New research: Sleep apnoea tests missing patients' 'full story'

[Respirator99]

A single night sleep study may seriously under-diagnose apnea or miss it altogether. A means of measuring sleep performance over periods of many nights gives a much more reliable diagnosis. Flinders University are playing around with an under-mattress sensor pad: https://www.withings.com/au/en/sleep Has anybody tried these?

https://www.abc.net.au/news/2021-12-20/ ... /100710190

[Rob K]

I've had three sleep studies now. The results have varied quite a bit. I always thought one night was not enough and that they miss things. Especially with sleep disorders that go beyond apnea.

The original Whithings seemed pretty accurate when keeping track of sleep or awake. Stages of sleep not so accurate. Even less so now that the sleep pads are made my Nokia. Maybe it's Whitings again, I've lost track at this point. I've never checked the accuracy of the heart rate and breathing monitors. I wouldn't rely to much on their accuracy. Especially for something so important. if you just want a general idea of what's going on then probably just fine for that.

[dataq1]

A single night sleep study may seriously under-diagnose apnea...

Also, the converse can be true, a single night sleep study could over-estimate the severity of sleep disturbance.

Just my opinion, but I'd think that observation (via low pressure CPAP) over a period of time (say a week or more) would yield a more accurate "full story".

[Dog Slobber]

Just my opinion, but I'd think that observation (via low pressure CPAP) over a period of time (say a week or more) would yield a more accurate "full story".

What are your medical qualifications to be forming and publishing such an opinion?

[Bertha deBlues]

Just my opinion, but I'd think that observation (via low pressure CPAP) over a period of time (say a week or more) would yield a more accurate "full story".

What are your medical qualifications to be forming and publishing such an opinion?

dataq1 did state that it is an opinion, not a fact.

[Dog Slobber]

Just my opinion, but I'd think that observation (via low pressure CPAP) over a period of time (say a week or more) would yield a more accurate "full story".

What are your medical qualifications to be forming and publishing such an opinion?

dataq1 did state that it is an opinion, not a fact.

Which should be obvious, given I specifically acknowledged it as opinion.

[Bertha deBlues]

Just my opinion, but I'd think that observation (via low pressure CPAP) over a period of time (say a week or more) would yield a more accurate "full story".

What are your medical qualifications to be forming and publishing such an opinion?

dataq1 did state that it is an opinion, not a fact.

Which should be obvious, given I specifically acknowledged it as opinion.

Good. I'm glad we agree that it is only an opinion.

[Bertha deBlues]

A single night sleep study may seriously under-diagnose apnea or miss it altogether. A means of measuring sleep performance over periods of many nights gives a much more reliable diagnosis. Flinders University are playing around with an under-mattress sensor pad: https://www.withings.com/au/en/sleep Has anybody tried these?

https://www.abc.net.au/news/2021-12-20/ ... /100710190

I have not tried the sensor pad, but it's an interesting concept. Anything we can do to more fully understand and diagnose sleep apnea is a good thing . . . in my opinion.

[dataq1]

Just my opinion, but I'd think that observation (via low pressure CPAP) over a period of time (say a week or more) would yield a more accurate "full story".

What are your medical qualifications to be forming and publishing such an opinion?

This is how threads get derailed….. going off topic to raise unrelated questions that are intended to provoke.

If you really are interested in my medical qualifications, the appropriate thread would be the prior thread specifically on qualifications.

Now, the specific opinion that I expressed, that obtaining clinical observations over a longer period of time might yield a more accurate “full story” is intuitive. No special training or experience necessary.

[Dog Slobber]

Just my opinion, but I'd think that observation (via low pressure CPAP) over a period of time (say a week or more) would yield a more accurate "full story".

What are your medical qualifications to be forming and publishing such an opinion?

This is how threads get derailed….. going off topic to raise unrelated questions that are intended to provoke.

If you really are interested in my medical qualifications, the appropriate thread would be the prior thread specifically on qualifications.

Now, the specific opinion that I expressed, that obtaining clinical observations over a longer period of time might yield a more accurate “full story” is intuitive. No special training or experience necessary.

You're the guy who's posting about the importance about qualifications on the forums. And no, my question was not unrelated. You expresses an opinion (a real asinine one BTW) and I asked what your qualifications were. It was related.

Another topic would not be more appropriate. Given, that you feel qualifications are important, it would be essential that qualifications be shared at or near the post where the opinion is posted. Not another topic.

Now as far as your asinine opinion.

It was *not* as simple as, a longer period of time, it was a longer period of time "via a low pressure CPAP".
This opinion is absolutely asinine because:

• Low pressure is still treating the airway
• The correlation between treatment pressures and severity is loose at best
• Low pressure CPAP is extremely uncomfortable for a significant portion of the adult population
• Compliance is one of the biggest challenges to success, your solution to getting the "full story" adds no useful data and will contribute to greater non-compliance

[SJ-Paddler]

Now as far as your asinine opinion.

There are more polite ways to express yourself. I mean you are from Canada right?

[zonker]

post removed by author.

[SummerTime]

Now as far as your asinine opinion.

Am I missing something Zonker? IMO THIS is how threads get derailed.

[dataq1]

Still trying to keep this thread on topic....
Is there any doubt that collection of sleep data over a longer period of time might yield a more accurate picture of a patient's average sleep disfunction?
(obviously if a single night's study demonstrates that the patient is in extremis, that a bit different - but if a single night study reveals moderate apneic disability, according to the AASM grading scale < 30 AHI, a longer term study may be in order to avoid a single one-off "bad night".)

The research that Flinders University is doing (see the OP) is simply examining the impact of longer term observation.
The product that the OP pointed to is an effort to have a system that would provide a longer term observation and yet be minimally invasive and comfortable. The Withings product may work out or not to that goal. It seems like a worthwhile investigation, but not without it's deficiencies.

The measurement of inhaled and exhaled air is likely to continue to be the gold-standard for initial detection of respiratory based sleep disorders. New technology may come to pass someday that equals physical air movement for diagnostic purposes, but in the meanwhile air flowrate versus time is a pretty good tool.

I put forward the thought that a Cpap device, operating at the lowest possible therapy range (so as to minimize the therapy impact) might be useful to observe breathing behavior over a longer (> one night) period of time- perhaps breathing behavior over a week or so.

Slobber asserts that this thought is "asinine" because:
-Low pressure is still treating the airway. True, a better approach would be no or near zero pressure, however currently there are hundreds of thousands of Cpap machines that can be adjusted to low pressure temporarily to gather observations of near no-therapy. And that's what is trying to be achieved - what disfunctions (and their degree) can be observed prior to applying a more aggressive therapy.

"-The correlation between treatment pressures and severity is loose at best What is being studied is the degree of respiratory disfunction in a non-therapy setting. Treatment pressures (therapy) comes after the determination of disfunction severity

"-Low pressure CPAP is extremely uncomfortable for a significant portion of the adult population" While I can't speak for "a significant portion of the adult population" - My wife experienced no distress at all with mask on and Cpap set at 4 cm for two weeks, HOWEVER, her TREATED 6 month average AHI is 3.9. I, on the other hand, with a UNTREATED AHI of >80 would probably experience distress. I suggest to you that persons who are UNTREATED with an AHI less than 5 (and possibly even less than 15 would likely have no problems with a temporary observation at low pressure. But even if a person had "extreme discomfort", all they would have to do is discontinue.

"-Compliance is one of the biggest challenges to success, your solution to getting the "full story" adds no useful data and will contribute to greater non-compliance" I'm not understanding your logic here. What are you trying to suggest?

[GrumpyHere]

https://www.withings.com/au/en/sleep Has anybody tried these?

The validation study for the pad was published in the AASM journal behind a paywall.
https://jcsm.aasm.org/doi/10.5664/jcsm.9168

METHODS:One hundred eighteen patients suspected to have obstructive sleep apnea syndrome completed a night at a sleep clinic with a simultaneous polysomnography (PSG) and recording with the Withings Sleep Analyzers. PSG nights were scored twice: first as simple polygraphy, then as PSG.

RESULTS:Average (standard deviation) apnea-hypopnea index from PSG was 31.2 events/h (25.0) and 32.8 events/h (29.9) according to the Withings Sleep Analyzers. The mean absolute error was 9.5 events/h. The sensitivity, specificity, and area under the receiver operating characteristic curve at thresholds of apnea-hypopnea index ≥ 15 events/h were, respectively, sensitivity (Se)15 = 88.0%, specificity (Sp)15 = 88.6%, and area under the receiver operating characteristic curve (AUROC) 15 = 0.926. At the threshold of apnea-hypopnea index ≥ 30 events/h, results included Se30 = 86.0%, Sp30 = 91.2%, AUROC30 = 0.954. The average total sleep time from PSG and the Withings Sleep Analyzers was 366.6 (61.2) and 392.4 (67.2) minutes, sleep efficiency was 82.5% (11.6) and 82.6% (11.6), and wake after sleep onset was 62.7 (48.0) and 45.2 (37.3) minutes, respectively.

Accurate? ¯\_(ツ)_/¯