Authors (including presenting author) :
YOUNG BHK(1), KWOK ICY(2), CHAN PC(1), KWOK APL(3), WONG SCY(2)
Affiliation :
(1) Department of Medicine and Rehabilitation,
(2) Department of Clinical Psychology, Tung Wah Eastern Hospital, Hong Kong
(3) Department of Clinical Psychology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
Introduction :
Obstructive sleep apnea (OSA) is a common sleep disorder associated with adverse health consequences. Current protocol for OSA management relies on polysomnography, which is resource-intensive and has limited accessibility. Furthermore, ineffective delineation of comorbid insomnia and OSA leads to reduced treatment efficacy and unmet medical needs. Established in 2022, the “Magic Ring” Triage Service is a multidisciplinary service model involving Respiratory Team and Clinical Psychology Department that addresses current service gaps using Artificial Intelligence (AI) and Belun Ring.
Objectives :
To evaluate the effectiveness of “Magic Ring” Service in (i) guiding diagnosis and referrals, (ii) shortening waiting time for sleep assessment and/or treatment without incurring additional manpower, and (iii) optimising treatment outcomes.
Methodology :
Twenty-eight adult and elderly patients (2 inpatients, 26 outpatients) with sleep complaints were recruited. At baseline, patients completed (i) mood screening (Patient Health Questionnaire; Generalised Anxiety Disorder scale), (ii) sleep questionnaires (Insomnia Severity Index; STOP-Bang Questionnaire), and (iii) ambulatory sleep assessment using Belun Ring. Post-test measurements of mood and sleep symptoms and Service Satisfaction Questionnaire were administered in fifth week.
Result & Outcome :
With reference to the screening battery, patients were triaged into (i) comorbid OSA and insomnia group (n = 6) and (ii) insomnia group for respective treatment (n = 22). Current analysis revealed marked discrepancies between subjective and AI-generated sleep statistics, with 0.07 concordance rate only (chi-square test). Post-hoc analysis revealed considerable portions of patients with atypical autonomic arousal and/or comorbid sleep pathologies, which were identified as treatment targets in subsequent management. This supported the effectiveness of Belun Ring in supplementing diagnosis, thereby guiding accurate referrals and treatment. The “Magic Ring” Triage Service demonstrated efficacy in reducing waiting time for sleep assessment and consultation, from a median of 104 weeks initially at our local hospital to current 45 weeks (Wilcoxon signed-rank test, p < .001). User satisfaction score was high (mean = 75.4%), with patients reporting 42.4% reduction in insomnia severity (paired t-test, p = .001) and 22.4% reduction in depressive symptoms (paired t-test, p = .031) upon fifth week.
To conclude, the “Magic Ring” Triage Service demonstrated efficacy in narrowing existing service gaps, reducing waiting time, optimising clinical treatment and service triage, and maximising patient outcomes.
