Comparison of hospital-based and home-based obstructive sleep apnoea severity measurements with a single-lead electrocardiogram patch

Wen Te Liu, Shang Yang Lin, Cheng Yu Tsai, Yi Shin Liu, Wen Hua Hsu, Arnab Majumdar, Chia Mo Lin, Kang Yun Lee, Dean Wu, Yi Chun Kuan, Hsin Chien Lee, Cheng Jung Wu, Wun Hao Cheng, Ying Shuo Hsu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

6 Scopus citations


Obstructive sleep apnoea (OSA) is a global health concern, and polysomnography (PSG) is the gold standard for assessing OSA severity. However, the sleep parameters of home-based and in-laboratory PSG vary because of environmental factors, and the magnitude of these discrepancies remains unclear. We enrolled 125 Taiwanese patients who underwent PSG while wearing a single-lead electrocardiogram patch (RootiRx). After the PSG, all participants were instructed to continue wearing the RootiRx over three subsequent nights. Scores on OSA indices—namely, the apnoea–hypopnea index, chest effort index (CEI), cyclic variation of heart rate index (CVHRI), and combined CVHRI and CEI (Rx index), were determined. The patients were divided into three groups based on PSGdetermined OSA severity. The variables (various severity groups and environmental measurements) were subjected to mean comparisons, and their correlations were examined by Pearson’s correlation coefficient. The hospital-based CVHRI, CEI, and Rx index differed significantly among the severity groups. All three groups exhibited a significantly lower percentage of supine sleep time in the home-based assessment, compared with the hospital-based assessment. The percentage of supine sleep time (∆Supine%) exhibited a significant but weak to moderate positive correlation with each of the OSA indices. A significant but weak-to-moderate correlation between the ∆Supine% and ∆Rx index was still observed among the patients with high sleep efficiency (≥80%), who could reduce the effect of short sleep duration, leading to underestimation of the patients’ OSA severity. The high supine percentage of sleep may cause OSA indices’ overestimation in the hospital-based examination. Sleep recording at home with patch-type wearable devices may aid in accurate OSA diagnosis.

Original languageEnglish
Article number8097
Issue number23
StatePublished - 01 12 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • Apnoea–hypopnea index (AHI)
  • Cyclic variation of heart rate index (CVHRI)
  • Obstructive sleep apnoea (OSA)
  • Polysomnography (PSG)


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