Help us make diagnosis easier for you

[sruftz]

Hey all,

I am part of a team currently working on a senior design project to develop a better at home sleep apnea diagnostic device. We read a lot of papers and talked to clinicians but at the end of the day, we realized that the only way to build something useful is to actually ask you guys, the patients. So if you have a few minutes to spare, my team and I would like to know a little more about your experience with these at home diagnostic devices. If you were diagnosed through a sleep study (PSG) at a hospital, please feel free to reply as well. Specifically, we hope you can give us some feedback with these questions:

1) How did you decide to get diagnosed for sleep apnea i.e. how did you even suspect that you could have it?

2) During the diagnostic procedure (using a device or spending a night at the clinic), what was the most uncomfortable aspect? For example, my teammate tested one of these devices and found the nasal cannula to be really bothersome while sleeping.

3) If you used a pulse oximeter during your diagnostic procedure, how did you secure it to your finger so that it would not fall off? And did it fall off in the night?

4) For the people who did the diagnostic test at home, did you monitor your EEG signals? If so, were you able to sleep comfortably with electrodes on your scalp? Did the electrodes ever fall out while you were sleeping?

5) Did your clinician ask you to repeat the diagnostic procedure? If so, why?

My team and I would really appreciate any feedback with these questions. Thanks for your time, and please know that it will go towards making sleep apnea diagnosis easier for everyone.

[BlackSpinner]

1) How did you decide to get diagnosed for sleep apnea i.e. how did you even suspect that you could have it?

My sister heard me "sleep" and said I sounded like her husband and I needed to get tested. But I also knew I snored badly and that I probably had it long before that but it didn't seem to bother me as I was not tired at the time. However my blood pressure was erratic.

2) During the diagnostic procedure (using a device or spending a night at the clinic), what was the most uncomfortable aspect? For example, my teammate tested one of these devices and found the nasal cannula to be really bothersome while sleeping.

the oximeter on the finger

3) If you used a pulse oximeter during your diagnostic procedure, how did you secure it to your finger so that it would not fall off? And did it fall off in the night?

It was a clip - it was annoying

4) For the people who did the diagnostic test at home, did you monitor your EEG signals? If so, were you able to sleep comfortably with electrodes on your scalp? Did the electrodes ever fall out while you were sleeping?

there was nothing on my head that measured that that I am aware off - this was 5 years ago
I slept comfortably in my own bed

5) Did your clinician ask you to repeat the diagnostic procedure? If so, why?

no

[Bill44133]

What kind of team and for who do you work for? Could you give more information please.

[Julie]

I seriously doubt that anyone has done an at-home EEG.

I think you may have a new oximeter ready to try out... no? yes? It would really be nice if you'd be straight about who you are and why you want random people on this site to do your research.

[sruftz]

Thank you for the replies thus far. I apologize for the lack in detail, it was unintentional. We are a team of undergraduate seniors majoring in mechanical and biomedical engineering who are working on developing a better way to diagnose sleep apnea at home. We don't really work for anyone, this is our project for our senior design class. Our goal is to essentially come up with a prototype device, but before we do that, we have to conduct market research. We have talked to clinicians and found that their major critique was the pulse oximeter, especially since the oximeter signal is considered the benchmark test for apnea events, and the lack of sleep monitoring (EEG) in home devices. We wanted to contrast this with opinions from users of these devices to see which aspects of the home monitoring devices we could specifically work on. I hope this clarifies the situation. Please let me know if you need any more information. Also, that was an astute observation Julie, since our current idea is to actually modify the pulse oximeter.

[49er]

Hi,

I had been having sleep difficulties that initially I thought were due to withdrawal insomnia from being on psych meds for years. But knowing I had a family history of apnea, I decided to consult with a sleep physician who suspected that I had it immediately. It was confirmed with a home test.

2. Being hypersensitive, everything about the wires bothered me. Yup, I remember the nasal canula being particularly bothersome due to my nasal congestion issues.

3. My pulse oximeter did fall off which resulted in no data. I can't remember how I secured it.

4. No eeg testing.

5. After I expressed concern that I hadn't slept enough to get any meaningful data, the sleep lab manager allowed me to repeat the test at no charge.

I have a question. One forum member, Todzo who hasn't posted recently, has asked why sleep studies can't be done wirelessly since so many other technologies do it this way. This would seem like an ideal situation since so many people like myself are very hypersensitive to having anything on their body.

Thanks!

49er

Hey all,

I am part of a team currently working on a senior design project to develop a better at home sleep apnea diagnostic device. We read a lot of papers and talked to clinicians but at the end of the day, we realized that the only way to build something useful is to actually ask you guys, the patients. So if you have a few minutes to spare, my team and I would like to know a little more about your experience with these at home diagnostic devices. If you were diagnosed through a sleep study (PSG) at a hospital, please feel free to reply as well. Specifically, we hope you can give us some feedback with these questions:

1) How did you decide to get diagnosed for sleep apnea i.e. how did you even suspect that you could have it?

2) During the diagnostic procedure (using a device or spending a night at the clinic), what was the most uncomfortable aspect? For example, my teammate tested one of these devices and found the nasal cannula to be really bothersome while sleeping.

3) If you used a pulse oximeter during your diagnostic procedure, how did you secure it to your finger so that it would not fall off? And did it fall off in the night?

4) For the people who did the diagnostic test at home, did you monitor your EEG signals? If so, were you able to sleep comfortably with electrodes on your scalp? Did the electrodes ever fall out while you were sleeping?

5) Did your clinician ask you to repeat the diagnostic procedure? If so, why?

My team and I would really appreciate any feedback with these questions. Thanks for your time, and please know that it will go towards making sleep apnea diagnosis easier for everyone.

[HerbM]

You have said "senior design engineers" but if you are legit you could give us the University name and probably some more details like the course name or supervising professor.

I don't really mind sharing but giving the above information is the polite thing to do and might get you more responders.

I initially did:

PulseOx study at home which was offered to my by my dentist when we discussed the sleep apnea poster on his wall. (My cardiologist had previously had this discussion with me and since I don't have any of the "discomfort" symptoms dismissed the possibility. I have the snoring, overweight, blood pressure, and had cardiomyopathy at the time.

The finger sensor was mildly annoying, no big deal. I strapped it along the length of the finger, around the end and back along the other side with tape, and then wrapped tape around the strap portion not on the machine; it stayed with no issue. (Also this was a "wrist unit" so that was fixed on my wrist like a bracelet; no issue there either despite my wrists being VERY VERY large.)

Went to sleep doc, he sent me to split sleep study.

Slept very badly (but remained quite and most in place with no restlessness) during the diagnostic portion.

I never did get to sleep during the therapeutic portion despite accepting the mask and wires etc. comfortably. 3 hours, and we ran out of time.

The main issue seemed to be the pressure was TOO LOW -- turning it up after 2nd hour helped but not enough. Since I didn't get to sleep, there is no way I can be sure that is correct.

However, as soon as I started using CPAP at home I turned the thing up until it seemed comfortable (a little each night) and that allowed me to fall asleep easily so having the start pressure too low seems to be what bugged me the most. (I haven't used the ramp at all.)


Due to the above, I have been thinking that these Pulse Oximeter home studies should become a LOT more common.

A doctor visit alone (to a specialist) can cost almost as much (I paid $160 US) and despite this being NOT a definitive diagnoses (the sleep study is required), in my case it was SO OBVIOUSLY going to be sleep apnea that my semi-failed and expensive sleep study was pretty much a formality, and a waste of time and money.

$160 and two nights wearing the pulseOx and we pretty much KNEW what the situation would be.

BTW: Not to take anything away from the dentist, but I believe he uses the pulseOx kit to make a few extra bucks and to discover candidates for dental appliances (if the person can't or doesn't need to use CPAP.)

There is NOTHING WRONG with this despite the way I wrote it. Capitalism at its best in fact.

The dentist (likely) makes a nice, easy extra profit by doing a lot of people a lot of good -- even perhaps saving lives.

That's a good thing.

Why didn't my primary care physician or my cardiologist have this cheap little test over the last few years?

No blame here either -- they either didn't know or didn't realize how easy and beneficial this could be.

However, it's quite possible that I could have been on CPAP the last 3 years (after the cardio problem) or the last 6-7 years after my high blood pressure was diagnosed.

It's even possible that the cadiomyopathy would never have occurred had the primary figured out the apnea back at the first. We'll never know, but if this happens to 100 people then how many lives or years of good health might be saved?

My guess is that it is more than a few percentage points.

[Nozzelnut]

Hey all,

I am part of a team currently working on a senior design project to develop a better at home sleep apnea diagnostic device. We read a lot of papers and talked to clinicians but at the end of the day, we realized that the only way to build something useful is to actually ask you guys, the patients. So if you have a few minutes to spare, my team and I would like to know a little more about your experience with these at home diagnostic devices. If you were diagnosed through a sleep study (PSG) at a hospital, please feel free to reply as well. Specifically, we hope you can give us some feedback with these questions:

1) How did you decide to get diagnosed for sleep apnea i.e. how did you even suspect that you could have it? My ENT Dr sent me for a sleep study; I just thought I had my family's crappy sleep patterns. I think better questions from my primary care Dr could have put me on the road to feeling better sooner with some more/better sleep oriented questions. Maybe I should have brought it up or thought it could have been a problem; but it was "normal" for me and the way I had always slept.

2) During the diagnostic procedure (using a device or spending a night at the clinic), what was the most uncomfortable aspect? For example, my teammate tested one of these devices and found the nasal cannula to be really bothersome while sleeping. The wires were ok compared to the cannula; I really didn't like that sticking in my nose. The sleep tech even cut it back some so it wasn't as intrusive. If I had it to do over again, I'd ask for a sleep aid prior to the test. The advil pm didn't that I took didn't help enough for me to get past the gear they hooked me up in. At the time of my sleep test I had an extremely narrow window for falling asleep.

3) If you used a pulse oximeter during your diagnostic procedure, how did you secure it to your finger so that it would not fall off? And did it fall off in the night? The one they used was single use with the very sticky backing; (kind of stretchy); it was comfortable enough and didn't fall off

4) For the people who did the diagnostic test at home, did you monitor your EEG signals? If so, were you able to sleep comfortably with electrodes on your scalp? Did the electrodes ever fall out while you were sleeping? My home sleep study only monitored HR, resp rate (possibly effort too) and pulse ox. There wasn't anything for me to read or follow was all internally recorded.

5) Did your clinician ask you to repeat the diagnostic procedure? If so, why? Sleep Dr wanted me to get a titration study in the lab, but the first study was so rough for me I opted for at home titration with an APAP. I didn't have to repeat the initial sleep study; they said they had enough data.

My team and I would really appreciate any feedback with these questions. Thanks for your time, and please know that it will go towards making sleep apnea diagnosis easier for everyone.

I had my at home sleep study last August and in lab study in September. PM me if you have any other questions.

[ems]

My primary care physician suggested a sleep study because I was always fatigued and had Migraines.

Primary care doctor suggested a pulmonary sleep specialist and I had my sleep study in a sleep center near my home. None of it was fun but had an idea before going in what I might expect. They did put an oximeter on my finger and I didn't have a problem keeping it on.

My doctor suggested a titration but I wasn't about to go through that again. She said I had classic SA, no centrals, so she suggested a pressure which worked well for me.

The oximeter on my finger during the sleep study was not a problem. It was repeated at home with no problems either.

IMO, the oximeter is the last thing you should be focusing on. Other aspects of the sleep study are so much more annoying.

[abby123]

Hey all,

I am part of a team currently working on a senior design project to develop a better at home sleep apnea diagnostic device. We read a lot of papers and talked to clinicians but at the end of the day, we realized that the only way to build something useful is to actually ask you guys, the patients. So if you have a few minutes to spare, my team and I would like to know a little more about your experience with these at home diagnostic devices. If you were diagnosed through a sleep study (PSG) at a hospital, please feel free to reply as well. Specifically, we hope you can give us some feedback with these questions:

1) How did you decide to get diagnosed for sleep apnea i.e. how did you even suspect that you could have it? I referred myself to an ENT/ sleep expert after 7 years of complaining of headaches, severe fatigue to my primary care doc, neurologist, endocronologist and cardiologist. I had every workup except a sleep study.... My dad has sleep apnea, diagnosed about 6 mo before me. I figured maybe I had it too because I started to wake up gasping for air and dreaming that I was drowning. I was also awakening with heart palipatations (which only occured at night!)- but cardiology said I was fine.

2) During the diagnostic procedure (using a device or spending a night at the clinic), what was the most uncomfortable aspect? For example, my teammate tested one of these devices and found the nasal cannula to be really bothersome while sleeping. When I did the overnight sleep study in a clinic, I thought the worst part was trying to sleep with all the wires, expecially on your face and head. Also, needing to request to go to the bathroom was a bother.

3) If you used a pulse oximeter during your diagnostic procedure, how did you secure it to your finger so that it would not fall off? And did it fall off in the night? The sleep tech attached with tape, no it did not fall off.

4) For the people who did the diagnostic test at home, did you monitor your EEG signals? If so, were you able to sleep comfortably with electrodes on your scalp? Did the electrodes ever fall out while you were sleeping? n/a

5) Did your clinician ask you to repeat the diagnostic procedure? If so, why? Yes, the first study was a diagnostic sleep study, I was on the very border of being able to do a split-night study (where they daignose OSA first half, then titrate a cpap mask the second half). Since I didn't quite qualify for the split night study the first time, I had to return for another titration overnight study in the same sleep lab.

My team and I would really appreciate any feedback with these questions. Thanks for your time, and please know that it will go towards making sleep apnea diagnosis easier for everyone.

[chunkyfrog]

If the availability of a home EEG is a problem, I propose you look into MelonEEG.
You might also consider using OTC sensors and an Arduino or Raspberry Pi.
Motion sensors could be useful, and inexpensive. This does not have to be as difficult as you think.
Think of the comfort of the patient very seriously, as results can be skewed by the testing process.
--and comfort is one of the primary reasons for a home test.

[skram]

Hey all,

I am part of a team currently working on a senior design project to develop a better at home sleep apnea diagnostic device. We read a lot of papers and talked to clinicians but at the end of the day, we realized that the only way to build something useful is to actually ask you guys, the patients. So if you have a few minutes to spare, my team and I would like to know a little more about your experience with these at home diagnostic devices. If you were diagnosed through a sleep study (PSG) at a hospital, please feel free to reply as well. Specifically, we hope you can give us some feedback with these questions:

1) How did you decide to get diagnosed for sleep apnea i.e. how did you even suspect that you could have it?
I used to only snore when on my back. My wife would poke me and I'd roll on my side and stop snoring. She started to notice that my snoring got louder and that I'd snore no matter what position I was in.

2) During the diagnostic procedure (using a device or spending a night at the clinic), what was the most uncomfortable aspect? For example, my teammate tested one of these devices and found the nasal cannula to be really bothersome while sleeping.
I did an at home sleep study. It used an ARES device that strapped around my head and had a nasal cannula. The cannula was not an issue, but having the device strapped around my head and centered on my forehead was uncomfortable and affected my sleep. It also bothered my wife as a couple of times the electrode contacts lost contact with my forehead and a voice comes on to tell you to adjust it.

3) If you used a pulse oximeter during your diagnostic procedure, how did you secure it to your finger so that it would not fall off? And did it fall off in the night?
The ARES has (http://www.bmedical.com.au/shop/sleep-d ... s/ares.htm)
blood oxygen saturation (SpO2)
pulse rate (reflectance pulse oximetry)
airflow (by nasal cannula connected to a pressure transducer)
snoring levels (calibrated acoustic microphone)
head movement and head position (accelerometers).
This is all on the forehead equipment - so nothing on my finger.


4) For the people who did the diagnostic test at home, did you monitor your EEG signals? If so, were you able to sleep comfortably with electrodes on your scalp? Did the electrodes ever fall out while you were sleeping?
I'm not sure if the electrodes did EEG - but they did tell me they could tell if I was asleep or awake. The electrodes were part of the device on the forehead. A couple of times they did not have sufficient contact, so the "alarm" voice came on to tell me to adjust it.

5) Did your clinician ask you to repeat the diagnostic procedure? If so, why?
No

My team and I would really appreciate any feedback with these questions. Thanks for your time, and please know that it will go towards making sleep apnea diagnosis easier for everyone.

[Janknitz]

Make sure you don't reinvent the wheel.

Kaiser uses the Itamar Watch Pat for home studies. There are two probes you stick on two fingers and then strap the unit to your forearm. The probes have disposable adhesive liners so they don't come off easily, and the unit attaches around your forearm with strong velcro. That's it, it's pretty unobtrusive and I slept very well with it. It records things like sleep time, sleep latency, and quality, in addition to SAO2, blood pressure, etc., but I'm not sure how exactly it does the sleep component since it doesn't record EEG brain waves.

This is a good little unit, and I'm not sure what to even suggest to improve it from an engineering standpoint. And after hearing everyone's horror stories about sleep lab testing, I'm very glad that I could do testing in my own bed and sleeping conditions. I would never have tolerated being strapped up to wires and trying to sleep in an uncomfortable bed with strangers watching me.

[sruftz]

Thank you for the responses everyone! We have decided to look more into the eeg and the oximeter as a whole. Your responses have really helped gain a perspective of the patient side of things, so we all really appreciate your time and effort. As for those who asked more about our background, we are a team from Georgia Tech and our course is called GT 4823, which you can look at here: http://www.capstone.gatech.edu/. I hope this proves that we are just some college students passionate about making something that can help people with sleep apnea.

[ptl4now]

I was diagnosed in a clinic. The only interesting response I have is to the discomfort. I was not used to sleeping on my back, but with all the stuff hooked up to me, I was unable to sleep in my usual position on the side, with pillows between my knees and feet for support, a pillow under my arm, and a good down pillow for my neck. The testing did not allow for much movement or ability to be in any position other than my back. This was my first test, when I did not test positive for sleep apnea. I woke up many times during the night due to my lack of pillows, which was highly unusual for me to sleep light or wake up. A couple years later, I was tested again, due to my continued exhaustion, and this time I tested positive for sleep apnea.

I think it's a great idea to test at home, and research how to make it better and more effective. I think the results have to be more accurate when you are sleeping at home, the way you are used to sleeping, in your own bed, with your own pillows, and your own blankets, and your temperature setting.

I recently did an overnight with the oxy thing that measured the oxygen in my blood as I slept through my finger. It fell off repeatedly. If you can find a way to keep it on, you can probably make a fortune. Maybe use those one dollar cheapy winter gloves to hold in on, with a hole cut for the cord? or maybe that wrap they put on my arm when they take blood and I refuse a bandaid, maybe that would hold it on.

I think it's smart you are bringing your questions to the patients. Keep asking!!!