BIOTEK2021-Bioteknologi for verdiskaping

Breathing problems associated with snoring affect at least one in ten adults while they sleep. The diagnosis of sleep apnea is made today by measuring the number of breathing cessations. The overall aim of the project was to develop new, portable sensors for measuring sleep, improve current sleep analyzes and develop personalized risk estimates and treatment choices. Researchers at Akershus University Hospital, the universities of Oslo, Reykjavik and Eastern Finland have collaborated in the project. The Norwegian part of the project is based on more than 2000 people included in the "Akershus Sleep Apnea (ASAP) Cohort". The Norwegian part of the project has aimed to contribute to the development of new treatment solutions for co-morbid sleep apnea and chronic insomnia, to improve existing tools for sleep measurement, to study the consequences of sleep apnea over time, as well to study shared decision making and treatment adherence. In this project, Akershus University Hospital and the University of Oslo have contributed to Norwegian innovation through a collaboration with the company Drowzee AS and by developing technology that can be commercialized in the future. The Norwegian part of the project has, in work package IC, published a validation article for a pressure-based sensor with the title "A validation study of an esophageal probe-based polygraph against polysomnography in obstructive sleep apnea". The University of Reykjavik has continued to work with anonymised, time-synchronized data from the two devices. These results have not yet been published. Data from work package IE is part of a doctoral course for doctor and research fellow Tonje Caroline Øverby. The candidate has finalized the training part of the doctoral education at the University of Oslo and, at the end of the project, has published two articles as first author/shared first authorship in a peer-reviewed journal and is working on the last article and compilation. The candidate is in the final phase of the education funded by the University of Oslo as a clinical fellow. The collaboration on work package IE has also contributed to additional funding for partner Drowzee AS through a collaborative project in the "Eurostars" programme. This collaborative project finances a doctoral course for nurse and research fellow Thea Christine Thorshov. The candidate has finalized the training part of the doctoral education at the University of Oslo and, at the end of the project, has published an article as first author in a peer-reviewed journal. This article is a validation study of the automatic self-monitoring tool that was developed in the work package. The tool developed in work package IE was an important prerequisite for the consortium to receive funding from Horizon 2020 for the Sleep Revolution project. The self-monitoring tool used in this project is based on the experience gained in work package iE. The Sleep Revolution contributes with funding for a PhD candidate enrolled at the doctoral program at the University of Oslo and a post doc researcher at the University of Oslo. Work package 3 was led by Dr. Hrubos-Strøm. Data collection in 3A has been done in Finland, while 3B has been solved in the form of longitudinal, statistical models for mortality and heart-related events in the Akershus Søvnapné Epidemiological cohort. At the end of the project, the manuscript is in the last phase before submission to the journal "Sleep". Work package 3C was solved through an application to the "Scientia Fellows 2" programme, which financed visits for one year for guest researcher Caner Sahin. Dr. Sahin has quality assured the data base and is working on a scientific article at the end of the project with the aim of identifying predictors for treatment compliance with positive airway pressure. The work in work package 3C has resulted in funding for a further PhD candidate through the project "Beamer" and the funding program "Innovative Medicines Initiative". The Beamer project contributes with funding for a PhD candidate enrolled at the doctoral programme at the University of Oslo.

The project met the overall objectives of Nordic PerMed: • We have promoted new, personalised medicine approaches for more effective and sustainable health care for the benefit of patients, citizens and society; • We have improved the Nordic position in personalised medicine through research and innovation that builds on Nordic strengths; • We have increased collaboration between companies, research-performing organisations and public-sector organisations (hospitals and relevant agencies) and civil society; • We have promoted Responsible Research and Innovation (RRI) perspectives in personalised medicine within a Nordic context, including diversity, inclusion, openness and transparency; • We have contributed to the action plan of the EU initiative International Consortium for Personalised Medicine (ICPerMed).

Sleep apnea is a prevalent nocturnal breathing disorder and causes a high burden to the affected individuals, as well as to society and economy. However, current diagnostic methods for sleep apnea are complicated and labour-intensive processes involving various shortcomings related to measuring, analysing and reporting of data. In this research project we introduce novel diagnostic approaches for sleep apnea utilizing minimally sleep-disturbing wearable sensors and state-of-the art artificial intelligence and machine learning solutions. This responds the growing pressure to move most sleep studies from sleep lab to home and to reduce the workload and costs related to manual analysis of nocturnal sleep recordings. We aim to develop new metrics which correlate better with the disease severity, related daytime symptoms and risk of severe health consequences than the presently used diagnostic parameters. The project is based on large international patient pools collected and analyzed in collaboration with world top level clinicians, physicists and engineers in Norway, Iceland and Finland. By adapting modern artificial intelligence techniques, we can identify such features from polysomnographic signals that could be used as novel biomarkers to personalize sleep apnea subtypes and severity. The better understanding of sleep apnea subtypes and underlying pathological mechanisms is crucial while developing personalized approaches to disease management. The outcomes of this project can lead to paradigm shift in the diagnostics and treatment of sleep apnea and have significant positive impact in Nordic health and socioeconomy. Wearable sleep monitoring systems and sophisticated artificial intelligence based solutions could open global scalable business potential for industry partners operating at medical device sector as well as for health centers and sleep clinics by offering telemedicine sleep diagnostic and treatment follow-up services.