Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep MedicineJan 2, 2025

Comparing WatchPAT and standard sleep tests for measuring breathing problems and sleep apnea severity in overweight and obese teens

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 25, 2026

Abstract

The mean bias between WatchPAT and polysomnography-derived apnea-hypopnea index was 16.9 ± 13.4 events/h.

WatchPAT overestimated obstructive sleep apnea (OSA) severity compared to polysomnography in 89% of participants.
Sensitivity of WatchPAT ranged from 62% to 100%, while specificity varied from 5.5% to 32% across OSA severity levels.
In a subset of participants, 38% reported nasal flow sensor reliability below 75%, and 14% had an underestimated apnea-hypopnea index.
Discrepancies between WatchPAT and polysomnography measurements could not be fully explained by nasal flow sensor reliability.

Simplified

STUDY OBJECTIVES: The prevalence of obstructive sleep apnea (OSA) increases dramatically in adolescents with overweight or obesity. The gold standard for diagnosis of OSA is in-laboratory polysomnography (PSG). However, access to PSG can be challenging, necessitating development of alternative devices. This study aimed to compare the accuracy of WatchPAT, a device that indirectly detects apnea and hypopnea events through peripheral arterial tonometry, to PSG in adolescents with overweight and obesity.

METHODS: Thirty-eight participants (15.5 ± 1.6 years; 76% female; 40% Hispanic/Latino; body mass index 97.7 ± 2.0 percentile) were analyzed. Correlation, agreement, sensitivity, specificity, and concordance between WatchPAT with PSG-derived measures of apnea-hypopnea index (AHI) and OSA severity were conducted. A subset (n = 21) underwent self-reported assessment of nasal flow sensor reliability and video characteristics to evaluate possible underestimation of PSG-assessed AHI.

RESULTS: Mean bias between WatchPAT- and PSG-derived AHI was 16.9 ± 13.4 events/h (95% confidence interval 12.5-21.3). WatchPAT overestimated OSA severity compared to PSG in 89% of participants. Sensitivity was 62-100% and specificity was 5.5-32% across all OSA severity levels. Of the subset with self-reported assessment of PSG data, 38% had nasal flow sensor reliability < 75%, 14% had underestimated AHI, and 28% had probably underestimated AHI. However, these characteristics did not fully explain the discrepancy between WatchPAT and PSG measurements.

CONCLUSIONS: The WatchPAT device showed a significant discrepancy compared to the gold-standard PSG in measurement of AHI and accuracy of OSA severity in adolescents with overweight or obesity. Future research is needed to understand pathophysiological differences to enhance assessment of OSA in this high-risk population.

CITATION: Dobbin ML, Bernard A, Pyle L, et al. Comparison of WatchPAT to polysomnography measurement of apnea-hypopnea index and obstructive sleep apnea severity in adolescents with overweight and obesity.. 2025;21(4):695-702. J Clin Sleep Med

Funding

Competing interests

All authors have seen and approved this manuscript. Work was performed at Children’s Hospital Colorado and the University of Colorado Anschutz Medical Campus. This work was supported by the Department of Pediatrics, University of Colorado Anschutz Medical Campus. All authors report no conflicts of interest.

PubMed

Comparing WatchPAT and standard sleep tests for measuring breathing problems and sleep apnea severity in overweight and obese teens

Abstract

Funding

Competing interests

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Abstract

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