Treatment of Type2 Diabetes

Can You Diagnose Sleep Apnea at Home?

Sleep restores and repairs both mind and body, prompting organs to secrete hormones that regulate mood, growth, and yes, blood sugar. Consistently shortchanging the resting state negatively impacts one’s physical health, wreaking havoc on overall well-being and triggering feelings of grogginess, irritability, and general malaise. Reduced energy levels can result in higher levels of stress hormones, limited physical exercise, and a less-healthy diet, perpetuating the sleep loss-low energy-high blood-sugar cycle.

Sleep apnea, in which breathing stops temporarily, is a common disorder among people with diabetes, and the general population, as well. Causes can vary, but an estimated 50% of the 40 million Americans who suffer from sleep loss experience the obstructive form of apnea (OSA), in which breathing cessation is triggered by a physical barrier such as relaxed throat tissue temporarily blocking airways. Often associated with snoring, the condition is prevalent among physically larger adult males; it can affect everyone, including women and children.

Typically diagnosis at an outpatient sleep lab is expensive and time-consuming. That’s what makes the possibility of at-home sleep apnea testing so enticing. A new generation of entrepreneurs are striving for ways to do away with the traditional sleep lab in favor of the kind of lab that includes your comfy pillow and your favorite night light. They are hoping this shift in location can motivate even the most reluctant insomniac to seek treatment for possible sleep apnea.

There’s No Place Like Home

Watermark_300pxFlorida-based Watermark Medical has patented a system that includes both a sleep apnea monitoring device to be used at home and an internet-based diagnostic process. One’s primary care physician must order the testing and dispense the device, which patients then bring home to use. Usually one night of use gathers all the information needed, and then the patient returns the device to the dispensing physician, whose team uploads the patient data.

The device is cloud-based, says J.R. Finkelmeier, Vice President of Marketing at SleepMed, which owns Watermark Medical. A sleep-medicine physician receives and interprets the results, then collaborates with one’s primary-care physician to develop a treatment plan. Finkelmeier notes that often the prescribing physician may be an expert in endocrinology or cardiology, so the collaboration with the sleep-medicine expert can be highly beneficial for people with diabetes.

“Some of these patients that have concomitant and co-morbid conditions, they’re not a typical sleep apnea patient,” Finkelmeier says. “We see physicians will typically look to more aggressively treat borderline sleep apnea because of the co-morbidity.”

As Class 2 medical devices, the Watermark Medical devices are covered by Medicare and private insurers; the cost of in-home sleep diagnostics can vary from $200-$400, which compares favorably with the cost of lab diagnosis.

A Dashboard for the Body

BodyFit_300pxDo you enjoy statistics? Want to quantify how a night’s sleep (or lack thereof) is affecting your body? You might want to try the BodyMedia Fit wearable device, which yields important information about both your sleep quantity and quality. While not a pure sleep apnea device, the system can provide over 5,000 physiological readings of your body every minute, whether you are asleep or awake. Such info can help people with diabetes see health patterns and make lifestyle choices based on the information, says Ivo Stivoric, co-founder of BodyMedia.

“What we’ve seen anecdotally is these patterns do affect people’s ways to manage insulin and the diabetes they have,” Stivoric says.

The central piece of the BodyMedia system is an armband monitor that tracks a multitude of physiological data, such as pace of movement, body temperature, heart rate; calories consumed, and sleep-quality measurements. Since the information is stored indefinitely on the device or online, the BodyMedia system provides dual advantages of both real-time and longitudinal data. It can be like a “a dashboard for your own body,” Stivoric says.

BodyFIT systems cost $119-$149 for wrist or armband instruments; subscriptions to its internet-based activity manager are free of charge the first 3 months; after that, they range from about $4-$7 per month. The Class 2 FDA-approved medical devices do not require a prescription and can be purchased privately or through Medicare. Costs can be reimbursed by private insurers and flexible spending accounts (FSAs).

Although the sleep-monitoring function of BodyMedia is designed to compare with the scientific accuracy of polysomnography equipment in a sleep lab, Stivoric is careful to differentiate between them. He describes BodyMedia’s wearables as “lifestyle products” especially suited to those seeking a “quantifiable self.” In other words, seek a professional diagnosis for sleep apnea to confirm the data.

The Dawn of a Good Night’s Sleep?

NovaSomInfographic2_300px
Fact sheet provided by NovaSom.

More in-home testing devices are hitting the market each year, including the NovaSom AccuSom system, which is similar to the Watermark Medical home-testing device. As with any new home treatment option, the jury is still out on the long-term health benefits.

The American Academy of Sleep Medicine has put out a statement, for example, that home-testing equipment should only be done for those who have moderate to severe sleep apnea, for example. That’s because the Academy fears home-monitoring gear doesn’t do as great a job catching mild sleep apnea, which might put some users at risk of a false negative.

But advocates for home testing say that concern must be weighed against the fact that many Americans who might have sleep apnea will never set foot in a sleep lab, either because of the cost or because of the inconvenience. Home testing may be an imperfect net to get people thinking about sleep apnea, but at least it’s a wider one.

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Jennie Louise Barnes, LMSW, is a writer and editor for the Program in Public Health, College of Human Medicine at Michigan State University. She has published several hundred articles for regional newspapers and magazines in Virginia, Maine, Oregon, and Arizona, and her work on health policy and legislation was published nationally in Quest Magazine.

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