Snoring is a common problem among men and women and is one of the cardinal symptoms of obstructive sleep apnea (OSA). With the explosion of smartphones and the emphasis on in-home monitoring, sleep researchers have attempted to use measurement of snoring to determine risk of obstructive sleep apnea. It has been difficult to do this because not all people who snore have obstructive sleep apnea. In addition, sleep researchers don't agree on an objective definition of snoring or an established threshold level of loudness. The quality of snoring is determined by multiple factors including the stage of sleep, body position, use of alcohol or other sedating medications, and upper respiratory tract illnesses such as a cold. There is significant variation of snoring from night to night for no apparent reason as well. Finally, snoring can be chronic throughout the night or periodic meaning that there are periods of silence between snoring episodes. The periodic snoring may be more suggestive of obstructive sleep apnea.
This study evaluated the diagnostic value of periodic snoring sounds measured during home sleep apnea testing. Subjects that were at risk for obstructive sleep apnea were sent home with a home sleep study monitoring kit and worn while they slept. The home sleep study kit has a built-in microphone that is located on the chest to detect the snoring sounds. the results showed a strong positive correlation between the percentage of periodic snoring and obstructive sleep apnea severity (AHI). The correlation was strongest for younger subjects, females, and obese subjects. The researchers discussed that some women do not get evaluated for obstructive sleep apnea because they do not know that they snore or are embarrassed to report snoring. In my clinic, I find this to be the case as well. Therefore measuring snoring at home while the patient is asleep many help sleep physicians to recommend formal diagnostic sleep studies to accurately assess female patients without a strong history of snoring.
Showing posts with label home sleep study. Show all posts
Showing posts with label home sleep study. Show all posts
Friday, August 26, 2016
Wednesday, January 22, 2014
Using your smartphone to evaluate snoring and obstructive sleep apnea
In sleep medicine, there is a push to move the diagnosis of sleep apnea from the sleep lab to the patient's home. Home sleep studies are done routinely in certain regions of the US - the northeast and west coast, specifically.
Smartphones can do many things these days. These researchers from Japan developed an app for an Android phone that can monitor snoring and even obstructive sleep apnea. The app did this by measuring sound from the patient. Snoring was measured in a similar way that it is done in a sleep lab. But sleep apnea was measured in a novel way - by counting the number of "dips" in sound during recording. The app was tested alongside a standard in-lab sleep study and found to be relatively accurate.
The authors point out that the study has limitations...the first being that the subjects who tested the app were suspected of having sleep apnea. So more research is needed to see if this app would work in the general population as a screening tool. Also, how would the smartphone react if the patient and their bedpartner were snoring? Perhaps the bedpartner could sleep in a separate room for a night to allow the app to evaluate only the patient. The last limitation was that the correlation between sleep apnea severity detected by the app and the in-lab sleep study was not as good when the patient has mild to moderate sleep apnea. It was more accurate for severe sleep apnea.
The authors propose that an app like this could be used less for diagnosis, and more for monitoring changes in snoring as patients change their sleeping position or lose weight. In a commentary after the original article, it was suggested that the app could be used in combination with the phone's accelerometer to alert a patient that they are on their back and snoring. The patient would then roll on their sides again. I can envision an app like this combined with a wire that measures oxygen levels and pulse rate to make a diagnosis at home. This could be an even cheaper home study than what is available now.
Smartphones can do many things these days. These researchers from Japan developed an app for an Android phone that can monitor snoring and even obstructive sleep apnea. The app did this by measuring sound from the patient. Snoring was measured in a similar way that it is done in a sleep lab. But sleep apnea was measured in a novel way - by counting the number of "dips" in sound during recording. The app was tested alongside a standard in-lab sleep study and found to be relatively accurate.
The authors point out that the study has limitations...the first being that the subjects who tested the app were suspected of having sleep apnea. So more research is needed to see if this app would work in the general population as a screening tool. Also, how would the smartphone react if the patient and their bedpartner were snoring? Perhaps the bedpartner could sleep in a separate room for a night to allow the app to evaluate only the patient. The last limitation was that the correlation between sleep apnea severity detected by the app and the in-lab sleep study was not as good when the patient has mild to moderate sleep apnea. It was more accurate for severe sleep apnea.
The authors propose that an app like this could be used less for diagnosis, and more for monitoring changes in snoring as patients change their sleeping position or lose weight. In a commentary after the original article, it was suggested that the app could be used in combination with the phone's accelerometer to alert a patient that they are on their back and snoring. The patient would then roll on their sides again. I can envision an app like this combined with a wire that measures oxygen levels and pulse rate to make a diagnosis at home. This could be an even cheaper home study than what is available now.
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