Abstract
INTRODUCTION: Early detection of obstructive sleep apnea (OSA) is critical due to its link to cardiovascular diseases. Our previous study validated an algorithm-based photoplethysmography (PPG) smartwatch for OSA risk detection. OBJECTIVE: This study aimed to characterize OSA features and assess its association with arrhythmia risk among smart wearable device (SWD) consumers in China in a real-world setting. METHODS: Between December 15, 2019, and January 31, 2022, SWD consumers across China were screened for OSA risk using HUAWEI devices. OSA diagnosis was confirmed via telecare follow-ups, including clinical evaluations and sleep test records. Disease characteristics and arrhythmia risks were analyzed. RESULTS: In a large cohort of 1,056,494 participants, smart wearable devices (SWDs) effectively identified 19,563 individuals at high risk for OSA, with 1054 confirmed cases. OSA patients demonstrated high prevalence of obesity (46.8%), hypertension (19.8%), and arrhythmia (17.17%). SWDs detected abnormal heart rhythms or suspected arrhythmia in 95.9% of confirmed OSA cases. Age emerged as an independent predictor of arrhythmia risk, while hypertensive OSA patients were older, more obese, and experienced prolonged nocturnal hypoxia (Time length of SpO(2)<90%, P=0.020). These findings underscore the utility of SWDs in OSA screening and highlight the significant cardiovascular risks associated with OSA. CONCLUSION: PPG-based SWD effectively screened for OSA and identified elevated arrhythmia risks. These findings support their utility for large-scale OSA screening and highlight cardiovascular risks management. CLINICAL TRIAL REGISTRY NAME: Mobile Health (mHealth) technology for improved screening, patient involvement and optimizing integrated care in atrial fibrillation. REGISTRATION NUMBER: ChiCTR-OOC-17014138. DATE OF REGISTRATION: 2017-12-26. DATE OF LAST REFRESHED ON: 2018-11-18.