Comprehensive Analysis of Respiratory Events Using Smartphone Systems

Obstructive sleep apnea (OSA) is a form of sleep-disordered breathing (SDB) where cessation
of breathing occurs during sleep in 9% of middle-aged women and 25% or middle-aged men. Major
health issues and risks have been linked to untreated sleep apnea, including drug-resistant
hypertension, obesity, congestive heart failure and diabetes.

Patient awareness of this condition is growing, but obtaining adequate data has continuing
barriers. The gold standard for sleep testing is the overnight clinical polysomnogram (PSG)
where over 20 sensors are attached to a patient and vital signs are monitored and recorded
over the course of a 6-8 hour sleep test.

This is a prospective clinical performance study to compare the ability of proprietary
algorithms that analyze sleep recordings from smartphones, with FDA cleared Level III home
sleep testing (HST) devices, to identify patients with obstructive sleep apnea (OSA).

Consecutive patients referred for home sleep testing (HST) for possible OSA will be offered
participation. Participants who provide informed consent will fill out a questionnaire and
then proceed with HST in their home. During HST, additional sound recordings will be made
with either:

1. Android type smartphone with a recording application (app). The phone will be placed on
a table 50-100 cm (20-40 inches) from patient's mouth.

or

2. IPhone type smartphone with a recording application (app). Phone will be placed on a
table 50-100 cm (20-40 inches) from patient's mouth

The sound recordings obtained via smartphones will be analyzed electronically for OSA by the
proprietary algorithms. This will be performed by engineers at Resonea, Inc., the study
sponsor, who will be blinded to the results obtained by the Level III HST device

HST will be performed using a type III home sleep monitor that has been cleared by the FDA
and validated to assist in the diagnosis of OSA. HST results will be interpreted according to
the standards established for the device being utilized. HST tests will be interpreted by
sleep medicine physicians at the study sites who will be blinded to the assessment from the
proprietary algorithms.

The independently determined results of HST and proprietary algorithms analysis will then be
compared.

The results of the proprietary algorithm testing will not be known to those providing HST and
the proprietary algorithm analysis will not be utilized in the clinical management of study
participants

The primary objectives are: (a) to demonstrate that obtaining recordings in home setting for
use with the proprietary sound analysis software is feasible and safe; and (b) to compare the
results of the proprietary algorithm score with HST for the diagnosis of OSA.

The secondary objectives are: (a) to compare the recorded sound data against various scoring
metrics from the HST; and (b) to demonstrate that use of the sound analysis software on
smartphones is feasible for patients in the home sleep setting; and (c) to use the
proprietary software to identify sleep disordered breathing beyond OSA, including central
sleep apnea, snoring and other conditions.

Inclusion Criteria:

- referred for polysomnography (PSG) because of possible obstructive sleep apnea (OSA)

- owns/possesses a smartphone for use during the study. Must be:

- Android models running Android OS Samsung Galaxy 5 or later

- iPhone models running iOS 6 or later

Exclusion Criteria:

- previous PSG or home sleep testing (HST) confirmation of OSA

- prior surgery for snoring or OSA

- medical contraindication of HST, as applicable

- congnitive impairment that might interfere with obtaining informed consent, or
completing Clinical Questionnaire