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Purpose <p>This study aimed to evaluate the validity and feasibility of home obstructive sleep apnea screening using a sleep sound analysis smartphone app compared to the STOP-BANG questionnaire (SBQ) among Chinese adults with hypertension, including the impact of screening on intention to pursue treatment.</p> Methods <p>A randomized cross-over trial was conducted among adults with hypertension from a hospital clinic and community health center in Haikou, China. Participants were assigned to undergo sequential screening with a sleep sound analysis smartphone app (Snail Sleep) or the SBQ followed by home sleep apnea testing. Questionnaires measured satisfaction and intention to pursue treatment.</p> Results <p>Among 180 participants (median age: 51.0 years, 72.2% male), 91.7% had OSA, including 28.3% with moderate OSA, and 37.2% with severe OSA (mean AHI 28.6, SD = 23.02). An app-generated apnea index (APP-AI) optimal cutoff of 7.1 achieved 72.0% sensitivity, 85.5% specificity, a 4.96 positive likelihood ratio (LR), and a 0.33 negative LR for moderate-to-severe OSA (AHI ≥ 15), with an area under the curve (AUC) of 0.831 (95% CI 0.773–0.89), outperforming the original SBQ (BMI &gt; 35) (AUC 0.728) and modified SBQ (BMI &gt; 28) (AUC 0.754). Participants reported high satisfaction levels. Intention to pursue treatment decreased among those given normal screening results while remaining high among those given abnormal results.</p> Conclusion <p>A sleep sound analysis smartphone app achieved acceptable validity and feasibility for home OSA screening in a group of Chinese adults with hypertension. Further studies should evaluate app screening in other populations and effects on patient attitudes and behavior.</p>

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Evaluation of a sleep sound analysis smartphone app for home obstructive sleep apnea screening among community-dwelling Chinese adults with hypertension

  • 期刊论文

  • 发表日期：

    2026年7月7日

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  • Timothy Noel Stephens,
  • Yingxiu Wang,
  • Jingzhu Guo,
  • Jiaofeng Wang

摘要

Purpose

This study aimed to evaluate the validity and feasibility of home obstructive sleep apnea screening using a sleep sound analysis smartphone app compared to the STOP-BANG questionnaire (SBQ) among Chinese adults with hypertension, including the impact of screening on intention to pursue treatment.

Methods

A randomized cross-over trial was conducted among adults with hypertension from a hospital clinic and community health center in Haikou, China. Participants were assigned to undergo sequential screening with a sleep sound analysis smartphone app (Snail Sleep) or the SBQ followed by home sleep apnea testing. Questionnaires measured satisfaction and intention to pursue treatment.

Results

Among 180 participants (median age: 51.0 years, 72.2% male), 91.7% had OSA, including 28.3% with moderate OSA, and 37.2% with severe OSA (mean AHI 28.6, SD = 23.02). An app-generated apnea index (APP-AI) optimal cutoff of 7.1 achieved 72.0% sensitivity, 85.5% specificity, a 4.96 positive likelihood ratio (LR), and a 0.33 negative LR for moderate-to-severe OSA (AHI ≥ 15), with an area under the curve (AUC) of 0.831 (95% CI 0.773–0.89), outperforming the original SBQ (BMI > 35) (AUC 0.728) and modified SBQ (BMI > 28) (AUC 0.754). Participants reported high satisfaction levels. Intention to pursue treatment decreased among those given normal screening results while remaining high among those given abnormal results.

Conclusion

A sleep sound analysis smartphone app achieved acceptable validity and feasibility for home OSA screening in a group of Chinese adults with hypertension. Further studies should evaluate app screening in other populations and effects on patient attitudes and behavior.