Computer Science Provides a Better Way to Test for Sleep Apnea

Posted: November 4, 2009

A computer scientist from the University of Houston and a doctor of sleep medicine at the University of Texas Health Science Center at Houston have teamed up to create a new, less invasive method of diagnosing sleep apnea. Their findings appear in the November issue of the journal Sleep.

Sleep apnea is serious disorder that causes a person to momentarily stop breathing while they sleep. These pauses in breathing can occur many times an hour, and can cause low oxygen levels in the blood and chronic sleepiness, which in turn can lead to deadly accidents. Sleep apnea has also been associated with a range of serious health problems including depression, heart disease and stroke.

Approximately 24 percent of men and 9 percent of women experience sleep apnea, but getting a diagnosis involves a procedure called polysomnography, also known as a sleep study. "It's not as simple as paying a visit to the doctor in the morning for an hour and walking away with a prescription," said Ioannis Pavlidis, Eckhard-Pfeiffer Professor of Computer Science at the University of Houston, and co-investigator of the study. "You have to undergo overnight monitoring in a sleep lab. The subject is wired and sleeps there. Sometimes, the subject has to spend more than one night."

Adding to the difficulty in getting a sleep apnea diagnosis is the invasive nature of current testing methods. "During a sleep study a subject has an average of more than 20 sensors attached to the head and body. It's a very complex procedure where many physiological parameters are simultaneously monitored to help in the diagnosis of sleep disorders. However, these sensors can disturb sleep and contribute to the patient's anxiety," said Jayasimha N. Murthy, assistant professor of medicine from the Division of Pulmonary Critical Care Sleep Medicine at UTHSC at Houston and study co-investigator.

The new diagnostic procedure developed by Pavlidis, Murthy and their collaborators uses a thermal infrared camera to monitor breathing waveforms and airflow as a patient breathes in and out of his or her nose. The measurements are processed using computational algorithms and produce results that have proved to be as accurate as traditional polysomnography. The new method also provides doctors with more information about the patient's breathing.

"In contrast to the traditional one-dimensional methods, this new method is an imaging one and thus, multi-dimensional," said Pavlidis. "We now can see how airflow is distributed locally throughout the extent of the nostril. We get not a single, but multiple values for each nostril at every point in time and this makes a lot of difference when it comes to appreciating subtle pathology."

The researchers believe that this new technology could change the way sleep apnea is diagnosed, potentially helping millions of Americans sleep better and possibly live longer.

The current method of proper sleep testing should not be viewed so negatively

Before jumping to a conclusion regarding how best to establish a proper diagnosis of a sleep related breathing disorder (such as obstructive sleep apnea), it is important to have a clear understanding of the issues. The report here states that current sleep testing methods provide a one dimensional look at the patients sleep. This is by far not true. Multiple parameters are monitored all at once time. What is important to understand is that severe sleep apnea is easy to diagnosis. All you need to do is watch someone stop breathing while asleep. However, the fact is that a person does not have to stop breathing in order to have Obstructive Sleep Apnea. There can be milder forms of airway blockage; with reduction of air flow resulting in what is called hypopneas. Repetitive hypopneas can still pose an increase risk for stroke, heart disease ... etc. There are many people who have very subtle disturbances in their breathing during sleep that cause repetitive disruptions in their sleep continuity and that without measuring the disruption in the brain activity then quantifying these disruptions is not possible. A condition called the Upper Airway Resistance Syndrome presents this type of problem. Many people diagnosed with Chronic Fatigue Syndrome actually suffer from the Upper Airway Resistance Syndrome. I encourage readers to find more information on my web page at www.HoustonSleep.net .

The technology presented in this report is exciting and should be investigated further and compared to with current techniques, not only in severe cases but symptomatic patients that have a mild degree of breathing disturbance. Hopefully over time we will come to recognize how thermal imaging techniques can be best used, but for now we should not discredit the current technology that is able to provide good care to many people.

Jerald H Simmons, MD Sleep Disorders Specialist of TX @ Nov 05, 2009 03:27:24 AM

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