Validation and implementation of ambulatory obstructive sleep apnea polygraphy screening combined with wearable semi-continuous heart rhythm monitoring in patients with atrial fibrillation: a validation and a pilot study - Report - MDSpire

Validation and implementation of ambulatory obstructive sleep apnea polygraphy screening combined with wearable semi-continuous heart rhythm monitoring in patients with atrial fibrillation: a validation and a pilot study

  • By

  • Anouk Delaet

  • Rana Önder

  • Paulien Vermunicht

  • Lieselotte Knaepen

  • Michiel Delesie

  • Johan Verbraecken

  • Karolien Weytjens

  • Paul Dendale

  • Johan Vijgen

  • Hein Heidbuchel

  • Lien Desteghe

  • June 26, 2026

  • 0 min

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Clinical Report: Assessment and Application of Polygraphic Screening for OSA

Overview

This study validates the NOX-T3s polygraphy device for obstructive sleep apnea (OSA) screening in atrial fibrillation (AF) patients and evaluates a combined screening pathway with heart rhythm monitoring.

Background

Obstructive sleep apnea (OSA) is a significant risk factor in atrial fibrillation (AF) patients, yet it remains underdiagnosed. The prevalence of moderate-to-severe OSA in AF patients is estimated to be between 42.1% and 56.1%, with only a small percentage receiving formal diagnoses. Effective screening and monitoring are crucial for improving patient outcomes and managing AF effectively.

Data Highlights

MeasureValue
AUC for NOX-T3s (simultaneous)0.83
AUC for NOX-T3s (home)0.80
AHI cut-off for improved accuracy11.1 events/h
Sensitivity of NOX-T3s92.9%
Specificity of NOX-T3s75.0%
OSA screening success rate97.1%
AF detection rate64.3%

Key Findings

  • NOX-T3s demonstrated good diagnostic performance for moderate-to-severe OSA.
  • An optimized AHI cut-off of 11.1 events/h improved NOX-T3s accuracy to 0.85.
  • OSA screening was successful in 97.1% of patients, identifying moderate-to-severe OSA in 79.3%.
  • 61.9% of patients who screened OSA-positive underwent PSG, confirming OSA.
  • Semi-continuous rhythm monitoring detected 6.7 times more AF episodes compared to spot-checks alone.
  • High patient comfort was reported for both NOX-T3s and rhythm monitoring devices.

Clinical Implications

The NOX-T3s device is a reliable tool for home screening of moderate-to-severe OSA in AF patients. The combination of OSA screening with semi-continuous heart rhythm monitoring may enhance the management of AF and improve patient outcomes.

Conclusion

The study supports the use of NOX-T3s for OSA screening in AF patients, demonstrating its reliability and feasibility in clinical practice. Further research may be warranted to explore the long-term impacts of this combined approach.

Related Resources & Content

  1. JMIR Medical Informatics, 2026 -- Machine Learning–Based Multidimensional Oximetry for Obstructive Sleep Apnea Screening: Development and External Validation
  2. Clinical Research in Cardiology, 2019 -- Assessment of the Modified Microlife Blood Pressure Monitor in Patients Experiencing Paroxysmal Atrial Fibrillation
  3. Frontiers in Neurology, 2026 -- Performance of wrist-worn home sleep apnea testing (watch-PAT) among individuals with chronic insomnia: a comparative study with polysomnography
  4. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
  5. 2024 ESC Guidelines for Management of Atrial Fibrillation: Key Points - American College of Cardiology
  6. Clinical Research in Cardiology — Use of Automatic Positive Airway Pressure in Managing Obstructive Sleep Apnea Among Patients with Heart Failure and Reduced Ejection Fraction
  7. Clinical use of a home sleep apnea test - AASM
  8. Prevalence and Diagnosis of Obstructive Sleep Apnea in Atrial Fibrillation Patients: A Systematic Review
  9. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
  10. 2024 ESC Guidelines for Management of Atrial Fibrillation: Key Points - American College of Cardiology
  11. EFFECTS OF CPAP USE IN PREVENTING ATRIAL FIBRILLATION RECURRENCE POST-ABLATION IN OSA PATIENTS - ScienceDirect
  12. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
  13. Extended Cardiac Monitoring in Patients With Severe Sleep Apnea and No History of Atrial Fibrillation (The Reveal XT-SA Study) - PubMed
  14. Validation of the Nox-T3 Portable Monitor for Diagnosis of Obstructive Sleep Apnea in Chinese Adults - PMC

Original Source(s)

Validation and implementation of ambulatory obstructive sleep apnea polygraphy screening combined with wearable semi-continuous heart rhythm monitoring in patients with atrial fibrillation: a validation and a pilot study

  • by Anouk Delaet, Rana Önder, Paulien Vermunicht, Lieselotte Knaepen, Michiel Delesie, Johan Verbraecken, Karolien Weytjens, Paul Dendale, Johan Vijgen, Hein Heidbuchel, Lien Desteghe

  • June 26, 2026

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