Evaluation of an Algorithm to Detect Sleep and Wake in Continuous Positive Airway Pressure (CPAP)

Not Applicable

Completed

Brief Summary: The purpose of this engineering trial is to develop and validate an algorithm that will deliver Paced Breathing as a ramp feature to obstructive sleep apnea (OSA) subjects using Continuous Positive Airway Pressure (CPAP) therapy. In this trial the investigators will be evaluating the algorithm's ability to correctly distinguish between sleep and wake.

Recruitment & Eligibility

Inclusion Criteria

Age 21-70
Diagnosis of obstructive sleep apnea (OSA)
Current adherent CPAP user (has been using CPAP nightly for at least 2 weeks).
On CPAP pressures of 5-10cm.
Subjects wishing to complete a day or evening appointment need to have significant daytime sleepiness (Epworth Sleepiness Scale score of 8 or above)
Able and willing to provide written informed consent
English speaking

Exclusion Criteria

Participation in another interventional research study within the last 30 days
Major controlled or uncontrolled medical condition such as congestive heart failure, neuromuscular disease, renal failure etc.
Inability to tolerate nasal CPAP mask due to problems breathing solely through their nose.
Chronic respiratory failure or insufficiency with suspected or known neuromuscular disease, moderate or severe chronic obstructive pulmonary disease (COPD), or any condition with an elevation of arterial carbon dioxide levels while awake (PaCo2≥55mmHg)
Severe oxygen desaturation on the polysomnography (PSG), i.e. Sa02 < 70% for 10% of the study.
Surgery of the upper airway, nose, sinus or middle ear within the past 90 days
Currently using supplemental oxygen
Regular use of sleeping pills or stimulants (> 3 nights a week)
Currently working night shift or rotating day/night shift
Drowsy Driving or near miss accident in the past 6 months
Inability to tolerate or track to Paced Breathing device during initial habituation session in lab
Chronic insomnia, Restless legs syndrome, or severe periodic limb movement disorder (PLMD - PLMAI>20/hr).

Arm && Interventions

Group	Intervention	Description
Paced Breathing Sleep/Wake detection	Paced Breathing	All subjects enrolled will have oobstructive sleep apnea (OSA) and will be current Continuous Positive Airway Pressur (CPAP) users.

Primary Outcome Measures

Name	Time	Method
Sleep/Wake Algorithm	The performance of the algorithm will be evaluated in real time while the subject is wearing the device during the sleep study, an average of 08 hours.	We tested the ability of the Sleep/Wake algorithm to identify sleep an wake periods with precision, as compared to standard polysonography (PSG) measures, which was used as the gold standard, i.e. we tested the accuracy of the algorithm. Accuracy was defined as the proportion of true results (both true positives and true negatives)in the population and it was assesed using as 2 X 2 table, i.e. accuracy = number of true positives + number of true negatives/ number of true positives + false positives + false negatives +true negatives. where True positive = the algorithm tested correctly identified sleep, False positive = the algorithm tested incorrectly identified sleep, True negative = the algorithm tested correctly rejected awake periods, and False negative = the algorithm tested incorrectly rejected awake periods.

Secondary Outcome Measures