At-home validation of a non-contact, radar-based breathing monitor for long-term care of patients with respiratory diseases: A proof-of-concept study

Abstract

Background

Long-term monitoring of respiratory rate (RR) is an important component in the management of chronic respiratory diseases (CRDs). Specifically, predicting acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is of significant scientific and clinical interest. This study aimed to evaluate the long-term validity of a novel contactless sleep monitor (CSM) in the home environment of CRD patients receiving ventilatory support. Additionally, we assessed patient acceptance, device usability, and RR fluctuations associated with AECOPD to establish a robust foundation for future research.

Patients and Methods

In this prospective proof-of-concept study, nineteen patients requiring non-invasive ventilation (NIV) were provided with the CSM in their home environment for six months and seven patients requiring invasive mechanical ventilation (IMV) for one month. The primary indication for NIV therapy was chronic obstructive pulmonary disease (COPD).

The CSM was validated under real-life conditions by comparing its nocturnal RR values with software data from both types of ventilators. Acceptability and usability of the sensor were assessed using a questionnaire. Additionally, COPD exacerbations occurring during the study period were analyzed for potential RR fluctuations preceding these events.

Results

Mean absolute error (MAE) of median RR between the NIV device and the CSM, based on 2326 nights, was 0.78 (SD: 1.96) breaths per minute (brpm). MAE between the IMV device and the CSM was 0.12 brpm (SD: 0.52) for 215 nights. The non-contact device was accepted by the patients and proved to be easy in use. In some of the overall only 13 cases of AECOPD, RR time courses showed variations of increased nocturnal respiratory activity a few days before the occurrence of such events.

Conclusion

The present CSM is suitable for valid long-term monitoring of nocturnal RR in patients’ home environment and is well accepted by the patients. The exploratory findings related to AECOPD events may serve as a starting point for larger studies aimed at developing robust prediction rules.

Zusammenfassung

Hintergrund

Die langfristige Überwachung der Atemfrequenz (RR) ist ein wichtiger Baustein für das Management chronischer Atemwegserkrankungen (CRD). Dabei ist insbesondere die Vorhersage akuter Exazerbationen der chronisch obstruktiven Lungenerkrankung (AECOPD) von großem wissenschaftlichem und klinischem Interesse. Ziel der vorliegenden Studie war es, die Langzeitvalidität eines neuen kontaktlosen Schlafmonitors (CSM) in der häuslichen Umgebung von CRD-Patienten mit Beatmungsunterstützung zu evaluieren. Zudem wurden die Patientenakzeptanz und die Benutzerfreundlichkeit des Gerätes erfasst sowie RR-Schwankungen im Zusammenhang mit AECOPD untersucht, um eine robuste Grundlage für zukünftige Forschung zu schaffen.

Patienten und Methoden

In dieser prospektiven Proof-of-Concept-Studie wurden 19 Patienten, die eine nicht-invasive Beatmung (NIV) benötigten, und 7 Patienten, die eine invasive mechanische Beatmungstherapie (IMV) benötigten, jeweils 6 bzw. 1 Monat lang mit dem CSM in ihrer häuslichen Umgebung versorgt. Die Hauptindikation für die NIV-Therapie war die Diagnose einer chronisch obstruktiven Lungenerkrankung (COPD).

Der CSM wurde unter realen Bedingungen validiert, indem seine nächtlichen RR-Werte mit den Softwaredaten der Beatmungsgeräte verglichen wurden. Die Akzeptanz und Benutzerfreundlichkeit des Sensors wurden mittels eines Fragebogens bewertet. COPD-Exazerbationen, die während des Studienzeitraums auftraten, wurden auf mögliche RR-Schwankungen untersucht, die diesen Ereignissen vorausgingen.

Ergebnisse

Der mittlere absolute Fehler (MAE) der medianen Atemfrequenz zwischen den NIV-Geräten und dem CSM betrug 0,78 (SD: 1,96) Atemzüge pro Minute (brpm), basierend auf 2326 Nächten. Der MAE zwischen den IMV-Geräten und dem CSM betrug für 215 Nächte 0,12 brpm (SD: 0,52). Der CSM wurde von den Patienten akzeptiert und erwies sich als leicht bedienbar. In einigen der nur insgesamt 13 Fälle von AECOPD wiesen die Atemfrequenzverläufe in den Tagen vor dem Auftreten der Ereignisse Schwankungen mit erhöhter nächtlicher Atemaktivität auf.

Schlussfolgerung

Der CSM eignet sich für die valide Langzeitüberwachung der nächtlichen Atemfrequenz im häuslichen Umfeld und wird von den Patienten gut akzeptiert. Die explorativen Ergebnisse im Zusammenhang mit AECOPD-Ereignissen können als Grundlage für größere Studien dienen, die auf die Entwicklung robuster Vorhersagemodelle abzielen.

Keywords

telehealth - respiratory rate - AECOPD - exacerbation - non-invasive ventilation - PREM

Schlüsselwörter

Telemedizin - Atemfrequenz - AECOPD - Exazerbation - nicht-invasive Beatmung - PREM

Publikationsverlauf

Eingereicht: 03. September 2024

Angenommen nach Revision: 31. Januar 2025

Artikel online veröffentlicht:
09. Mai 2025

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