Examining the Efficacy of a Home Sleep Apnoea Testing Kit and the Effect of liraglutide 3.0mg on Parameters of Sleep Apnoea and Metrics of Health and Obesity

Background: As the global prevalence of obesity continues to rise, the health and economic burden of a variety of obesity-related co-morbidities is becoming more substantial. Obesity is a recognised risk factor for the development of Obstructive Sleep Apnoea (OSA), a widely underdiagnosed condition which impacts significantly on patient health and quality of life. In recent years, devices which enable diagnosis and monitoring of OSA in the community have become more popular, given the extensive resource requirements of formal full polysomnography (PSG) testing for OSA. In this study, we compare the accuracy of a new home sleep-apnoea testing-kit against PSG, monitor the progression of OSA, and analyse changes and associations in multiple clinical, anthropometic and metabolic parameters in participants enrolled in a randomised controlled trial (RCT) assessing the effectiveness of Liraglutide 3.0mg for weight-loss and resolution of related co-morbidities. Methods: This was a prospective, longitudinal study of participants recruited from the STRIVE RCT cohort from a single centre in the Clinical Research Centre (CRC) at St. Vincent’s University Hospital (SVUH), Dublin between 2018 and 2020. Pre-intervention, participants underwent formal PSG and home sleep-apnoea testing using the BresoDx™ device to assess device accuracy. Demographic and health data were collected at commencement and at regular intervals during the study in addition to repeat OSA testing using the BresoDx™ device. Results: Using an Apnoea-Hypopnoea Index (AHI) threshold of 10/hr to diagnose OSA, the BresoDx performed with a sensitivity of 81.82% and reached 100% specificity in patients undergoing weight loss interventions as part of the STRIVE RCT. Of participants that returned sufficient AHI measurements at baseline and week 32 (n=9), we found that total AHI had improved significantly by week 32 of this trial with an average reduction of 26.8% (p=0.041). Statistically significant correlations to AHI were observed for neck circumference, BMI, weight and waist circumference in addition to between baseline high-density lipoprotein (HDL) and subsequent improvement in AHI with weight-loss interventions. Conclusion: This study reports a high level of agreement between the BresoDx device and PSG in diagnosing clinically significant OSA. The study also demonstrates statistically significant correlations between AHI and anthropometric variables of weight, BMI, waist circumference and neck circumference while suggesting baseline AHI may have use as a predictor for AHI improvement with weight-loss interventions.