. The purpose of the present study was to investigate the polysomnographical characteristics of individuals who had sought medical help for both disturbed sleep and for snoring. Read More

Sleep Med 2018 Oct 30;50:145-151. Epub 2018 May 30.

Advanced Brain Monitoring, Carlsbad, CA, USA.

Objective/background: Systematically compare four criteria for Positional Obstructive Sleep Apnea (POSA) based on AASM 2007 and 2012 hypopnea scoring definitions.

Patients/methods: 142 records acquired by in-home polysomnography (Sleep Profiler PSG2™) were retrospectively analyzed using AHI based on the American Academy Sleep Medicine 2007 and 2012 criteria (AHI and AHI). Positional obstructive sleep apnea (POSA) was characterized using four criteria: Amsterdam Positional OSA Classification (APOC), supine AHI twice the non-supine AHI (Cartwright), Cartwright plus the non-supine AHI < 5 (Mador), and the overall AHI severity at least 1. Read More

Sleep Breath 2019 Mar 18;23(1):269-279. Epub 2018 Jul 18.

Resonea Inc., 11445 E Via Linda, Suite 2 # 224, Scottsdale, AZ, 85259, USA.

Purpose: Diagnosis of obstructive sleep apnea by the gold-standard of polysomnography (PSG), or by home sleep testing (HST), requires numerous physical connections to the patient which may restrict use of these tools for early screening. We hypothesized that normal and disturbed breathing may be detected by a consumer smartphone without physical connections to the patient using novel algorithms to analyze ambient sound.

Methods: We studied 91 patients undergoing clinically indicated PSG. Read More

Cureus 2018 May 8;10(5):e2593. Epub 2018 May 8.

Bariatric Surgery, University of north dakota.

Background Obstructive sleep apnea (OSA) is a common sleep disorder, especially in patients with obesity. Bariatric surgery is an effective tool to reduce weight and treat co-morbid diseases in patients with morbid obesity. One of these disorders is OSA. Read More

IEEE Trans Biomed Circuits Syst 2018 08 7;12(4):762-773. Epub 2018 May 7.

Obstructive Sleep Apnea (OSA) is one of the main under-diagnosed sleep disorder. It is an aggravating factor for several serious cardiovascular diseases, including stroke. There is, however, a lack of medical devices for long-term ambulatory monitoring of OSA since current systems are rather bulky, expensive, intrusive, and cannot be used for long-term monitoring in ambulatory settings. Read More

IEEE J Biomed Health Inform 2019 Mar 4;23(2):825-837. Epub 2018 Apr 4.

Sleep disorders are a common health condition that can affect numerous aspects of life. Obstructive sleep apnea is one of the most common disorders and is characterized by a reduction or cessation of airflow during sleep. In many countries, this disorder is usually diagnosed in sleep laboratories, by polysomnography, which is an expensive procedure involving much effort for the patient. Read More

IEEE J Biomed Health Inform 2018 Jun 1. Epub 2018 Jun 1.

Obstructive Sleep Apnea (OSA) is a prevalent sleep disorder, and highly affects the quality of human life. Currently, gold standard for OSA detection is Polysomnogram. Since this method is time consuming and cost inefficient, practical systems focus on the usage of electrocardiogram (ECG) signals for OSA detection. Read More

J Clin Sleep Med 2018 Jul 15;14(7):1245-1247. Epub 2018 Jul 15.

Division of Sleep Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract: The diagnostic criteria for obstructive sleep apnea (OSA) in adults, as defined in the International Classification of Sleep Disorders, Third Edition, requires an increased frequency of obstructive respiratory events demonstrated by in-laboratory, attended polysomnography (PSG) or a home sleep apnea test (HSAT). However, there are currently two hypopnea scoring criteria in The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications (AASM Scoring Manual). This dichotomy results in differences among laboratory reports, patient treatments and payer policies. Read More

Chest 2019 Jan 5;155(1):227-233. Epub 2018 Jul 5.

Division of Pulmonary, Critical Care, Allergy and Immunology, Department of Medicine, Northshore University Health System, Evanston, IL. Electronic address:

As the cost of health care continues to escalate, payers are adapting by moving away from models based on traditional fee-for-service reimbursement to models focused on rewarding care delivery that reduces costs and improves quality. These alternative payment models (APMs) are being introduced by government and commercial payers and will likely become the norm over time. Recent changes in sleep medicine related to advances in technology and approaches by payers for the management of OSA make this an appropriate time to incorporate the delivery of sleep medicine services into APMs. Read More

Sleep Disord 2018 3;2018:2394146. Epub 2018 Jun 3.

Department of Psychiatry, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.

Introduction: Obstructive sleep apnea (OSA) is common and usually underdetected in patients with cardiac arrhythmia. Ambulatory sleep testing may provide an alternative method for detection of OSA under realistic conditions compared to in-laboratory polysomnography. We aimed to (1) determine the sleep architecture in arrhythmia patients; (2) detect differences in sleep parameters between patients with and without OSA; and (3) compare the results of two consecutive nights of unattended ambulatory sleep testing. Read More

Sleep Med 2018 Aug 9;48:157-162. Epub 2018 Mar 9.

Center for Investigation and Research in Sleep, University Hospital of Lausanne (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland.

Objective/background: To determine the prevalence of positional obstructive sleep apnea (POSA) and exclusive POSA (ePOSA) in the general population and to assess the factors independently associated with POSA and ePOSA according to gender and menopausal status.

Patients/methods: Participants of the population-based HypnoLaus Sleep Cohort underwent full polysomnography at home. POSA was defined as an apnea-hypopnea index (AHI) ≥5/h, and supine/non-supine AHI ratio (sAHI/nsAHI) ≥2 (ePOSA when non-supine AHI was normalized). Read More

Sleep Breath 2018 Dec 29;22(4):1153-1160. Epub 2018 Jun 29.

Interdiscplinary Center for Sleep Medicine, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.

Background: OSA-patients with persistent excessive daytime sleepiness (EDS) despite CPAP treatment are challenging in daily clinical life. To rule out residual sleep-disordered breathing (SDB), CPAP device-derived data are used in outpatient setting. In case of no pathological finding, a more intensive work-up with is necessary. Read More

J Clin Sleep Med 2018 Jun 15;14(6):991-1003. Epub 2018 Jun 15.

Sleep Disorders Centre, Department of Respiratory and Sleep Medicine, Princess Alexandra Hospital, Woolloongabba, Australia.

Study Objectives: Severities of obstructive sleep apnea (OSA) estimated both for the overall sleep duration and for the time spent in rapid eye movement (REM) and non-rapid eye movement (NREM) sleep are important in managing the disease. The objective of this study is to investigate a method by which snore sounds can be analyzed to detect the presence of OSA in NREM and REM sleep.

Methods: Using bedside microphones, snoring and breathing-related sounds were acquired from 91 patients with OSA (35 females and 56 males) undergoing routine diagnostic polysomnography studies. Read More