Children's Hospital Los Angeles Launches First-of-Its-Kind Sleep App
Children's Hospital Los Angeles (CHLA) is launching the first sleep registry in the country for children using Apple Watch as well as a new data collection app called WISE-HARE, or 'Wearable Intelligent Sensor Enhancement Home Apnea Risk Evaluation.' The app was developed to gather streams of high-fidelity data for future research, such as training machine learning algorithms from Apple Watch data to detect sleep disorders and provide crucial information to clinicians that inform patient care decisions.
'There are not enough pediatric sleep study beds in the country, which inevitably results in delayed care for children. In looking into solutions to solve this, it was clear that no application currently on the market would give us the immense amount of raw data needed to properly conduct sleep studies on children at home without specialized equipment,' said Eugene Kim, MD, principal investigator and chief of the Division of Pain Medicine in the Department of Anesthesiology and Critical Care Medicine.
'At Children's Hospital Los Angeles, we are always looking to pioneer the latest research and innovations with the goal of advancing the standards of pediatric care. We developed a custom app with graduates from Apple's Developer Academy in Fortaleza, Brazil, who supported the integration of Apple technologies, including HealthKit. This will allow us to create a first-of-its-kind sleep registry, which will be used to train machine learning algorithms from Apple Watch data to detect sleep disorders and inform clinicians on the need for ICU (Intensive Care Unit) admissions following surgery,' according to Kim.
Polysomnography (PSG) studies, in which patients are admitted to the hospital overnight and numerous sensors are placed on the patient while they sleep, are the gold-standard test for assessing sleep and are essential in the diagnosis of sleep disorders such as sleep apnea. They are often needed to assess anesthetic risk before procedures, to help clinicians evaluate the risk of complications post-surgery. However, these tests are costly, have significant waitlists and require children to sleep in an unfamiliar environment at the hospital, which can lead to different results than a child sleeping comfortably at home.
To launch this new registry, CHLA is enrolling children ages 5 to 18 years old currently scheduled for a PSG study. Enrolled participants will use the WISE-HARE app and wear an Apple Watch, in addition to the standard PSG sensors. Results from the PSG and Apple Watch devices over the next year will be used to train machine learning algorithms to detect high-risk sleep disorders, with families with the ability to screen for these highrisk sleep disorders at home without the need for special equipment.
'It was important that the benefits of our research would be made accessible for all patients. For this to happen, we needed a device that was comfortable to wear, commercially available and didn't require special training to operate,' added Dr. Kim. 'Apple Watch is a device that many children and their parents are already familiar with. The latest version met our requirements for a platform that allows us to collect and manage enormous amounts of data efficiently and securely.'
Throughout the course of a typical eight-hour sleep test, WISE-HARE will amass over 30 million lines of data per patient. As home to the Virtual Pediatric Intensive Care Unit (vPICU), a data hub for providers in pediatric intensive care units worldwide, CHLA and its team of data scientists are among the few in the country with the expertise and infrastructure required to manage this data.
'The WISE-HARE app has the potential to help alleviate the delays and frustrations caused by the national shortage of pediatric sleep study beds in the coming years,' said Emily Gillett, MD, pulmonologist and sleep medicine specialist at CHLA. 'The Sleep Center and Sleep Laboratory at Children's Hospital Los Angeles were among the first in the country to focus exclusively on sleep disorders in children, so it's very fitting that our team at CHLA is pioneering this new sleep monitoring technology with the potential to streamline care for pediatric sleep patients.'
The registry was funded by the Robert J. Coury Family Foundation. WISE-HARE will be accessible as open-source software and made available to researchers.
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