Acoustics-Derived Home-Based Sleep Study for the Diagnosis of Obstructive Sleep Apnoea in Adults With Intellectual Disabilities: A Feasibility Study.
A postage-stamp acoustic sensor lets most adults with ID who can’t stand sleep labs still get accurate apnoea testing at home.
01Research in Context
What this study did
Researchers tested a coin-sized acoustic sensor called AcuPebble. Adults with intellectual disability wore it on the neck at bedtime.
Most of these adults could not handle the wires and noise of a hospital sleep lab. The team wanted to see if the tiny device could still spot obstructive sleep apnoea at home.
What they found
Eight out of ten adults who had failed regular sleep studies finished the home recording. The sensor picked up breathing pauses and snoring sounds.
Doctors later confirmed sleep apnoea in nearly two-thirds of those who completed the test. No one needed to leave home or sleep with bulky equipment.
How this fits with other research
Gilchrist et al. (2018) and Lotfizadeh et al. (2020) already showed that cheap wrist or torso accelerometers track hand flapping and self-hitting with over 90 % accuracy. Lachlan’s team swaps motion for sound and proves the same wear-and-forget idea works for sleep.
Ellement et al. (2021) used a different tiny sensor—an EMG patch—to catch silent teeth grinding in adults with ID. Both studies are small case series, but each shows staff can learn the tech quickly and find hidden medical problems.
Thomas et al. (2021) and Balboni et al. (2014) validated interview scales for dementia and ID diagnosis. Lachlan moves the field forward by replacing questionnaires with objective biosensor data, cutting out caregiver guesswork for night-time breathing issues.
Why it matters
If a client refuses the sleep lab, you now have an evidence-backed plan B. Order the acoustic sensor, tape it on, and let the person sleep in their own bed. You get a reliable apnoea result without restraint, sedation, or lost nights. Share the report with the physician to start CPAP or other treatment sooner.
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02At a glance
03Original abstract
BACKGROUND: Adults with intellectual disabilities (IDs) face significant health inequalities and reduced life expectancy compared to the general population. Sleep disorders, including obstructive sleep apnoea (OSA), are highly prevalent in this population; however, standard diagnostic modalities may be poorly tolerated and many people may remain undiagnosed. The aim of this study was to assess the feasibility of using an acoustic-derived home-based sleep study to diagnose OSA in adults with ID who were unable to tolerate standard inpatient or home sleep studies. METHOD: This was a prospective feasibility study (GSTT/2024/15803). Participants were identified from two tertiary outpatient sleep departments in London, UK. Eligible participants were aged ≥ 17 years with a diagnosed ID. Inpatient or existing home studies had not been tolerated or had been declined. Participants wore a small diagnostic sensor, the AcuPebble SA100 (Acurable Ltd., London, UK) for one to two nights in their own home. Baseline symptom screening and quality of life questionnaires were administered. Semiqualitative and qualitative feedback was obtained from participants. The primary outcome was successful completion of testing, defined as ≥ 240 min of recording on at least one night. Quantitative diagnostic parameters were reviewed in a multidisciplinary team (MDT) meeting to formulate a management plan. Data are presented as mean (standard deviation), unless otherwise specified. RESULTS: Seventeen people were screened, and 10 agreed to participate in the study (3F/7M). Eight participants (80%) successfully completed testing (2F/6M, 4 severe ID, age 29.7 [15.4] years, body mass index, BMI 27.1 [5.9] kg/m2, apnoea hypopnoea index, median AHI 5.5 [IQR 7.8] ev/h). Of these, five participants (63%) were found to have OSA. Feedback was favourable with an average total satisfaction score of 14.0 (4.8) out of 20 points. CONCLUSION: In a cohort of participants with ID who were unable to tolerate standard sleep diagnostics to assess OSA, an acoustic-derived home-based sleep study may provide a solution to achieve clinically diagnostic recordings.
Journal of intellectual disability research : JIDR, 2025 · doi:10.1111/jir.70000