{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T22:42:48Z","timestamp":1793659368005,"version":"4.5.1"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"PranaQ Pte. Ltd."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Study Objectives<\/jats:title>\n                  <jats:p>This paper validates TipTraQ, a compact home sleep apnea testing (HSAT) system. TipTraQ comprises a fingertip-worn device, a mobile application, and a cloud-based deep learning artificial intelligence (AI) system. The device utilizes photoplethysmography (red, infrared, and green channels) and accelerometer sensors to assess sleep apnea by the AI system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We prospectively enrolled 240 participants suspected of obstructive sleep apnea (OSA) at a tertiary medical center for internal validation and 112 participants independently at another center for external validation. All participants underwent simultaneous polysomnography and TipTraQ HSAT. We compared TipTraQ-derived total sleep time (TQ-TST) and TipTraQ-derived Respiratory Events Index (TQ-REI) with expert-determined TST and apnea\u2013hypopnea index (AHI), based on AASM standards with the 1B hypopnea rule. Temporal event localization analysis for respiratory event prediction was conducted at both event and hourly levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the external validation, the Spearman correlation coefficients for TQ-TST vs. TST and TQ-REI vs. AHI were 0.81 and 0.95, respectively. The root mean square error were 0.53 hours for TQ-TST vs. TST and 7.53 events\/h for TQ-REI vs. AHI. For apnea\/hypopnea prediction with a 10-second grace period, the true positive, false positive, and false negative rates in temporal event localization analysis were 0.76, 0.24, and 0.23, respectively. The four-way OSA severity classification achieved a Cohen\u2019s kappa of 0.7.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>TQ-TST and TQ-REI predict TST and AHI with comparable performance to existing devices of the same type, and respiratory event prediction is validated through temporal event localization analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials<\/jats:title>\n                  <jats:p>Development of TipTraQ Home Sleep Test, https:\/\/clinicaltrials.gov\/study\/NCT06474351?term=NCT06474351&amp;rank=1, NCT06474351<\/jats:p>\n                  <jats:p>TipTraQ Home Sleep Test Study, SHH, https:\/\/clinicaltrials.gov\/study\/NCT06633887?term=NCT06633887&amp;rank=1, NCT06633887<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleep\/zsae317","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T16:56:39Z","timestamp":1737046599000},"source":"Crossref","is-referenced-by-count":10,"title":["Validation of a fingertip home sleep apnea testing system using deep learning AI and a temporal event localization analysis"],"prefix":"10.1093","volume":"48","author":[{"given":"Ke-Wei","family":"Chen","sequence":"first","affiliation":[{"name":"PranaQ Pte. Ltd. ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Hsien","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Taipei Veterans General Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7557-8259","authenticated-orcid":false,"given":"Hsin-Chien","family":"Lee","sequence":"additional","affiliation":[{"name":"Graduate Institute of Humanities in Medicine, College of Humanities & Social Sciences, Taipei Medical University , Taipei ,","place":["Taiwan"]},{"name":"Department of Psychiatry & Sleep Center, Taipei Medical University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Te","family":"Liu","sequence":"additional","affiliation":[{"name":"Sleep Center, Shuang Ho Hospital, Taipei Medical University , New Taipei City ,","place":["Taiwan"]},{"name":"School of Respiratory Therapy, College of Medicine, Taipei Medical University , Taipei ,","place":["Taiwan"]},{"name":"Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University , New Taipei City ,","place":["Taiwan"]},{"name":"Research Center of Artificial Intelligence in Medicine, Taipei Medical University , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun-Ta","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Taipei Veterans General Hospital , Taipei ,","place":["Taiwan"]},{"name":"College of Medicine, National Yang Ming Chiao Tung University , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0253-3156","authenticated-orcid":false,"given":"Hau-Tieng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Mathematics, Courant Institute of Mathematical Sciences, New York University , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"2025051210422370000_CIT0001","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1001\/jama.2020.3514","article-title":"Diagnosis and management of obstructive sleep apnea: a review","volume":"323","author":"Gottlieb","year":"2020","journal-title":"JAMA."},{"key":"2025051210422370000_CIT0002","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis","volume":"7","author":"Benjafield","year":"2019","journal-title":"Lancet Respir Med"},{"key":"2025051210422370000_CIT0003","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1016\/j.smrv.2011.10.001","article-title":"Impact of sleep apnea on economics","volume":"16","author":"Leger","year":"2012","journal-title":"Sleep Med Rev."},{"key":"2025051210422370000_CIT0004","doi-asserted-by":"publisher","first-page":"257","DOI":"10.5935\/1984-0063.20200111","article-title":"The public health burden of obstructive sleep apnea","volume":"14","author":"Faria","year":"2021","journal-title":"Sleep Sci."},{"key":"2025051210422370000_CIT0005","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1515\/reveh-2018-0068","article-title":"Obstructive sleep apnea: personal, societal, public health, and legal implications","volume":"34","author":"Morsy","year":"2019","journal-title":"Rev Environ Health."},{"key":"2025051210422370000_CIT0006","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.1056\/NEJMoa043104","article-title":"Obstructive sleep apnea as a risk factor for stroke and death","volume":"353","author":"Yaggi","year":"2005","journal-title":"N Engl J Med."},{"key":"2025051210422370000_CIT0007","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1164\/rccm.201005-0693OC","article-title":"Obstructive sleep apnea: brain structural changes and neurocognitive function before and after treatment","volume":"183","author":"Canessa","year":"2011","journal-title":"Am J Respir Crit Care Med."},{"key":"2025051210422370000_CIT0008","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1007\/s00408-011-9340-1","article-title":"Cardiovascular consequences of sleep apnea","volume":"190","author":"Golbidi","year":"2012","journal-title":"Lung."},{"key":"2025051210422370000_CIT0009","doi-asserted-by":"publisher","first-page":"479","DOI":"10.5664\/jcsm.6506","article-title":"Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline","volume":"13","author":"Kapur","year":"2017","journal-title":"J Clin Sleep Med."},{"key":"2025051210422370000_CIT0010","doi-asserted-by":"crossref","first-page":"737","DOI":"10.5664\/jcsm.27032","article-title":"Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine","volume":"3","author":"Collop","year":"2007","journal-title":"J Clin Sleep Med."},{"key":"2025051210422370000_CIT0011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-69935-7","article-title":"Wearable monitoring of sleep-disordered breathing: estimation of the apnea\u2013hypopnea index using wrist-worn reflective photoplethysmography","volume":"10","author":"Papini","year":"2020","journal-title":"Sci Rep."},{"key":"2025051210422370000_CIT0012","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1007\/s13534-017-0055-y","article-title":"Obstructive sleep apnoea detection using convolutional neural network based deep learning framework","volume":"8","author":"Dey","year":"2018","journal-title":"Biomed Eng Lett."},{"key":"2025051210422370000_CIT0013","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.5664\/jcsm.7398","article-title":"An evaluation of the NightOwl home sleep apnea testing system","volume":"14","author":"Massie","year":"2018","journal-title":"J Clin Sleep Med."},{"key":"2025051210422370000_CIT0014","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsac028","article-title":"A multicentric validation study of a novel home sleep apnea test based on peripheral arterial tonometry","volume":"45","author":"Van Pee","year":"2022","journal-title":"Sleep."},{"key":"2025051210422370000_CIT0015","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1093\/sleep\/29.3.367","article-title":"Validation a portable monitoring device for sleep apnea diagnosis in a population based cohort using synchronized home polysomnography","volume":"29","author":"Zou","year":"2006","journal-title":"Sleep."},{"key":"2025051210422370000_CIT0016","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.sleh.2023.05.001","article-title":"Belun Ring (Belun Sleep System BLS-100): deep learning-facilitated wearable enables obstructive sleep apnea detection, apnea severity categorization, and sleep stage classification in patients suspected of obstructive sleep apnea","volume":"9","author":"Strumpf","year":"2023","journal-title":"Sleep Health"},{"key":"2025051210422370000_CIT0017","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1378\/chest.106.6.1695","article-title":"Changes in obstructive sleep apnea characteristics through the night","volume":"106","author":"Charbonneau","year":"1994","journal-title":"Chest."},{"key":"2025051210422370000_CIT0018","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1183\/09031936.01.00038101","article-title":"Apnoea characteristics across the night in severe obstructive sleep apnoea: influence of body posture","volume":"18","author":"Oksenberg","year":"2001","journal-title":"Eur Respir J."},{"key":"2025051210422370000_CIT0019","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. Version 3","author":"Troester","year":"2023"},{"key":"2025051210422370000_CIT0020","doi-asserted-by":"publisher","first-page":"20582","DOI":"10.1038\/s41598-022-25183-5","article-title":"Obstructive sleep apnea in young Asian adults with sleep-related complaints","volume":"12","author":"Chiu","year":"2022","journal-title":"Sci Rep."},{"key":"2025051210422370000_CIT0021","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1111\/j.1553-2712.1996.tb03538.x","article-title":"Statistical methodology: I. Incorporating the prevalence of disease into the sample size calculation for sensitivity and specificity","volume":"3","author":"Buderer","year":"1996","journal-title":"Acad Emerg Med."},{"key":"2025051210422370000_CIT0022","doi-asserted-by":"publisher","first-page":"e0176991","DOI":"10.1371\/journal.pone.0176991","article-title":"Prediction of the severity of obstructive sleep apnea by anthropometric features via support vector machine","volume":"12","author":"Liu","year":"2017","journal-title":"PLoS One."},{"key":"2025051210422370000_CIT0023","doi-asserted-by":"crossref","first-page":"665","DOI":"10.5664\/jcsm.6576","article-title":"The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications version 2.6","volume":"13","author":"Berry","year":"2020","journal-title":"J Clin Sleep Med."},{"key":"2025051210422370000_CIT0024","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1007\/s10710-017-9314-z","article-title":"Ian Goodfellow, Yoshua Bengio, and Aaron Courville: deep learning","volume":"19","author":"Heaton","year":"2018","journal-title":"Genet Program Evolvable Mach"},{"key":"2025051210422370000_CIT0025","volume-title":"Photoplethysmography: Technology, Signal Analysis and Applications","author":"Kyriacou","year":"2021"},{"key":"2025051210422370000_CIT0026","doi-asserted-by":"publisher","first-page":"100964","DOI":"10.1016\/j.accpm.2021.100964","article-title":"Perfusion index: physical principles, physiological meanings and clinical implications in anaesthesia and critical care","volume":"40","author":"Coutrot","year":"2021","journal-title":"Anaesth Crit Care Pain Med"},{"key":"2025051210422370000_CIT0027","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1037\/\/0033-2909.86.2.420","article-title":"Intraclass correlations: uses in assessing rater reliability","volume":"86","author":"Shrout","year":"1979","journal-title":"Psychol Bull."},{"key":"2025051210422370000_CIT0028","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1007\/s11325-019-01885-5","article-title":"Intra-night variation in apnea-hypopnea index affects diagnostics and prognostics of obstructive sleep apnea","volume":"24","author":"Nikkonen","year":"2020","journal-title":"Sleep Breath."},{"key":"2025051210422370000_CIT0029","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.5664\/jcsm.8620","article-title":"Performance of peripheral arterial tonometry-based testing for the diagnosis of obstructive sleep apnea in a large sleep clinic cohort","volume":"16","author":"Ioachimescu","year":"2020","journal-title":"J Clin Sleep Med."},{"key":"2025051210422370000_CIT0030","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.5664\/jcsm.9808","article-title":"A meta-analysis of diagnostic test performance of peripheral arterial tonometry studies","volume":"18","author":"Iftikhar","year":"2022","journal-title":"J Clin Sleep Med."},{"key":"2025051210422370000_CIT0031","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1001\/jamaoto.2013.5338","article-title":"Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: meta-analysis","volume":"139","author":"Yalamanchali","year":"2013","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"2025051210422370000_CIT0032","doi-asserted-by":"publisher","first-page":"563","DOI":"10.5664\/jcsm.8278","article-title":"A comparison of automated and manual sleep staging and respiratory event recognition in a portable sleep diagnostic device with in-lab sleep study","volume":"16","author":"Zhang","year":"2020","journal-title":"J Clin Sleep Med."},{"key":"2025051210422370000_CIT0033","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1016\/j.chest.2020.01.039","article-title":"Variability and misclassification of sleep apnea severity based on multi-night testing","volume":"158","author":"Punjabi","year":"2020","journal-title":"Chest."},{"key":"2025051210422370000_CIT0034","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.3390\/s20051493","article-title":"Motion artifact reduction in wearable photoplethysmography based on multi-channel sensors with multiple wavelengths","volume":"20","author":"Lee","year":"2020","journal-title":"Sensors"},{"key":"2025051210422370000_CIT0035","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1093\/eurpub\/ckac174","article-title":"The impact of switching from single-use to reusable healthcare products: a transparency checklist and systematic review of life-cycle assessments","volume":"33","author":"Keil","year":"2023","journal-title":"Eur J Public Health."},{"key":"2025051210422370000_CIT0036","doi-asserted-by":"publisher","first-page":"2477","DOI":"10.1056\/NEJMc2029240","article-title":"Racial Bias in Pulse Oximetry Measurement","volume":"383","author":"Sjoding","year":"2020","journal-title":"N Engl J Med."},{"key":"2025051210422370000_CIT0037","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/j.psychres.2012.07.045","article-title":"Is a one-night stay in the lab really enough to conclude? First-night effect and night-to-night variability in polysomnographic recordings among different clinical population samples","volume":"200","author":"Newell","year":"2012","journal-title":"Psychiatry Res."}],"container-title":["SLEEP"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/sleep\/advance-article-pdf\/doi\/10.1093\/sleep\/zsae317\/61462106\/zsae317.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleep\/article-pdf\/48\/5\/zsae317\/61462106\/zsae317.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleep\/article-pdf\/48\/5\/zsae317\/61462106\/zsae317.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T14:42:35Z","timestamp":1747060955000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/sleep\/article\/doi\/10.1093\/sleep\/zsae317\/7958709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,16]]},"references-count":37,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,1,16]]},"published-print":{"date-parts":[[2025,5,12]]}},"URL":"https:\/\/doi.org\/10.1093\/sleep\/zsae317","relation":{},"ISSN":["0161-8105","1550-9109"],"issn-type":[{"value":"0161-8105","type":"print"},{"value":"1550-9109","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,1,16]]},"article-number":"zsae317"}}