Title: OSA detection in children Presenter Information: Stacey L. Ishman, MD, MPH Professor, Otolaryngology – Head and Neck Surgery & Pulmonary Medicine Surgical Director, Upper Airway Center

Problem Statement In the US Snoring OSA Children 12% 1-4% Wireless Wearable OSA Detection In the US Snoring OSA Children 12% 1-4% Adults 20% 4% Prevalence likely to increase with rising obesity Associated with Poor school performance Long-term cardiovascular issues Behavioral problems Currently diagnosis requires sleep study (polysomnogram) which is expensive & inconvenient

Problem Statement Good night sleep is essential for: Quality of life, Productivity and creativity at-home and in-work, Social interaction, Education achievements, Health (cardiovascular morbidity,…)

Problem Statement Symptoms Snoring Excessive Daytime Sleepiness Pauses in Breathing While Sleeping Abrupt Awakenings Morning Headache Awakening with Chest pain

Problem Statement Polysomnography (PSG) – gold-standard Expansive Long waiting lists Uncomfortable >80% remain undiagnosed

Problem Statement Home sleep studies Wireless Wearable OSA Detection Home sleep studies Have become the norm in the US for adults Algorithms are typically not intended for children (different desaturation indices) Not sized for children

Problem Statement Sleep evaluation Device There is a need for a technology that will evaluate sleep and respiration for the mass population. Will improve accessibility, Early diagnosis and treatment will improve health and quality of life.

Need Statement A home-use, portable, non-invasive device for diagnosing and detection of sleep quality and sleep apnea events, over a night sleep

Main requirements: Ideal Current practice easy to use Wireless Wearable OSA Detection Ideal easy to use low cost evaluation method assess for obstructive sleep apnea in children in-home easy for children to tolerate can differentiate sleep from non-sleep Current practice Inlab sleep study

Available products on the market

Summary OSA is common in the US and worldwide Wireless Wearable OSA Detection OSA is common in the US and worldwide In-lab study is the primary ped option in the US Wearable, wireless assessment would be ideal PAT technology may be a way to get this accomplished OR use 1-2 wearable patches to extend what you can obtain from a home study Could be extended to adults Could expand home studies to include EEG and/or detect central vs obstructive events based on where they are worn Limited by what you can put in a wearable patch & expense