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CompletedNCT03470493Updated May 20, 2021Results posted

ApneaLink Air Home Sleep Testing (HST) Device Validation Study

An interventional study of ApneaLink Air in Sleep-disordered Breathing, sponsored by ResMed. Completed at 2 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-05-20.

Sponsored by ResMed · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
130
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This study compares the diagnostic capability of a home sleep apnea testing device to polysomnography.

Read the detailed description

The current gold standard for sleep disordered breathing (SDB) diagnosis is in-laboratory polysomnography (PSG). A barrier of acceptance of Home Sleep Apnea Testing (HSAT) devices as a diagnostic test is their inability to accurately measure total sleep time (TST). A novel algorithm developed by ResMed, Ltd. allows the AL device to accurately calculate TST, however, this algorithm has not yet been validated.

The ApneaLink Air (AL) device is a type III HSAT device. The device is capable of recording up to four channels of data including: flow and snore via a nasal cannula attached to a pressure transducer, a respiratory effort belt, a pulse oximeter to measure pulse and oxygen saturation, and an actigraphy monitor to measure TST along with flow. The AL device has been validated against PSG for AHI, and Cheyne-Stoke respiration detection . Further validation of the effort belt is necessary to determine the accuracy of the AL ability to differentiate between obstructive and central apneic events.

02

Conditions studied

  • Sleep-disordered Breathing
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Participant is 18 years of age or older
  • Participant is willing to provide informed consent
  • Participant is willing to participate in all study related procedures

Exclusion criteria

Exclusion Criteria:

  • Unable to cease positive airway pressure (PAP) therapy during PSG (if currently using)
  • Requires use of oxygen therapy during sleep
  • Diagnosis of uncontrolled clinically relevant sleep disorder (e.g., untreated insomnia or restless leg syndrome)
  • Pregnant
  • Participant is unsuitable to participate in the study in the opinion of the investigator
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
130 participants (actual)

Study arms

  • Experimental
    Participants

    ApneaLink Air

    Diagnostic Test: ApneaLink Air

Interventions

  • Diagnostic testApneaLink Air

    ApneaLink Air to be used on each participant undergoing PSG

05

What researchers measure

Primary outcomes

  1. Diagnostic Sensitivity of Apnealink (AL) Compared With Polysomnography (PSG)

    The Respiratory Event Index (REI) provided by the AL will be compared with the REI provided by the PSG test. REI will be scored according to American Academy of Sleep Medicine (AASM) 2012 guidelines. The REI provided by the AL for each participant is divided by the REI provided by the PSG for the same participant to get the diagnostic sensitivity of the Apnealink.

    Time frame: Day 1

Secondary outcomes

  1. Diagnostic Sensitivity of Apnealink (AL) Compared With Polysomnography (PSG) to Identify Obstructive Events

    Total number of Obstructive events reported by the ApneaLink (AL) compared with total number of Obstructive Events reported by polysomnography (PSG). The Obstructive events of the AL are divided by the Obstructive events of the PSG to get the diagnostic sensitivity. This is then compared with the threshold of 0.825

    Time frame: Day 1

  2. Diagnostic Sensitivity of the AL to Determine Central Events Compared With PSG

    Total number of Central events reported by the ApneaLink (AL) compared with total number of Central Events reported by polysomnography (PSG). The Central events of the AL are divided by the Central events of the PSG to get the diagnostic sensitivity. This is then compared with the threshold of 0.825

    Time frame: Day 1

  3. Positive Likelihood Ratio of Apnealink Air

    The positive likelihood ratio (the estimated sensitivity divided by 1 minus the estimated specificity) was calculated along with the associated one-sided 97.5% confidence interval. The positive likelihood ratio was compared with the threshold of 5 (AASM criteria for out-of-center testing devices12) using a Wald test.

    Time frame: Day 1

06

Results

Posted May 20, 2021

Participant flow

Participant flow — Overall Study
MilestoneParticipants
Started130
Met primary endpoint80
Completed130
Not completed0

Outcome measures

PrimaryDiagnostic Sensitivity of Apnealink (AL) Compared With Polysomnography (PSG)

The Respiratory Event Index (REI) provided by the AL will be compared with the REI provided by the PSG test. REI will be scored according to American Academy of Sleep Medicine (AASM) 2012 guidelines. The REI provided by the AL for each participant is divided by the REI provided by the PSG for the same participant to get the diagnostic sensitivity of the Apnealink.

Time frame:
Day 1
Reported as:
Number · percent of agreement between AL and PSG
Diagnostic Sensitivity of Apnealink (AL) Compared With Polysomnography (PSG)
percent of agreement between AL and PSGParticipants
Diagnostic Sensitivity of Apnealink (AL) Compared With Polysomnography (PSG)91.5 (82.8 to 100)
SecondaryDiagnostic Sensitivity of Apnealink (AL) Compared With Polysomnography (PSG) to Identify Obstructive Events

Total number of Obstructive events reported by the ApneaLink (AL) compared with total number of Obstructive Events reported by polysomnography (PSG). The Obstructive events of the AL are divided by the Obstructive events of the PSG to get the diagnostic sensitivity. This is then compared with the threshold of 0.825

Time frame:
Day 1
Reported as:
Number · Weighted Kappa statistic
Diagnostic Sensitivity of Apnealink (AL) Compared With Polysomnography (PSG) to Identify Obstructive Events
Weighted Kappa statisticParticipants
Diagnostic Sensitivity of Apnealink (AL) Compared With Polysomnography (PSG) to Identify Obstructive Events0.61
SecondaryDiagnostic Sensitivity of the AL to Determine Central Events Compared With PSG

Total number of Central events reported by the ApneaLink (AL) compared with total number of Central Events reported by polysomnography (PSG). The Central events of the AL are divided by the Central events of the PSG to get the diagnostic sensitivity. This is then compared with the threshold of 0.825

Time frame:
Day 1
Reported as:
Number · Weighted Kappa statistic
Diagnostic Sensitivity of the AL to Determine Central Events Compared With PSG
Weighted Kappa statisticParticipants
Diagnostic Sensitivity of the AL to Determine Central Events Compared With PSG0.48
SecondaryPositive Likelihood Ratio of Apnealink Air

The positive likelihood ratio (the estimated sensitivity divided by 1 minus the estimated specificity) was calculated along with the associated one-sided 97.5% confidence interval. The positive likelihood ratio was compared with the threshold of 5 (AASM criteria for out-of-center testing devices12) using a Wald test.

Time frame:
Day 1
Reported as:
Mean · Likelihood Ratio
Positive Likelihood Ratio of Apnealink Air
Likelihood RatioParticipants
Positive Likelihood Ratio of Apnealink Air3.7 (1.1 to 4.7)

Adverse events

Collected over 1 year. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Participants0/80 (0%)0/80 (0%)0/80 (0%)

Baseline characteristics

Baseline population included participants that were considered eligible for the primary endpoint analysis.

Age, Continuous
Age, Continuous(years)Participants
Mean53.2 ± 13.0
Sex: Female, Male
Sex: Female, Male(Participants)Participants
Female23
Male57
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Participants
Hispanic or Latino36
Not Hispanic or Latino44
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Participants
American Indian or Alaska Native0
Asian1
Native Hawaiian or Other Pacific Islander1
Black or African American4
White74
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Participants
United States80
Body Mass Index
Body Mass Index(kg/m^2)Participants
Mean35.1 ± 8.9
Current PAP therapy user
Current PAP therapy user(Participants)Participants
Count of participants30
Current oxygen user
Current oxygen user(Participants)Participants
Count of participants1
07

Study locations

2 sites
  • University of Florida
    Gainesville, Florida 32611, United States
  • University of Miami
    Miami, Florida 33136, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Jan 31, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03470493
Lead sponsor
ResMed
Responsible party
Sponsor
First posted
Mar 20, 2018
Start date
Apr 11, 2018
Primary completion
Mar 6, 2019
Completion
Jul 31, 2019
Results posted
May 20, 2021
Last update
May 20, 2021

Study contacts

Richard Berry, MD
principal investigator · University of Florida

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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