Augmenting management of obstructive sleep apnea with consumer wearable devices to increase use of positive airway pressure therapy: a pilot randomized trial

Clinical Snapshot

Key Findings

• P Value: p = 0.0097 for primary outcome

• Effect Size: Between-group difference of 1.50 hours (90 minutes) increased nightly PAP use

• Primary Outcome: Change in PAP use from baseline to 35 days: +1.33 hours (immediate group) vs -0.17 hours (waitlist control)

• Nnt Or Sensitivity: Not calculable from available data

• Confidence Interval: Not reported in abstract

Clinical Application

High feasibility given widespread consumer wearable adoption and existing pulse oximetry capabilities Relevant to Australian sleep medicine practice; consumer wearables not PBS-subsidised but increasingly affordable; aligns with digital health initiatives Adults with OSA and documented poor PAP adherence in sleep clinic settings

Abstract

STUDY OBJECTIVES: This pilot randomized trial measured the effects of a consumer-grade wearable-augmented program, which provides nightly pulse oximetry data to patients in a weekly report, on positive airway pressure (PAP) use in adults with obstructive sleep apnea (OSA) recruited from an outpatient sleep center. METHODS: This single-blind, parallel, two-group waitlist-controlled, single-site randomized trial recruited individuals with OSA with insufficient PAP use from a Department of Veterans Affairs medical center and randomized them to immediate participation in the consumer wearable-augmented self-monitoring program versus waitlist. The primary outcome was the change in modem-measured PAP use (mean hours or minutes per night over a 7-day period) from baseline (T1) to T3 assessment, which was 35 days following randomization (7 days post-intervention for the immediate group and prior to intervention for the waitlist group). RESULTS: We randomized 50 participants (mean age 47.9 years [SD 11.4]; 88% male). The change in PAP use was +1.33 hours (+79.8 minutes) for the immediate group and -0.17 hours (-10.2 minutes) for the waitlist control group, with a between-group difference of 1.50 hours (90 minutes) (p = .0097). The change in the number of days PAP was used for 4 hours or more over a 7-day period was +1.32 days for the immediate and 0.12 days for the waitlist control group, with a between-group difference of 1.20 (p = .0401). CONCLUSIONS: This pilot trial demonstrated that the consumer-grade wearable-augmented program is a promising intervention for increasing PAP use. A future full-scale trial that follows participants for a longer period is needed. Statement of Significance This pilot trial tested a novel use of the pulse oximetry feature available on some consumer-grade wearable devices to increase use of positive airway pressure (PAP) devices among adults with obstructive sleep apnea (OSA) and insufficient PAP use. The widespread and growing use of consumer-grade wearable devices offers an opportunity to leverage the features on these devices to tackle a common, problematic issue among individuals with OSA-insufficient use of PAP therapy. The randomized controlled design provides support for future research involving these devices.

References

1. 1.Fung, C. H., Mak, S., Ash, G., Der-McLeod, E., Ereso, J. B., Naeem, S., Liu, J., Ghadimi, S., Te, T. T., Chan, V., Hurtado, J., Wong, S., Zeidler, M., & Liang, L. J. (2026). Augmenting management of obstructive sleep apnea with consumer wearable devices to increase use of positive airway pressure therapy: a pilot randomized trial. Sleep. https://doi.org/10.1093/sleep/zsaf342