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Introdução: O sono desempenha um papel crucial na manutenção da saúde cognitiva, cardiovascular, imunológica e metabólica. Ele é composto por diferentes estágios, incluindo o sono de ondas lentas (NREM) e o sono REM, cada um com características fisiológicas distintas e funções específicas. A Apneia Obstrutiva do Sono, um dos distúrbios respiratórios do sono mais prevalentes, está associada a diversas comorbidades graves, como doenças cardiovasculares, diabetes tipo II e disfunções cognitivas. A polissonografia é o método padrão-ouro para o diagnóstico da AOS, mas apresenta limitações, como o elevado custo e desconforto para o paciente. Em resposta, a medicina está migrando para métodos de diagnóstico mais acessíveis e menos invasivos, incluindo o uso de wearables, nearables e apps. Estes dispositivos, oferecem uma alternativa promissora para o diagnóstico da AOS, fornecendo dados sobre os padrões de sono e sinais vitais de forma contínua e em ambientes domésticos. A adoção de tais tecnologias pode facilitar o diagnóstico precoce da AOS, contribuindo para intervenções mais eficazes e melhorando a qualidade de vida dos pacientes. Objetivos: O objetivo do presente estudo, foi realizar uma revisão sistemática, do tipo umbrella review, para avaliar se os dispositivos domésticos (wearables, nearables e apps) podem ser uma alternativa à polissonografia. Materiais e métodos: A literatura considerada foi baseada nas diretrizes PRISMA com o intuito de responder à seguinte questão construída no formato PICO: “Pode a tecnologia de consumo doméstico ser uma alternativa fiável e eficaz no rastreio/diagnóstico de distúrbios do sono (AOS) para a identificação da população de risco como alternativa aos métodos convencionais tais como a PSG nível I e II?”. Os motores de busca utilizados foram a PubMed, Scopus e Cochrane Após os critérios de elegibilidade, de inclusão e exclusão, foi feita uma análise descritiva com os dados extraídos. A qualidade metodológica foi avaliada através da ferramenta AMSTAR-2, enquanto o risco de viés foi avaliado através do ROBIS. Resultados: No total foram incluídas 6 revisões sistemáticas. Os artigos que constituem esta umbrela review exploram tecnologias emergentes, como aplicações para smartphones, dispositivos domésticos e inteligência artificial, no diagnóstico da apneia obstrutiva do sono. Embora algumas dessas tecnologias mostrem potencial significativo, com vantagens como maior conforto e acessibilidade, elas ainda apresentam limitações em termos de sensibilidade e especificidade, não substituindo completamente a polissonografia. A maioria dos estudos seguiu protocolos rigorosos, mas há necessidade de validação clínica adicional. No geral, as novas ferramentas têm o potencial de complementar, e eventualmente substituir, os métodos tradicionais, mas requerem desenvolvimento contínuo e validação mais ampla. Conclusão: A análise revela que as tecnologias emergentes, como smartphones, dispositivos domésticos e inteligência artificial, têm o potencial de transformar o diagnóstico da apneia obstrutiva do sono. No entanto, esses avanços enfrentam desafios significativos, incluindo a necessidade de validação clínica rigorosa, padronização de métodos, e integração segura na prática clínica. A colaboração multidisciplinar e a aceitação por profissionais de saúde e pacientes são cruciais. Apesar dos desafios, essas inovações podem, no futuro, complementar ou até substituir a polissonografia, oferecendo abordagens mais acessíveis e personalizadas para o manejo da apneia obstrutiva do sono.
Introduction: Sleep plays a crucial role in maintaining cognitive, cardiovascular, immunological and metabolic health. It is made up of different stages, including slow-wave sleep (NREM) and REM sleep, each with distinct physiological characteristics and specific functions. Obstructive Sleep Apnea, one of the most prevalent respiratory sleep disorders, is associated with several serious comorbidities, such as cardiovascular disease, type II diabetes and cognitive dysfunction. Polysomnography is the gold standard method for diagnosing OSA, but it has limitations, such as high cost and discomfort for the patient. In response, medicine is moving towards more accessible and less invasive diagnostic methods, including the use of wearables, nearables and apps. These devices offer a promising alternative for diagnosing OSA, providing data on sleep patterns and vital signs continuously and in home environments. The adoption of such technologies could facilitate the early diagnosis of OSA, contributing to more effective interventions and improving patients' quality of life. Objectives: The aim of this study was to carry out a systematic umbrella review to assess whether home devices (wearables, nearables and apps) could be an alternative to polysomnography. Materials and Methods: The literature considered was based on the PRISMA guidelines in order to answer the following question constructed in the PICO format: "Can home consumer technology be a reliable and effective alternative in the screening/diagnosis of sleep disorders (OSA) for the identification of the at-risk population as an alternative to conventional methods such as level I and II PSG?". The search engines used were PubMed, Scopus and Cochrane. Once the eligibility, inclusion and exclusion criteria had been met, a descriptive analysis was carried out on the data extracted. Methodological quality was assessed using the AMSTAR-2 tool, while risk of bias was assessed using ROBIS. Results: A total of 6 systematic reviews were included. The articles reviewed explore emerging technologies, such as smartphone apps, home devices and artificial intelligence, in the diagnosis of obstructive sleep apnea. Although some of these technologies show significant potential, with advantages such as greater comfort and accessibility, they still have limitations in terms of sensitivity and specificity, and do not completely replace polysomnography. Most studies have followed strict protocols, but there is a need for additional clinical validation. Overall, the new tools have the potential to complement, and eventually replace, traditional methods, but they require continuous development and more extensive validation. Conclusions: The analysis reveals that emerging technologies, such as smartphones, home devices and artificial intelligence, have the potential to transform the diagnosis of obstructive sleep apnea. However, these advances face significant challenges, including the need for rigorous clinical validation, standardization of methods, and safe integration into clinical practice. Multidisciplinary collaboration and acceptance by healthcare professionals and patients are crucial. Despite the challenges, these innovations may in the future complement or even replace polysomnography, offering more accessible and personalized approaches to the management of obstructive sleep apnea.
Introduction: Sleep plays a crucial role in maintaining cognitive, cardiovascular, immunological and metabolic health. It is made up of different stages, including slow-wave sleep (NREM) and REM sleep, each with distinct physiological characteristics and specific functions. Obstructive Sleep Apnea, one of the most prevalent respiratory sleep disorders, is associated with several serious comorbidities, such as cardiovascular disease, type II diabetes and cognitive dysfunction. Polysomnography is the gold standard method for diagnosing OSA, but it has limitations, such as high cost and discomfort for the patient. In response, medicine is moving towards more accessible and less invasive diagnostic methods, including the use of wearables, nearables and apps. These devices offer a promising alternative for diagnosing OSA, providing data on sleep patterns and vital signs continuously and in home environments. The adoption of such technologies could facilitate the early diagnosis of OSA, contributing to more effective interventions and improving patients' quality of life. Objectives: The aim of this study was to carry out a systematic umbrella review to assess whether home devices (wearables, nearables and apps) could be an alternative to polysomnography. Materials and Methods: The literature considered was based on the PRISMA guidelines in order to answer the following question constructed in the PICO format: "Can home consumer technology be a reliable and effective alternative in the screening/diagnosis of sleep disorders (OSA) for the identification of the at-risk population as an alternative to conventional methods such as level I and II PSG?". The search engines used were PubMed, Scopus and Cochrane. Once the eligibility, inclusion and exclusion criteria had been met, a descriptive analysis was carried out on the data extracted. Methodological quality was assessed using the AMSTAR-2 tool, while risk of bias was assessed using ROBIS. Results: A total of 6 systematic reviews were included. The articles reviewed explore emerging technologies, such as smartphone apps, home devices and artificial intelligence, in the diagnosis of obstructive sleep apnea. Although some of these technologies show significant potential, with advantages such as greater comfort and accessibility, they still have limitations in terms of sensitivity and specificity, and do not completely replace polysomnography. Most studies have followed strict protocols, but there is a need for additional clinical validation. Overall, the new tools have the potential to complement, and eventually replace, traditional methods, but they require continuous development and more extensive validation. Conclusions: The analysis reveals that emerging technologies, such as smartphones, home devices and artificial intelligence, have the potential to transform the diagnosis of obstructive sleep apnea. However, these advances face significant challenges, including the need for rigorous clinical validation, standardization of methods, and safe integration into clinical practice. Multidisciplinary collaboration and acceptance by healthcare professionals and patients are crucial. Despite the challenges, these innovations may in the future complement or even replace polysomnography, offering more accessible and personalized approaches to the management of obstructive sleep apnea.
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Keywords
Wearables Nearables Apps Diagnóstico da apneia obstrutiva do sono Polissonografia Revisão sistemática Diagnosis of obstructive sleep apnea Polysomnography Systematic review