Wearable Devices for Monitoring and Management of Comorbid Obstructive Sleep Apnea and Hypertension: Scoping Review

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Not applicable — no pooled quantitative effect sizes reported; descriptive synthesis only across 13 eligible studies

• Primary Outcome: Descriptive mapping of wearable device categories, physiological indicators monitored, and clinical application scenarios for comorbid OSA and hypertension management

• Nnt Or Sensitivity: Not reported at the review level; individual device sensitivity/specificity data from included studies not synthesised in the abstract. Device categories evaluated: wrist-worn devices, fingertip contact devices, patch and single-lead devices, and multiparameter portable monitoring systems

• Confidence Interval: Not reported — scoping review design with narrative synthesis; no meta-analytic confidence intervals calculated

Clinical Application

Current wearable devices are feasible as adjunctive screening and monitoring tools but are not validated for diagnostic replacement of polysomnography or ambulatory blood pressure monitoring. Significant heterogeneity in device accuracy, reference standards, and validation pathways means clinicians must evaluate individual device performance data before clinical adoption. Remote monitoring applications may be particularly relevant for patients with limited access to sleep laboratories. In Australia, OSA affects approximately 5–10% of the adult population and is a recognised independent risk factor for hypertension, with significant cardiovascular burden. The RACGP supports evidence-based management of OSA and hypertension as comorbid conditions. Polysomnography remains the gold standard for OSA diagnosis under MBS item numbers, and ambulatory blood pressure monitoring is recommended for hypertension diagnosis and management. No wearable OSA-hypertension monitoring devices are currently listed on the Australian Register of Therapeutic Goods (ARTG) specifically for comorbid management. The TGA regulates wearable medical devices under the Therapeutic Goods Act 1989, and any device claiming diagnostic utility would require ARTG inclusion. PBS does not currently subsidise wearable monitoring devices for this indication. The findings of this review support a cautious, adjunctive role for wearables in Australian clinical practice, pending higher-quality local validation studies. Telehealth expansion post-COVID-19 in Australia creates an enabling environment for remote wearable monitoring integration, but clinical governance frameworks for data quality and diagnostic thresholds remain underdeveloped. Adults with confirmed or suspected comorbid OSA and hypertension, particularly those requiring longitudinal nocturnal monitoring, remote management, or risk stratification in settings where polysomnography and ambulatory blood pressure monitoring are resource-limited or logistically challenging

Abstract

BACKGROUND: As an established driver of hypertension, obstructive sleep apnea (OSA) generates a significant cardiovascular burden when both disorders are present. This intersection not only compromises nocturnal hemodynamics but also hampers long-term clinical management. Yet, current health care delivery rarely integrates the simultaneous and continuous tracking of these dual burdens. While wearable technology provides a noninvasive, pragmatic toolset for synchronized physiological monitoring, research remains largely siloed within single-disease frameworks. Consequently, clinical evidence supporting wearable applications specifically for comorbid populations remains sparse. OBJECTIVE: In this scoping review, we summarized the current applications of wearable technology for comorbid OSA and hypertension. The analysis primarily outlines device categories, monitored physiological indicators, prevalent clinical scenarios, and existing challenges. METHODS: The search for relevant literature spanned PubMed, Web of Science, Embase, and IEEE Xplore, covering the period from January 2015 to February 2026. Eligible studies included adults and used wearable or portable technologies to objectively track sleep- or respiratory-related indicators and cardiovascular/blood pressure metrics. Study selection, data charting, and evidence synthesis were conducted using a 2-reviewer process and descriptive and narrative approaches. RESULTS: Our initial search yielded 739 records. Following title and abstract screening, we reviewed 54 full texts, ultimately finalizing a cohort of 13 eligible studies. Published between 2015 and 2026 across 9 countries, these articles capture data from 5596 participants. Most were observational studies and device validation studies. Evaluated device types included wrist-worn devices, fingertip contact devices, patch and single-lead devices, and multiparameter portable monitoring systems. The clinical applications mainly focused on screening and risk stratification for comorbid OSA and hypertension, monitoring of abnormal nocturnal blood pressure and hemodynamic changes, and cardiovascular risk assessment and remote longitudinal management. However, research remains sparse, and different devices vary greatly in reference standards, diagnostic thresholds, and validation pathways; therefore, their clinical translational value still requires further validation. CONCLUSIONS: Wearable devices may complement traditional assessment by providing continuous nocturnal and longitudinal data. However, at present, they are more suitable as auxiliary monitoring and risk warning tools in comorbidity management and cannot yet replace standard sleep studies or standard blood pressure monitoring. Future research should further shift from feasibility validation to large-sample, prospective, multicenter clinical studies in comorbid populations.

References

1. 1.Wang, H., Cheng, A., Li, Y., Zhang, H., Fan, S., Shen, R., Zhang, W., Li, H., & Wang, J. (2026). Wearable devices for monitoring and management of comorbid obstructive sleep apnea and hypertension: Scoping review. JMIR mHealth and uHealth. https://doi.org/10.2196/84506