Objective:

To evaluate the performance of a wrist-worn device in diagnosing sleep apnea among individuals with chronic insomnia, particularly in the context of comorbid conditions.

Key Findings:

• Sensitivity for identifying moderate-to-severe obstructive sleep apnea was 77.3% (95% CI 54.2–91.3%).
• Specificity was 100.0% (95% CI 81.5–100.0%).
• Area under the receiver operating characteristic curve was 0.92 (95% CI 0.80–0.98).
• Diagnostic agreement was reached in 36 (82%) subjects.
• Watch-PAT overestimated total sleep time and rapid eye movement sleep duration.

Interpretation:

The wrist-worn home sleep apnea testing maintained acceptable diagnostic performance for identifying moderate-to-severe obstructive sleep apnea in individuals with chronic insomnia, without unsupported conclusions.

Limitations:

• The study had a small sample size of 44 participants, which may limit the generalizability of the findings.
• The accuracy of sleep duration and staging parameters provided by the device should be interpreted with caution.

Conclusion:

The wrist-worn device shows acceptable diagnostic performance for identifying obstructive sleep apnea in patients with chronic insomnia, but caution is advised regarding sleep duration and staging accuracy.