About 25% of the global, adult population is believed to suffer from sleep apnea, and it is estimated that 175 million people in Europe suffer from obstructive sleep apnea. But many patients are undiagnosed – as much as 80% in the US. This is critical, since sleep apnea is a disorder that greatly impacts the life of the individual, but also greatly affects the surroundings and greater society: In the US, it is estimated that sleep apnea causes 800,000 car accidents a year, resulting in 1,400 deaths, and costing society 15.9 billion dollars.
So, there is a great, global need for testing, diagnosing, and treating more of the population. Let us take a closer look at the disorder and its symptoms and consequences and how it can be effectively diagnosed.
Sleep apnea is a sleep disorder characterized by repeated pauses in breathing during sleep. These breathing interruptions called apneas can lead to disrupted sleep and various health complications. Apnea episodes can last over a minute and can occur up to a hundred times a night.
Common symptoms of sleep apnea include loud snoring, restless sleep, gasping or choking sensations, frequent awakenings, excessive daytime sleepiness, morning headaches, difficulty concentrating, irritability, and observed episodes of breathing cessation during sleep.
There are three types of sleep apnea: Obstructive sleep apnea (OSA), central sleep apnea (CSA) and a combination of the two called mixed sleep apnea. Obstructive sleep apnea is by far the most common type of sleep apnea. It occurs when the airway is blocked, preventing oxygen from reaching the lungs. Central sleep apnea occurs when the brain does not send the proper signals needed for breathing.
The causes of sleep apnea differ for OSA and CSA. OSA, the most prevalent form of sleep apnea, occurs when the muscles in the back of the throat fail to keep the airway open, leading to temporary blockages. The primary risk factors for OSA include obesity, excess weight around the neck, large tonsils, a small jaw or airway, a family history of sleep apnea, and certain medical conditions such as hypertension and diabetes.
CSA is less common and results from the brain’s failure to transmit proper signals to the muscles that control breathing during sleep. Risk factors for CSA include medical conditions such as heart disorders and having suffered a stroke, and certain types of medication.
Untreated sleep apnea can lead to serious health complications. 26 clinical and non-clinical conditions have been found to be significantly influenced by OSA. Potential short-term risks include automotive accidents, excessive sleepiness, decreased quality of life and neurocognitive and performance deficits. The potential long-term health consequences of untreated sleep apnea include hypertension, heart disease, heart attack, arrhythmias, stroke, and diabetes.
Therefore, early diagnosis and effective treatment are crucial in managing the condition and improving overall health and quality of life.
If sleep apnea is suspected, a comprehensive evaluation is necessary for diagnosis. This typically involves a sleep study, which is conducted overnight in a sleep laboratory or using portable monitoring devices at home.
A common test for sleep apnea is polysomnography (PSG). It is a sleep study used for diagnosing sleep disorders. It measures sleep stages by recording airflow as the patient breathes, level of oxygen in the blood, body position, brain waves (EEG), breathing effort and rate, electrical activity of muscles, eye movement and heart rate. Polysomnography is typically carried out in a sleep clinic. For sleep apnea testing at home, cardiorespiratory monitoring (CRM) can be used. A CRM study measures breathing and other physical conditions during sleep to diagnose sleep apnea.
As new technologies are developed, more comfortable and convenient sleep apnea tests specifically designed for home use have emerged, such as the WatchPAT. The WatchPAT is developed by ZOLL Itamar and distributed by Medidyne in Denmark, Sweden, Norway, and Finland.
WatchPAT is an innovative home sleep apnea test (HSAT) with only three points of contact: Wrist, finger, and chest. There is no airway equipment, chest belts, scalp electrodes or other equipment associated with traditional sleep tests. Therefore, it is a test solution that helps patients to sleep more comfortably. Still, the WatchPAT is also highly accurate, reliable and effective: It has a 98% study success rate and prevents up to 20% of misdiagnoses by using true sleep time.
The technology uses the peripheral arterial tone (PAT) signal, which measures blood volume at the fingertip and changes caused by sleep related breathing disturbances. It is clinically validated with an 89% correlation to PSG. Via the three points of contact, the home sleep test registers data from seven channels to provide an accurate diagnosis of sleep apnea. At the end of a test, a comprehensive report is automatically generated from the collected data. The report includes accurate sleep time, sleep stages, apnea episodes and more. The WatchPAT can detect all types of apnea events, and it identifies CSA and percentage of sleep time with Cheyne-Stokes Respiration.
In addition to providing comfort and accuracy, the WatchPAT is a big timesaver for healthcare professionals. It is simple and user-friendly, which means clinicians spend less time instructing patients in the use of the equipment. The test even comes in a disposable version, the WatchPAT ONE, which is simply shipped to patients in their home, where they can operate the device themselves with app guidance. In addition to eliminating the time spent on guidance, the WatchPAT ONE also eliminates time spent cleaning equipment. Moreover, the single use test is advantageous for the patients who are less mobile or far away from the hospital. For multiple use, ZOLL Itamar has designed the WatchPAT 300.
When a test is ended, data is either downloaded from the device (WatchPAT 300), or automatically uploaded to a cloud (WatchPAT ONE). The data is automatically scored, which means clinicians can diagnose and make decisions on treatment right away. However, you can also view all the data and perform manual scoring, if preferred.
Ultimately, WatchPAT is a very effective tool for testing and diagnosing sleep apnea patients at home. Plus, whenever more patients can be effectively tested in their home, it saves valuable time for personnel and reduces costs, as fewer patients are admitted for sleep testing and sleep monitoring.
Mette Jungersen, Product Specialist, elaborates: “What really makes the WatchPAT a smart solution is its telehealth capabilities: You do not need a sleep specialist in-house to interpret data and diagnose patients. You can have data analyzed remotely by a specialist. Therefore, the WatchPAT is a highly effective solution, not just for the sleep clinics, but also for ENT doctors (otolaryngologists), cardiac wards and dentists.”
When patients have been diagnosed with sleep apnea, there are a variety of treatment options available. Non-invasive treatment options include positional therapy, oral appliances, and positive airway pressure. Invasive treatment options include hypoglossal nerve stimulation and surgical removal of tissue.
The treatment approach for sleep apnea depends on its severity and the underlying causes. Lifestyle modifications are often recommended as a first-line treatment. These include weight loss, regular exercise, avoiding alcohol and sedatives before bedtime, and sleeping on one’s side instead of the back.
Mette explains: “It is well known that obesity is a large risk factor for sleep apnea. The way sleep apnea works is stressful for the heart, and therefore sleep apnea may trigger atrial fibrillation and lead to heart diseases. Thus, weight loss can combat heart disorders by reducing or eliminating sleep apnea.”
But for moderate to severe cases of sleep apnea, or when lifestyle changes do not provide sufficient relief, other treatment options may be explored.
Sleep apnea is a potentially serious disorder that may have fatal consequences to both patients and their surroundings when the disorder is not treated. Therefore, raising awareness of the condition and testing more patients is key. Traditional sleep tests in a lab can be time-consuming for personnel and uncomfortable for patients. But new solutions on the market like the WatchPAT ONE and WatchPAT 300 address these challenges and offer an innovative method for testing and diagnosing sleep apnea in the patient’s home. The result is accurate, comfortable, and time-saving sleep tests, which greatly benefits both patients and clinicians.
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Product Specialist
ABM Respiratory Care, Microlife, Philips Respiratory Care, Philips Sleep Therapy, ZOLL Itamar
Product Specialist
Philips Sleep Therapy, ZOLL Itamar