Validation of sleep-staging accuracy for an in-home sleep electroencephalography device compared with simultaneous polysomnography in patients with obstructive sleep apnea

Abstract

Efforts to simplify standard polysomnography (PSG) in laboratories, especially for obstructive sleep apnea (OSA), and assess its agreement with portable electroencephalogram (EEG) devices are limited. We aimed to evaluate the agreement between a portable EEG device and type I PSG in patients with OSA and examine the EEG-based arousal index’s ability to estimate apnea severity. We enrolled 77 Japanese patients with OSA who underwent simultaneous type I PSG and portable EEG monitoring. Combining pulse rate, oxygen saturation (SpO2), and EEG improved sleep staging accuracy. Bland–Altman plots, paired t-tests, and receiver operating characteristics curves were used to assess agreement and screening accuracy. Significant small biases were observed for total sleep time, sleep latency, awakening after falling asleep, sleep efficiency, N1, N2, and N3 rates, arousal index, and apnea indexes. All variables showed > 95% agreement in the Bland–Altman analysis, with interclass correlation coefficients of 0.761–0.982, indicating high inter-instrument validity. The EEG-based arousal index demonstrated sufficient power for screening AHI ≥ 15 and ≥ 30 and yielded promising results in predicting apnea severity. Portable EEG device showed strong agreement with type I PSG in patients with OSA. These suggest that patients with OSA may assess their condition at home.

Relationship between macronutrients, dietary components, and objective sleep variables measured by smartphone applications

“…Moreover, because users have their own smartphones, the reliability of accelerometer measurements varies across different device models. In the future, integrating alternative methods, such as tappigraphy, for sleep-wake rhythms, actigraphy, or portable EEG devices could provide more objective evaluations [10][11][12]. Finally, because this study was retrospective, we could not adequately capture confounding factors related to sleep and nutrition.…”

“…Compared to dietary assessments, evaluating sleep is more challenging. However, in recent years, polysomnography, often considered the gold standard for sleep assessment, has been adapted from novel methods using portable EEG devices and accelerometers to more accessible methods, such as smartphone accelerometers and tappigraphy, which determine sleep and wakefulness by logging the timing of day-to-day touchscreen interactions [8,[10][11][12]. While there is an ongoing debate regarding their validity, we are entering an era in which sleep assessments are becoming more accessible to users.…”

Physiological Evaluation of Far Infrared-Emitting Garments on Sleep and Thermoregulation

“…This lightweight (162 g) recording device consisted of four EEG electrodes (Fp1, Fp2, M1, and M2) and one reference electrode (Fpz) according to the 10–20 system. To validate the sleep-staging accuracy, simultaneous recording using the portable system revealed over 95% agreement for all variables, with interclass correlation coefficients ranging from 0.761 to 0.982 in sleep scoring with polysomnography (PSG) [22]. The montage was combined with four electroencephalogram derivations (Fp1–M2, Fp2–M1, Fp1– average M, and Fp2–average M), using Fp1–Fp2 and Fp2–Fp1 for left and right electrooculography, respectively, and M1–M2 for chin electromyography to analyze sleep staging.…”

“…The copyright holder for this preprint this version posted June 15, 2024. ; https://doi.org/10.1101/2024.06.13.598953 doi: bioRxiv preprint the sleep-staging accuracy, simultaneous recording using the portable system revealed over 95% agreement for all variables, with interclass correlation coefficients ranging from 0.761 to 0.982 in sleep scoring with polysomnography (PSG) [22]…”