Hello! I am Liu Jian
Today is the 582nd issue that Jian Ge said to accompany you
March 21, 2022 is the 21st World Sleep Day, and this year's theme is Quality Sleep, Sound Mind, Happy World. Some people think that snoring represents quality sleep, but it is not! On the contrary, snoring may be a manifestation of the disease, that is, the obstructive sleep apnea we have introduced in the past, which will repeatedly cause the body to lack oxygen during sleep, and if the lack of oxygen is long, it will endanger physical and mental health.
Recently, the "Expert Consensus on the Application of Clinical Norms for Adult Family Sleep Apnea Monitoring" released by mainland sleep experts pointed out that high-risk groups with suspected obstructive sleep apnea can be assisted in diagnosis by home monitoring. In this issue, let's take a closer look.
Sleep monitoring devices
Clinically, polysomnography (PSG) is the classic diagnostic method of sleep apnea. This examination requires the patient to sleep in the sleep center overnight, wear sensors that collect brain waves, electrocardiogram, respiratory airflow, blood oxygen saturation and other indicators, and the sleep center is staffed by a doctor in order to adjust the instrument and the patient's emergency in time.
In contrast, home sleep apnea test (HSAT) has the advantages of convenience, comfort, accessibility, and low monitoring costs. Household sleep apnea monitoring is less than polysomnography, but needs to include at least four indicators: respiratory movement, respiratory airflow, heart rate or electrocardiogram, and pulse oximetry.
When to consider HSAT
So, who can use home sleep apnea monitoring?
Home sleep apnea monitoring is mainly used for two aspects: one is to make a diagnostic assessment of high-risk groups of obstructive sleep apnea, and the other is to evaluate the therapeutic effect of obstructive sleep apnea.
Specifically, in diagnostic assessment, if there is daytime sleepiness and habitual loud snoring; if there is apnea, wheezing, or asphyxia during sleep; and hypertension, two of the three items, are at high risk for obstructive sleep apnea. It belongs to high-risk groups and has no serious complications, such as severe cardiopulmonary disease, cerebrovascular disease, neuromuscular disease, etc., and can be considered for home monitoring.
There are also some inpatients with limited mobility or critical condition who are not suitable for monitoring in sleep centers, and can be considered for portable home sleep apnea monitoring after evaluation by a sleep professional doctor. In addition, in patients with refractory hypertension, pulmonary hypertension, and recurrent atrial fibrillation, home monitoring can be performed to find the cause if symptoms associated with sleep apnea occur.
In assessing the effectiveness of treatment, home sleep apnea monitoring can almost replace polysomnography monitoring.
Clinically, patients with obstructive sleep apnea prefer noninvasive continuous positive airway pressure ventilation, and home monitoring can be used to assist in adjusting ventilation patterns and parameters at the beginning of treatment. Patients who gain or lose more than 10% to 20% of their weight after positive airway pressure therapy, or who have new-onset cardiovascular disease, or whose pre-existing cardiovascular disease worsens, or whose symptoms recur or persist in remission, can be assessed by home monitoring.
If a patient with obstructive sleep apnea has received oral appliance therapy, upper airway surgery, postural therapy, weight loss therapy, and sublingual nerve stimulation and has not received continuous positive airway pressure, home monitoring may be used to assess efficacy.
However, if the patient has no symptoms after positive airway pressure ventilation therapy, routine home monitoring or polysomnography monitoring is not recommended.
The above eligible patients should be evaluated by a sleep professional and trained in sleep medicine to help implement or guide the wearing of home sleep apnea monitoring instruments and sensors. The results of the monitoring should also be handed over to a sleep professional for interpretation to decide on the next treatment plan.
Brother Jian said
Home sleep apnea monitoring, which is convenient, comfortable, accessible, and has the advantages of low monitoring cost, is helpful in patient-specific disease diagnosis and assessment.
Patients at high risk of obstructive sleep apnea without serious complications may be considered home monitoring to assist in diagnosis.
The incidence of obstructive sleep apnea is on the rise, and although home sleep apnea monitoring is not a complete substitute for polysomnography monitoring, it can help screen, diagnose and treat diseases and improve overall sleep quality.
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