DROWZLE

K173974 · Resonea, Inc. · MNR · Jul 14, 2019 · Anesthesiology

Device Facts

Record IDK173974
Device NameDROWZLE
ApplicantResonea, Inc.
Product CodeMNR · Anesthesiology
Decision DateJul 14, 2019
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 868.2375
Device ClassClass 2
AttributesAI/ML, Software as a Medical Device

Intended Use

DROWZLE is indicated to record a patient's respiratory pattern during sleep for the purpose of prescreening patients for obstructive sleep apnea (OSA) syndrome. The device is designed for use in home-screening of adults with suspected possible sleep breathing disorders. Results are used to assist the healthcare professional in determining the need for further diagnosis and evaluation. The system is not intended as a substitute for full polysomnography when additional parameters such as sleep stages, limb movements, or EEG activity are required

Device Story

DROWZLE is a mobile software application for home-based sleep apnea prescreening. It uses the native microphone of a user's smartphone to record sleep breathing sounds. The device captures audio data, which is uploaded to a secure cloud server for analysis. The system processes these sound files alongside patient-provided profile data and standardized questionnaires (STOP-BANG, Epworth Sleepiness Scale). The algorithm identifies respiratory events by detecting gaps in breathing sounds (>10 seconds) and calculates a 'Resonea Index'. The output is a report provided to the patient and/or healthcare provider via the app or email. Clinicians use these results to determine the necessity for further diagnostic evaluation, such as full polysomnography. The device benefits patients by providing an accessible, non-contact method to assess sleep-related health risks.

Clinical Evidence

Clinical study (NCT03288376) conducted 2015-2016 in three AASM-accredited labs with 242 subjects (≥21 years). Sound recordings were collected via consumer mobile devices during in-lab PSG. Performance metrics for AHI >15: sensitivity 93.7%, specificity 63%.

Technological Characteristics

Stand-alone software medical device; operates on iOS (v10.0+) smartphones. Uses native smartphone microphone for acoustic sensing. Cloud-based analysis. No direct patient contact. No biocompatibility, electrical, or EMC testing required as it is software-only.

Indications for Use

Indicated for adults with suspected obstructive sleep apnea (OSA) or sleep breathing disorders for home-based prescreening. Not for use when sleep stages, limb movements, or EEG activity are required.

Regulatory Classification

Identification

A breathing (ventilatory) frequency monitor is a device intended to measure or monitor a patient's respiratory rate. The device may provide an audible or visible alarm when the respiratory rate, averaged over time, is outside operator settable alarm limits. This device does not include the apnea monitor classified in § 868.2377.

Predicate Devices

Reference Devices

Related Devices

Submission Summary (Full Text)

{0}------------------------------------------------ Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo is a blue square with the letters "FDA" in white, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue. July 14, 2019 Resonea, Inc. % Melissa Walker President & CTO Graematter Inc 1324 Clarkson Clayton Center #332 St Louis, Missouri 63011 Re: K173974 Trade/Device Name: Drowzle sleep apnea prescreening device Regulation Number: 21 CFR 868.2375 Regulation Name: Breathing Frequency Monitor Regulatory Class: Class II Product Code: MNR Dated: June 16, 2019 Received: June 18, 2019 ### Dear Melissa Walker: We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading. If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part {1}------------------------------------------------ 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems. For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100). Sincerely, James Lee Assistant Director DHT1C: Division of ENT, Sleep Disordered Breathing, Respiratory and Anesthesia Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health Enclosure {2}------------------------------------------------ #### DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration #### Indications for Use 510(k) Number (if known) K173974 #### Device Name DROWZLE sleep apnea prescreening device #### Indications for Use (Describe) DROWZLE is indicated to record a patient's respiratory pattern during sleep for the purpose of prescreening patients for >> obstructive sleep apnea (OSA) syndrome. The device is designed for use in home-screening of adults with suspected = = = possible sleep breathing disorders. Results are used to assist the healthcare professional in determining the need for further diagnosis and evaluation. 100 The system is not intended as a substitute for full polysomnography when additional parameters such as sleep stages, limb movements, or EEG activity are required Type of Use (Select one or both, as applicable) > Prescription Use (Part 21 CFR 801 Subpart D) | | Over-The-Counter Use (21 CFR 801 Subpart C) #### CONTINUE ON A SEPARATE PAGE IF NEEDED. This section applies only to requirements of the Paperwork Reduction Act of 1995. #### *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW." The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to: > Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov "An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number." EF Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement below. {3}------------------------------------------------ ## DROWZLE Substantial Equivalence - 510(k) Summary | Submitter's information | Contact: Melissa Walker | |------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------| | Resonea, Inc<br>11445 E Via Linda, Suite 2<br>Box 224<br>Scottsdale AZ 85259 | 11445 E Via Linda, Suite 2<br>Box 224<br>Scottsdale AZ 85259<br>(314) 753-7790<br>Date: July 12, 2019 | Device/ classification name The new device trade name and common name are: · Trade Name: DROWZLE sleep apnea prescreening device • Common Name: Ventilatory Effort Recorder | 21 CFR<br>Reference | Product<br>Code | Class | Generic Device<br>Name | Classification<br>Description | |---------------------|-----------------|-------|--------------------------------|--------------------------------| | §868.2375 | MNR | 2 | Ventilatory Effort<br>Recorder | Breathing frequency<br>monitor | Predicate The predicate device for the DROWZLE screening device is described in the table device(s) below. | K<br>Number | Product<br>Code | Class | Device<br>Name | Indications for Use | |-------------|-----------------|-------|-------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| | K112822 | MNR | 2 | Sleep<br>Strip II | The SleepStrip II is intended to<br>measure apnea hypopnea events<br>during sleep for the purpose of<br>prescreening patients for sleep apnea<br>syndrome. The device is intended to<br>be used by adult patients as<br>prescribed by a physician in either<br>home, hospital or facility use settings. | Device DROWZLE is a mobile software used to collect symptom data for sleep apnea description risk, including severity of daytime sleepiness and personal chronic disease risk factors. DROWZLE also records sleep breathing patterns and sends the sound files to secure servers in the cloud. DROWZLE then analyzes and interprets the sleep breathing results, along with the profile data provided by the individual, to measure and track sleep-related health risks over time. Continued on next page {4}------------------------------------------------ ## DROWZLE Substantial Equivalence Summary, Continued patients for sleep apnea syndrome. The device is home, hospital or facility intended to be used by adult patients as physician in either prescribed by a use settings. | Indications for<br>use | DROWZLE is indicated to record a patient's respiratory pattern during sleep<br>for the purpose of prescreening patients for obstructive sleep apnea (OSA)<br>syndrome. The device is designed for use in home-screening of adults with<br>suspected possible sleep breathing disorders. Results are used to assist the<br>healthcare professional in determining the need for further diagnosis and<br>evaluation.<br>The system is not intended as a substitute for full polysomnography when<br>additional parameters such as sleep stages, limb movements, or EEG<br>activity are required. | | | |----------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------| | Technology | DROWZLE is a stand-alone software medical device. It operates on a<br>mobile computing device with an Apple iPhone 7, iPhone 8 or iPhone X<br>using iOS v10.0 or later.<br>Breathing sounds during sleep are recorded using the microphone within<br>the mobile device. The sound file is uploaded to a cloud server for analysis<br>using the results of standard questionnaires and a proprietary algorithm. A<br>report is generated and provided to the individual and/or their healthcare<br>provider. Reports are provided within the mobile application and/or via<br>email. | | | | Function: | Predicate Device<br>K112822 Sleep Strip II | New Device<br>DROWZLE | Reference Device<br>K963597 Silent Night 1 | | Intended Use | Home-use device for<br>screening patients with<br>possible sleep disorders | Home-use device for<br>screening patients with<br>possible sleep disorders | Home-use device for<br>screening patients with<br>possible sleep disorders | | Indications for<br>Use | The SleepStrip II is<br>intended to measure<br>apnea hypopnea events<br>during sleep for the<br>purpose of prescreening | DROWZLE is indicated to<br>record a patient's<br>respiratory pattern during<br>sleep for the purpose of<br>prescreening patients for | The Silent Night I is<br>indicated for use in the<br>diagnostic evaluation of<br>adults with possible<br>Obstructive Sleep Apnea | | Function: | Predicate Device<br>K112822 Sleep Strip II | New Device<br>DROWZLE | Reference Device<br>K963597 Silent Night 1 | | Trade/Device<br>Name | SleepStrip II | DROWZLE | Silent Night I | | Regulation<br>Number | §868.2375 | §868.2375 | §868.2375 | | Regulation<br>Name | Ventilatory Effort<br>Recorder | Ventilatory Effort Recorder | Ventilatory Effort<br>Recorder | | Product Code | MNR | MNR | MNR | | Target<br>Population | Adults | Adults | Adults | | Intended<br>Environment<br>for Use | Home environment | Home environment | Home environment | | Method of<br>Measurement | Pressure/flow sensor;<br>thermal sensor | Acoustic analysis of<br>breathing sound | Acoustic analysis of<br>breathing sound | | Mode of Action | Analyzes airflow and<br>temperature | Analyzes sound to identify<br>respiratory events<br>indicative of sleep apnea<br>or other disorders | Analyzes sound to identify<br>respiratory events<br>indicative of sleep apnea<br>or other disorders | | Sensor<br>placement site | Rests over the lip, under<br>the nose | Smartphone placed within<br>24 inches of pillow | Microphone #1 is placed<br>near the patient to<br>capture breathing sounds.<br>Microphone #2 is<br>contained in the device to<br>sense ambient room<br>noise. | | Sensor<br>elements | 3 prongs - two nasal and<br>one oral | Microphone(s) native to<br>smartphone | Microphones | | Patient Contact | Yes | Software only. No direct<br>patient contact. | No patient contact during<br>use. Contact with the<br>recording device during<br>set up. | | Portability | Yes | Yes | Yes | | Recording<br>device | Contained in the device | Mobile device records<br>sound and uploads them<br>into a cloud-based server | Recording device is<br>housed in a metal box<br>consisting of hardware<br>and software. | | Measured<br>variable | Oral and nasal airflow | Oral and nasal breath<br>sounds | Oral and nasal breath<br>sounds | | Breathing<br>events | Respiration amplitude<br>drops >10 seconds | Breath sound gaps >10<br>seconds | | | Function: | Predicate Device<br>K112822 Sleep Strip II | New Device<br>DROWZLE | Reference Device<br>K963597 Silent Night 1 | | Sensor<br>attachment | Stick-on adhesive-<br>backed | NA | NA | | Display type | LED display | Smartphone display | Liquid crystal display | | Breathing<br>Indicator | Blinking light display | None | Not described | | Signal loss<br>indicator | Yes, on display | NA | Not described | | Breathing<br>interruption<br>counter | 126 per hour maximum | No maximum | Not described | | Generates a<br>calculated<br>index based on<br>breathing | AHI per sleep period | • Counts gaps in breathing<br>sounds<br>• Calculates Resonea<br>Index | • Counts "Disordered<br>Breathing Events"<br>• Calculates "Respiratory<br>Disturbance Index<br>(RDI)" | | Reported<br>Metrics | Counts apnea/hypopnea<br>events | Output:<br>• Number of breathing<br>sound gaps >10 seconds<br>• Average number of >10<br>second breathing sound<br>gaps per hour<br>• Risk classification based<br>on standard<br>questionnaires:<br>• STOP-BANG<br>• Epworth Sleepiness<br>Scale<br>• Calculated Resonea<br>Index | Output:<br>• Cumulative count of<br>Disordered Breathing<br>Events including<br>snoring, hypopnea, and<br>apnea. | | Display<br>function | Result display element | Results are reported to the<br>clinician and patient<br>• Within the mobile<br>device software and<br>• PDF format for printing<br>via email | Results reported on a<br>liquid crystal display.<br>There is no printing<br>capability. | | Sleep night use | Single night monitoring | Can be used multiple<br>nights | Single night monitoring | | Maximum run-<br>time | 5 hours | No maximum run time | Not described | | Minimum time<br>required | 3 hours | 2 hours | Not described | | Controller | Hardware and firmware | Smartphone<br>microprocessor | Internal to the box | | Airflow signal<br>conditioning | Filtered and digitized | NA | Not described | | Function: | Predicate Device<br>K112822 Sleep Strip II | New Device<br>DROWZLE | Reference Device<br>K963597 Silent Night 1 | | Sampling<br>method | Analog to digital<br>conversion | NA | Not described | | Sample rate | 10 per second<br>continuous | NA | Not described | | Breathing<br>interruption<br>detection<br>criterion | Signal decrease 10<br>seconds or longer | Breath sounds absent 10<br>seconds or longer | Not described | | Monitor<br>application | Patient self-applied | NA | NA | | Download | None – display readout<br>only | Wireless transmission of<br>data to cloud storage for<br>report generation | None – display readout<br>only | | Physical<br>Characteristics | Small, non-tether<br>monitor | Software runs on user's<br>smartphone | Box with 2 microphones.<br>23 cm wide X 17 cm deep<br>X 7.5 cm high | | Power | Battery | Smartphone plugged into<br>wall outlet with built-in<br>battery backup | Plugged into wall outlet | | Clinical Studies | Clinically tested against<br>PSG | Clinically tested against<br>PSG | Clinically tested against<br>PSG | obstructive sleep apnea device is designed for use (OSA) syndrome. The in home-screening of adults with suspected possible sleep breathing to assist the healthcare determining the need for further diagnosis and professional in evaluation. disorders. Results are used It is intended to record a designed for use in home screening of adults with possible sleep disorders. patient's respiratory pattern. The device is {5}------------------------------------------------ {6}------------------------------------------------ {7}------------------------------------------------ Non-clinical As a stand-alone software device non-clinical testing included software performance verification and validation testing. Usability testing demonstrated the data ability of the users to understand the labeling; correctly use the software for recording; and correctly interpret the report. > The DROWZLE software runs on a user-provided mobile device. No biocompatibility testing, electrical safety, or electromagnetic compatibility testing was required. Clinical Sound recordings from 242 individuals ≥ 21 years of age undergoing performance clinically indicated sleep study to assess sleep disordered breathing were data collected as part of an IRB-approved clinical study. The study was conducted from 2015-2016 in three AASM accredited laboratories in the United States (NCT03288376). > Each subject had sound recordings from one or more consumer mobile computing device placed on the bedside during PSG. Recordings were made using the standard audio recording function of each device. Separate recording cohorts were used to develop and validate the algorithm used in DROWZLE. {8}------------------------------------------------ # DROWZLE Substantial Equivalence Summary, Continued | Substantial<br>Equivalence<br>discussion | The new device has the same intended use as the predicate device. Both<br>are intended to be used for identification of adults who may be at risk for<br>sleep apnea and may require further clinical assessment and diagnosis. | |------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| | | The new device relies on a different technological assessment to assess the<br>risk of sleep apnea. The predicate device measures nasal and oral air flow<br>and the new device uses the sound generated by that air flow to identify<br>breathing events. Information about a cleared device using the same<br>technology is provided in the comparison table above. | | | The new device was tested against the results of in-lab PSG, providing a<br>sensitivity of 93.7% and specificity of 63% (AHI>15). The inclusion of the<br>results from validated sleep apnea risk questionnaires reinforces the<br>effectiveness by providing additional means of assessing risk, further<br>reducing the potential for false negative results. | | Conclusions | Based on the similarity in function and clinical performance, it is concluded<br>that DROWZLE is substantially equivalent to the predicate device. |
Innolitics
510(k) Summary
Decision Summary
Classification Order
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