By Alyx Arnett
Sleep specialists can increase their role in the early detection of cardiac comorbidities in sleep apnea patients. Sleep Review’s Cardiology-Sleep Solutions column shares new technologies that can help. Email [email protected] with solutions you’d like to see featured here.
Electrocardiogram (ECG) is a standard channel during in-lab polysomnography (PSG) but is generally absent from home sleep testing (HST) devices. Enter the debut device from Huxley Medical: its SANSA chest-worn diagnostic HST patch, cleared by the US Food and Drug Administration (FDA) for sleep apnea detection last year, includes an ECG channel.
While that channel is for reference only—the device is not FDA-cleared for automated arrhythmia detection, at least for now—its developers say SANSA is designed to streamline both sleep apnea diagnosis and cardiology referrals.
Both sleep apnea and cardiac patients often don wearable devices that measure signals and identify different events. So, says Brennan Torstrick, PhD, Huxley Medical’s president and chief scientific officer, “the whole impetus was—why not combine them into a singular device that makes it simple for patients to use and be able to identify undiagnosed cardiac disorders earlier in sleep apnea patients?”
Key Takeaway: SANSA by Huxley Medical aims to streamline cardio-sleep diagnostics by including an ECG channel in its HST.
Chest-Worn Form Factor
Sleep physicians express surprise that the design of the SANSA HST more closely resembles that of a Holter monitor than of legacy sleep diagnostic equipment. “This familiar form factor is widely prescribed by cardiologists, electrophysiologists, and primary care providers. Over time we expect this familiarity will help sleep practices increase referrals and potentially accelerate diagnosis for patients,” Torstrick says.
In addition to the reference ECG, the device measures oximetry, heart rate, chest movement, snoring, body position, respiratory effort, actigraphy, and sleep/wake staging. “We’ve engineered the ability to collect oximetry and respiratory measures from the chest, providing the insights needed for home sleep apnea testing,” Torstrick says.
How does SANSA do with detecting both sleep apnea and potential cardiac disruptions? One study of about 150 people with suspected obstructive sleep apnea (OSA) reported SANSA’s sensitivity and specificity to detect OSA ranged from 91-97% and 78-97%, respectively, across all severity levels. SANSA’s total sleep time correlation with PSG had a mean difference of 3.8 minutes. Its ECG waveforms demonstrated good signal quality compared to the PSG’s ECG, according to the findings published in the Journal of Clinical Sleep Medicine, and enabled clear distinction between ectopic beats of atrial and ventricular origin, as well as different premature ventricular complex sites of origin. In the single-night study, SANSA also detected 49 people with significant arrhythmias, only 10 of whom had a previous arrhythmia diagnosis.1
The ECG channel is part of the montage, and the waveform can be viewed in detail in Huxley Medical’s online analysis before being included in the report. “ECG is displayed similarly to what sleep physicians are used to with in-lab polysomnography, but ours is wireless, which often results in less interference since there are no tangled wires,” Torstrick says. In fact, the JCSM-published study found that SANSA’s P-wave clarity exceeded that of the concurrent PSG at times.1
Key Takeaway: The FDA-cleared SANSA patch is chest-worn, similar to a Holter monitor, and integrates sleep apnea detection with cardiac monitoring.
Wellstar Integrates SANSA Into Cardio-Sleep Collaboration
Sleep specialists at Wellstar Health System have been collaborating with their health system’s cardiologists to improve care for OSA patients through proactive assessment and a streamlined patient experience for almost a decade, beginning when the team introduced a direct-to-patient HST shipping model and integrated sleep apnea screenings into the discharge process for cardiology patients suspected of having OSA.
Wellstar sleep specialists recently added SANSA to their toolkit.
“It’s slightly more comprehensive health monitoring than your typical type II or type III home sleep apnea testing device,” says Massey Arrington, MBA, assistant vice president of respiratory and sleep service at Wellstar Health System.
Patients undergoing sleep apnea evaluations who are suspected of having cardiac comorbidities will be clear candidates for SANSA. Hitendra Patel, MD, practice leader at Wellstar in pulmonary, critical care, and sleep medicine and medical director of the Wellstar Sleep Program, highlights its potential to identify asymptomatic patients with cardiac issues as well. “I think that’s where we’re going to see a lot of gains,” says Patel.
Arrington and Patel, who trialed SANSA themselves in a pilot program, also appreciate the device’s simplicity. “You peel the sticker off, stick it on your chest, push a button, and then when you’re done, you take it off, put it back in a box that has a resealable label, and we can get those results to you quickly,” says Arrington.
In January, the device was FDA-cleared to use cellular data upload capabilities, allowing physicians and techs to receive data in near real-time once the test is complete. SANSA doesn’t need patients to pair the device with Bluetooth or download an app.
Key Takeaway: Wellstar Health System is incorporating SANSA into its cardio-sleep program to streamline sleep apnea and cardiac risk detection.
Beginnings of a Multi-Diagnostic Approach
While SANSA has clinically validated its capabilities as a home sleep apnea test, the team says they are in the early innings of expanding what the platform can offer to clinicians. “We see our initial clearances as the start of a broader multi-indication platform,” Torstrick says. “We plan to expand SANSA’s capabilities over time to grow both the number of patients it can assess and the number of actionable diagnostic assessments it provides with each use.”
While Wellstar is starting SANSA with its sleep patients, Patel says further FDA indications will “solidify our relationships with the cardiology team,” expanding cardiologists’ role in interpreting the device.
The Wellstar team believes this model could set a new standard for interdisciplinary care in sleep medicine and cardiology. “It’s just a much more efficient use of this technology, getting this all-encompassing view,” says Arrington. “It helps make sure these patients aren’t over-tested or undertreated.”
Key Takeaway: Huxley plans to seek additional FDA clearances and broaden its cardiovascular applications.
Reference
- Goldstein C, Ghanbari H, Sharma S, et al. Multi-diagnostic chest-worn patch to detect obstructive sleep apnea and cardiac arrhythmias. J Clin Sleep Med. Published online 2025 Jan 29.
