AcuPebble sleep apnoea device used in University of Warwick trial

Professor Esther Rodriguez Villegas, director of the Wearable Technologies Lab at Imperial College London and founder of medtech startup Acurable, updates readers on AcuPebble’s progress in the market. 

Obstructive sleep apnoea (OSA) affects up to 1 in 4 people - that’s up to a billion people worldwide. It’s a medical condition that causes those who have it to stop breathing very regularly while they sleep due to an obstruction of their airway. And although these pauses in breathing usually only last a few seconds because they happen over and over again, they can cause serious health problems such as cardiovascular diseases. The condition is also a leading cause of road traffic accidents. And yet 85% of people who have it aren’t diagnosed. How can this be?

Currently in the UK, to be diagnosed with OSA, one needs to go to their GP, who has to refer them to a sleep specialist at a hospital. This specialist will ask the patient to take an overnight sleep test, usually at home but sometimes in a sleep clinic, which involves wearing several sensors and cables on different parts of the body. The next day the kit needs to be returned to the clinic so that the signals obtained during the sleep test can be analysed by the specialist to confirm or reject the diagnosis of sleep apnoea, which, if positive, leads to the patient being referred for treatment.

This process generally takes months to complete due to its complexity and the limited amount of existing healthcare resources. This makes it difficult to get a diagnosis, even considering that only a minority of people who have the disease end up being referred by their GP. However, a trial currently underway at the University of Warwick called the FOUND Project is trying to change that by moving the point of diagnosis to GPs working in primary care. If it’s successful, this could make it a lot easier and quicker to receive a sleep apnoea diagnosis and receive the right treatment.

The FOUND (Finding Obstructive Sleep Apnoea Using a Novel Device) trial is led by researchers from the University of Warwick. It uses medtech start-up Acurable’s AcuPebble, a clinically validated wearable medical device that provides an automated diagnosis. This means it can be posted to patients directly, so they don’t have to travel to a hospital to collect or return the kit. To use it, a sensor is placed on the patient’s neck overnight and a mobile app with simple instructions to guide them through the sleep test, so no training is needed. In the morning, the mobile app uploads the signals from the sensor, and the doctor receives a diagnosis within minutes, while the patient simply pops the kit back in the post and continues with their day.

The trial team aims to recruit 1,426 patients in the West Midlands region and compare the new primary care approach using the AcuPebble device with traditional referral and diagnosis methods to see how many patients are diagnosed and examine the effectiveness and value for money for the NHS in each case. It’s anticipated that the new approach will prove to be easier, quicker, and cheaper, allowing more patients to be diagnosed and receive treatment while freeing up specialist clinicians' time to focus on patient care and more complex cases.

With the NHS increasingly stretched, the FOUND trial is a much-needed step in the right direction. It aims not only to improve the patient journey for sleep apnoea diagnosis, but also to reduce the long-term burden placed on the health service by the condition’s comorbidities - that is, the negative effects that untreated OSA can have on patients’ health and wellbeing. Wearable devices like AcuPebble make it easier for trials like this one to be conducted and enable a future where patients don’t have to wait months to receive the treatment they need.