Diagnostic Modalities in Sleep Disordered Breathing: Current and Emerging Technology and Its Potential to Transform Diagnostics

Underpinned by rigorous clinical trial data, the use of existing home sleep apnoea testing is now commonly employed for sleep disordered breathing diagnostics in most clinical sleep centres globally. This has been a welcome addition for the field given the considerable burden of disease, cost, and access limitations with in-laboratory polysomnography testing. However, most existing home sleep apnoea testing approaches predominantly aim to replicate elements of conventional polysomnography in different forms with a focus on the estimation of the apnoea-hypopnoea index. New, simplified technology for sleep disordered breathing screening, detection/diagnosis, or monitoring has expanded exponentially in recent years. Emerging innovations in sleep monitoring technology now go beyond simple single-night replication of varying numbers of polysomnography signals in the home setting. These novel approaches have the potential to provide important new insights to overcome many of the existing limitations of sleep disordered breathing diagnostics and transform disease diagnosis and management to improve outcomes for patients. Accordingly, the current review summarises the existing evidence for sleep study testing in people with suspected sleep-related breathing disorders, discusses novel and emerging technologies and approaches according to three key categories: (1) wearables (e.g., body-worn sensors including wrist and finger sensors), (2) nearables (e.g., bed-embedded and bedside sensors), and (3) airables (e.g., audio and video recordings), and outlines their potential disruptive role to transform sleep disordered breathing diagnostics and care.