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Validation of a wireless high-resolution oximeter with a built-in accelerometer linked to a smartphone with automated cloud analysis (Biologix) for diagnosis of obstructive sleep apnea at home


Obstructive sleep apnea (OSA) is a major public health problem because it is extremely common and is associated with several consequences. However, the majority of OSA patients remain not diagnosed. In this study, we hypothesized that a wireless high-resolution oximeter with a built-in accelerometer linked to a smartphone with automated cloud analysis (Biologix) is a reliable method for OSA diagnosis at home.


To compare the variability between a validated portable monitor (PM: ApneaLink Air) versus Biologix with the night-to-night PM apnea-hypopnea index (AHI) variability.


We invited patients with suspected OSA assigned to PM test. The patients participating took home a PM (ApneaLink Air) and the Biologix wireless oximeter and a dedicated smartphone. The patients were instructed to use the Biologix oximeter in a finger of the same hand of the PM oximeter. In addition, 62 patients performed PM for 2 consecutive nights. To assess the agreement between PM-apnea hypopnea index (AHI) and Biologix-oxigen desaturation index (ODI) we used intra-class correlation coefficient (ICC) and Bland-Altman plot. To assess the relationship between PM and Biologix we used Spearman´s correlation and HST night-to-night variability.


A total of 670 patients were invited for the study and 561 patients completed both PM and Biologix studies. We excluded 83 patients because they had > 1hour difference between PM and Biologix studies. Therefore, the final sample consisted of 478 patients. The HST-apnea-hypopnea index and the Biologix- oxygen desaturation index was 25.0 ± 25.0 events/h and 24.9 ± 26.5 events/h, respectively. The area under the curve (AUC), sensibility/specificity to detect at least mild (HST-AHI> 5), moderate-to-severe (HST-AHI>15) and severe OSA (HST-AHI > 30) was (0.983) 94.7/92.8, (0.986) 94.8/93.9 and (0.990) 95.8/94.3, respectively. The limits of agreement originated by Bland Altman plot and the correlation between HST-AHI and Biologix-ODI were lower than the night-to-night HST-AHI variability.


In conclusion, ODM-Biologix is a simple method that has a good performance for OSA diagnosis at home.


sleep apnea; oximetry, portable monitor


Área Clínica


ROSA HASAN, PEDRO RODRIGUES GENTA, George do Lago Pinheiro, Michelle Louvaes Garcia, Diego Campos Pietro, Carlos Roberto Ribeiro de Carvalho, Geraldo Lorenzi Filho