Consumer sleep technology for the screening of obstructive sleep apnea and snoring : current status and a protocol for a systematic review and meta-analysis of diagnostic test accuracy

Funding Information: This work has received research funding from the European Union's Horizon 2020 research and innovation programme under grant agreement no. 965417. Timo Leppänen reports additional funding from NordForsk (NordSleep project 90458) via Business Finland (5133/31/2018), the Academy of Finland (323536), and the Research Committee of the Kuopio University Hospital Catchment Area for the State Research Funding (5041794). Erna Sif Arnardóttir and Anna Sigridur Islind report additional funding from NordForsk (NordSleep project 90458) via the Icelandic Research Fund. Funding Information: European Union's Horizon 2020 research and innovation program, Grant/Award Number: 965417; Academy of Finland, Grant/Award Number: 323536; Kuopio University Hospital Catchment Area for the State Research Funding, Grant/Award Number: 5041794; NordForsk, Grant/Award Number: 90458 Funding information Publisher Copyright: © 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.There are concerns about the validation and accuracy of currently available consumer sleep technology for sleep-disordered breathing. The present report provides a background review of existing consumer sleep technologies and discloses the methods and procedures for a systematic review and meta-analysis of diagnostic test accuracy of these devices and apps for the detection of obstructive sleep apnea and snoring in comparison with polysomnography. The search will be performed in four databases (PubMed, Scopus, Web of Science, and the Cochrane Library). Studies will be selected in two steps, first by an analysis of abstracts followed by full-text analysis, and two independent reviewers will perform both phases. Primary outcomes include apnea–hypopnea index, respiratory disturbance index, respiratory event index, oxygen desaturation index, and snoring duration for both index and reference tests, as well as the number of true positives, false positives, true negatives, and false negatives for each threshold, as well as for epoch-by-epoch and event-by-event results, which will be considered for the calculation of surrogate measures (including sensitivity, specificity, and accuracy). Diagnostic test accuracy meta-analyses will be performed using the Chu and Cole bivariate binomial model. Mean difference meta-analysis will be performed for continuous outcomes using the DerSimonian and Laird random-effects model. Analyses will be performed independently for each outcome. Subgroup and sensitivity analyses will evaluate the effects of the types (wearables, nearables, bed sensors, smartphone applications), technologies (e.g., oximeter, microphone, arterial tonometry, accelerometer), the role of manufacturers, and the representativeness of the samples.Peer reviewe