Acoustics-Derived Home-Based Sleep Study for the Diagnosis of Obstructive Sleep Apnoea in Adults With Intellectual Disabilities: A Feasibility Study.

Background: Adults with intellectual disabilities (IDs) face significant health inequalities and reduced life expectancy compared to the general population. Sleep disorders, including obstructive sleep apnoea (OSA), are highly prevalent in this population; however, standard diagnostic modalities may be poorly tolerated and many people may remain undiagnosed. The aim of this study was to assess the feasibility of using an acoustic-derived home-based sleep study to diagnose OSA in adults with ID who were unable to tolerate standard inpatient or home sleep studies.

Method: This was a prospective feasibility study (GSTT/2024/15803). Participants were identified from two tertiary outpatient sleep departments in London, UK. Eligible participants were aged ≥ 17 years with a diagnosed ID. Inpatient or existing home studies had not been tolerated or had been declined. Participants wore a small diagnostic sensor, the AcuPebble SA100 (Acurable Ltd., London, UK) for one to two nights in their own home. Baseline symptom screening and quality of life questionnaires were administered. Semiqualitative and qualitative feedback was obtained from participants. The primary outcome was successful completion of testing, defined as ≥ 240 min of recording on at least one night. Quantitative diagnostic parameters were reviewed in a multidisciplinary team (MDT) meeting to formulate a management plan. Data are presented as mean (standard deviation), unless otherwise specified.

Results: Seventeen people were screened, and 10 agreed to participate in the study (3F/7M). Eight participants (80%) successfully completed testing (2F/6M, 4 severe ID, age 29.7 [15.4] years, body mass index, BMI 27.1 [5.9] kg/m², apnoea hypopnoea index, median AHI 5.5 [IQR 7.8] ev/h). Of these, five participants (63%) were found to have OSA. Feedback was favourable with an average total satisfaction score of 14.0 (4.8) out of 20 points.

Conclusion: In a cohort of participants with ID who were unable to tolerate standard sleep diagnostics to assess OSA, an acoustic-derived home-based sleep study may provide a solution to achieve clinically diagnostic recordings.