New technologies have become available to help screen/diagnose OSA; it remains unclear how these best fit in the diagnostic pathway.

This project aims to evaluate the use of a validated (Kelly, J.L. et al. 2021 Front. Neurosci 16:726880) automated accelerometer-based device (Sunrise - Sunrise SA, Namur, Belgium) for use in a pilot OSA clinic.

Using locally agreed inclusion and exclusion criteria the device was offered to patients as part of a remote assessment pathway in primary care. Exclusion criteria included oxygen saturation (SpO2) <95%, high occupational/driving risk, mandibular dysmotility, use of sedatives and presence of a comorbidity likely to complicate diagnosis. The pilot was funded by the Welsh Government Health and Social Services Transformation Fund. The service evaluation was approved by the Swansea Joint Study Review Committee.

41 referrals were accepted, of these 35 attended assessment and agreed to the pilot pathway. 27 patients met criteria for use of the device. Reasons for exclusion included low SpO2 (n=3), likely cardiovascular/respiratory disease (n=2), sleep related movement disorder (n=1), device understanding (n=1), high-risk occupation (n=1). Of these, 2 monitors were not initiated and 1 failed to initiate. Post-testing, 24 patients (89%) screened positive for OSA. The mean estimated AHI and RDI for the tested cohort were 30.04 and 25.28/hr respectively. The mean ESS recorded on the device app was 12 and insomnia severity index 18.6.

The device may provide an effective option for some patients if used as part of a range of investigations. This was a real-life service evaluation, caution should be taken in extrapolating the outcomes elsewhere.