Sleep apnea is classically thought of as a sleep disorder affecting overweight men snoring so loudly it keeps the entire house awake; however, with prevalence estimated to be as high as 26% in the adult population there is more to the story. While excess body weight is still a major contributing factor, there are many other considerations. Advancing age is a critical piece with over 50% of people over 65 having a sleep related complaint and one study showing 70% of men and 56% of women in that age group with a positive sleep study test. Hormones and other signaling pathways become an obvious target for treatment. Another overlooked aspect is craniofacial anatomy which includes aspect such as enlarged tonsils, narrow airway, enlarged tongue, and abnormal jaw positioning among others. Other risk factors include being male, smoking, alcohol, and other medical comorbidities.
The health consequences linked to sleep apnea are considerable including high blood pressure, cardiovascular disease, elevated blood sugars, hormonal imbalance, and a general lack of wellness. Considering the health burden that exists, one may pursue investigating a diagnosis of sleep apnea. Clinically an individual may experience chronic issues with loud snoring, episodes of witnessed stoppage of breathing, gasping for air during sleep, awakening with dry mouth, morning headache, difficulty staying asleep, excessive daytime sleepiness, difficulty paying attention while awake, and irritability.
Polysomnography (PSG) is the “gold standard” for sleep apnea testing, but it is not without its limitations. The test requires an overnight stay in a sleep laboratory including qualified personnel to collect and interpret the data. Sleeping in this unusual setting alone can disrupt an individual’s normal sleep routine. Other barriers include the limited number of facilities that exist, as well as the ability to get coverage from insurances. On a different note, even with attempting to standardize methodology, inconsistencies exist in collection, analysis, and interpretation across different laboratories making it difficult to compare. With an estimated 70-80% of people remaining undiagnosed, home sleep studies should be utilized.
Home sleep studies are becoming more accurate in their diagnostic abilities with certain devices like watchPAT one showing a correlation rate of 89% when compared to PSG. It allows for sleeping in the comfort of home and offer simple to use technology with chest, wrist, and finger attachments. Devices like the WatchPAT ONE are attached with simple adhesive to the chest and then both wrist and finger with attachments, which provide 98% success rate in study completion. At home testing can provide information including heart rate, oxygen saturation, movement, body position, snoring, and chest motion; all of which provide the necessary data to understand what is occurring during sleep. With the high accuracy and the simplicity of use, home sleep studies should be utilized for screening and even diagnosis of sleep apnea.
One final thought is that a CPAP face mask device is not the only option for the treatment of sleep apnea. Don’t let your fear of CPAP stop you from getting tested. Talk with your doctor about other options that you may find more acceptable.