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Paperdoi:10.1016/j.sleep.2026.109075

External validation of a fingertip wearable device for obstructive sleep apnea diagnosis and split-night tracking of CPAP treatment response

Venue listed2026Added Oct 29, 2026

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Authors: Ke-Wei Chen, Aatif M. Husain, David M. Rapoport, Hau-Tieng Wu

Sleep Medicine 146:109075 (Oct 2026 issue; epub 2026-06-09)

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TL;DR

Prospective Duke Sleep Disorders Center study, 198 enrolled (diagnostic cohort n = 147, split-night titration n = 29). TipTraQ REI vs PSG AHI: PCC 0.879 (AASM 1A, 3%) and 0.910 (1B, 4%). Short-term AHI/REI (15-min window, 5-min step) tracked respiratory-event dynamics in titration with median PCC 0.882 (1A) / 0.872 (1B).

  • Form factor: finger
Caveats
  • AASM 1B (4%); 0.879 with 1A (3%); vendor-authored (PranaQ).

Abstract

Study objectivesTo externally validate a novel Type IV fingertip wearable device, TipTraQ, against polysomnography (PSG) for diagnosing obstructive sleep apnea (OSA) in the western-country population with both AASM AHI1A(3%) and AHI1B(4%) labeling rules. Furthermore, evaluate its ability to dynamically track positive airway pressure (PAP) treatment effectiveness using split-night titration as surrogate with short-term apnea-hypopnea index (AHI) and TipTraQ-derived Respiratory Events Index (TQ-REI) sequences.MethodsIn a prospective study at the Duke Sleep Disorders Center, 198 participants were enrolled, including a diagnostic validation cohort (n = 147) and a split-night titration cohort (n = 29). Short-term AHI and TQ-REI sequences were calculated using a 15-min moving window updated every 5 min to capture respiratory event dynamics. Agreement between TipTraQ and PSG was evaluated using standard performance metrics.ResultsIn the diagnostic cohort, TipTraQ correlated strongly with PSG for total sleep time (TST; PCC = 0.786) and REM duration (PCC = 0.655). Bland-Altman analysis revealed mean biases of -9.50 min for TST and -9.46 min for REM. Epoch-by-epoch sleep staging (Wake, REM, Non-REM) yielded a Cohen's Kappa of 0.567, with highest sensitivity in non-REM sleep (0.824). TQ-REI correlated highly with AHI under AASM scoring rules (PCC = 0.879 for 1A; 0.910 for 1B). In the titration cohort, TipTraQ maintained consistent performance. Analysis of short-term AHI and TQ-REI sequences demonstrated the device's ability to track respiratory event dynamics, yielding a median PCC of 0.882 (1A) and 0.872 (1B).ConclusionTipTraQ shows strong agreement with PSG for respiratory metrics and moderate agreement with PSG for sleep metrics, and captures temporal dynamics of sleep-disordered breathing events.

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Results on ChatPPG leaderboards · 1

All leaderboards
LeaderboardMethodResultRank
Duke Sleep Center cohort Pearson rSleep apnea (OSA) screeningTipTraQ fingertip Type IV deviceCaveat: AASM 1B (4%); 0.879 with 1A (3%); vendor-authored (PranaQ).0.910Pearson r, higher is betterUnranked

1 row is credited to this paper. Ranks apply within each leaderboard only, as reported by the source.

Tasks & signals

Tasks

Sleep apnea (OSA) screeningSleep staging

Signals

PPGSpO₂

Keywords

OSAAHIREIType IV HSATSplit NightCPAPSleep StagingVendor Validation

How it works

How Method works: Setup → Method → TargetSetup: Signals (PPG, SpO2); Form factor (finger). Method: Method. Target: Sleep staging.SetupSignals: PPG, SpO2SignalsPPG, SpO2Form factor: fingerForm factorfingerMethodMethodTargetSleep stagingSleep staging

Cite this paper

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Chen, K.-W., Husain, A. M., Rapoport, D. M., & Wu, H.-T. (2026). External validation of a fingertip wearable device for obstructive sleep apnea diagnosis and split-night tracking of CPAP treatment response. Sleep Medicine, 146, 109075. https://doi.org/10.1016/j.sleep.2026.109075
Chen, Ke-Wei, Aatif M. Husain, David M. Rapoport, and Hau-Tieng Wu. 2026. "External validation of a fingertip wearable device for obstructive sleep apnea diagnosis and split-night tracking of CPAP treatment response." Sleep Medicine 146: 109075. https://doi.org/10.1016/j.sleep.2026.109075.
Chen, K.-W., Husain, A. M., Rapoport, D. M. and Wu, H.-T. (2026) 'External validation of a fingertip wearable device for obstructive sleep apnea diagnosis and split-night tracking of CPAP treatment response', Sleep Medicine, 146, p. 109075. doi: 10.1016/j.sleep.2026.109075.
Chen, Ke-Wei, et al. "External validation of a fingertip wearable device for obstructive sleep apnea diagnosis and split-night tracking of CPAP treatment response." Sleep Medicine, vol. 146, 2026, p. 109075. https://doi.org/10.1016/j.sleep.2026.109075.
K.-W. Chen, A. M. Husain, D. M. Rapoport, and H.-T. Wu, "External validation of a fingertip wearable device for obstructive sleep apnea diagnosis and split-night tracking of CPAP treatment response," Sleep Medicine, vol. 146, p. 109075, 2026, doi: 10.1016/j.sleep.2026.109075.
@article{chen2026external,
  title         = {{External validation of a fingertip wearable device for obstructive sleep apnea diagnosis and split-night tracking of CPAP treatment response}},
  author        = {Chen, Ke-Wei and Husain, Aatif M. and Rapoport, David M. and Wu, Hau-Tieng},
  year          = {2026},
  journal       = {Sleep Medicine},
  volume        = {146},
  pages         = {109075},
  doi           = {10.1016/j.sleep.2026.109075}
}

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